Wintemute G J, Teret S P, Kraus J F, Wright M
Department of Family Practice, University of California, Davis.
Accid Anal Prev. 1990 Jun;22(3):291-6. doi: 10.1016/0001-4575(90)90020-l.
We test the hypothesis that there are host or environmental factors that significantly affect the likelihood of alcohol involvement in drownings. Our results are based on records of 234 drownings that meet predetermined eligibility criteria designed to exclude cases with postmortem blood alcohol concentrations (BACs) that do not reflect the BAC at the time of immersion. Cases are drawn from a total of 442 drownings occurring in Sacramento County, California, from 1974 to 1985. Overall, 41% of deaths were alcohol-associated; among these only one victim was under 15 years old. Among older persons, increasing age generally suggested a higher likelihood of alcohol involvement, and particularly of a BAC greater than 200 mg/dl. Other associated factors were male gender (OR = 2.5; 95% CI = 1.6, 3.8), activity (for land motor-vehicle occupants vs. all others, OR = 3.3; 95% CI = 2.6, 4.3), and time of year (January-June vs. July-December, OR = 2.1; 95% CI = 1.6, 2.8). A lower likelihood of alcohol involvement was seen for drownings in bathtubs (OR = .16; 95% CI = .04, .57) and swimming pools (OR = .47; 95% CI = .27, .82). Race was not a factor. Differing eligibility criteria have been used in studies of alcohol and drowning. After a critical review of the experimental literature, we propose that the following be adopted in future such studies: (i) death must occur within six hours of the onset of immersion, unless an antemortem sample is available and, unless evidence to the contrary exists, death can be assumed to have occurred within a few minutes of immersion; (ii) blood must be drawn for BAC determination within 24 hours of death.
我们检验了这样一个假设，即存在显著影响溺水事件中酒精介入可能性的宿主或环境因素。我们的研究结果基于234例溺水事件的记录，这些事件符合预先设定的合格标准，旨在排除那些死后血液酒精浓度（BAC）不能反映浸没时BAC的案例。案例取自1974年至1985年在加利福尼亚州萨克拉门托县发生的总共442例溺水事件。总体而言，41%的死亡与酒精有关；其中只有一名受害者年龄在15岁以下。在老年人中，年龄增长通常表明酒精介入的可能性更高，尤其是BAC大于200mg/dl的可能性更高。其他相关因素包括男性性别（OR = 2.5；95%CI = 1.6, 3.8）、活动（陆地机动车乘客与所有其他人员相比，OR = 3.3；95%CI = 2.6, 4.3）以及一年中的时间（1月至6月与7月至12月相比，OR = 2.1；95%CI = 1.6, 2.8）。浴缸溺水（OR = 0.16；95%CI = 0.04, 0.57）和游泳池溺水（OR = 0.47；95%CI = 0.27, 0.82）中酒精介入的可能性较低。种族不是一个因素。在酒精与溺水的研究中使用了不同的合格标准。在对实验文献进行批判性审查后，我们建议在未来此类研究中采用以下标准：（i）死亡必须发生在浸没开始后的六小时内，除非有生前样本可用，并且除非有相反证据，否则可以假定死亡发生在浸没后的几分钟内；（ii）必须在死亡后24小时内采集血液进行BAC测定。
