Gmel Gerhard, Kuendig Hervé, Rehm Jürgen, Schreyer Nicolas, Daeppen Jean-Bernard
Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland.
BMC Public Health. 2009 Jan 29;9:40. doi: 10.1186/1471-2458-9-40.
There is sufficient and consistent evidence that alcohol use is a causal risk factor for injury. For cannabis use, however, there is conflicting evidence; a detrimental dose-response effect of cannabis use on psychomotor and other relevant skills has been found in experimental laboratory studies, while a protective effect of cannabis use has also been found in epidemiological studies.
Implementation of a case-crossover design study, with a representative sample of injured patients (N = 486; 332 men; 154 women) from the Emergency Department (ED) of the Lausanne University Hospital, which received treatment for different categories of injuries of varying aetiology.
Alcohol use in the six hours prior to injury was associated with a relative risk of 3.00 (C.I.: 1.78, 5.04) compared with no alcohol use, a dose-response relationship also was found. Cannabis use was inversely related to risk of injury (RR: 0.33; C.I.: 0.12, 0.92), also in a dose-response like manner. However, the sample size for people who had used cannabis was small. Simultaneous use of alcohol and cannabis did not show significantly elevated risk.
The most surprising result of our study was the inverse relationship between cannabis use and injury. Possible explanations and underlying mechanisms, such as use in safer environments or more compensatory behavior among cannabis users, were discussed.
有充分且一致的证据表明饮酒是导致受伤的一个风险因素。然而，对于使用大麻，证据存在冲突；在实验室内研究中发现使用大麻对精神运动及其他相关技能有有害的剂量反应效应，而在流行病学研究中也发现了使用大麻的保护作用。
采用病例交叉设计研究，从洛桑大学医院急诊科选取有代表性的受伤患者样本（N = 486；男性332名；女性154名），这些患者因不同病因的各类损伤接受治疗。
与未饮酒相比，受伤前六小时内饮酒与相对风险3.00（置信区间：1.78，5.04）相关，还发现了剂量反应关系。使用大麻与受伤风险呈负相关（相对风险：0.33；置信区间：0.12，0.92），同样呈剂量反应关系。然而，使用大麻者的样本量较小。同时使用酒精和大麻并未显示出风险显著升高。
我们研究中最令人惊讶的结果是使用大麻与受伤之间的负相关关系。讨论了可能的解释及潜在机制，比如在更安全环境中使用或大麻使用者中有更多补偿行为等。
