Asbridge Mark, Mann Robert, Cusimano Michael D, Tallon John M, Pauley Chris, Rehm Jürgen
Department of Community Health and Epidemiology, Dalhousie University, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada.
Department of Social and Epidemiological Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada.
Prev Med. 2014 Sep;66:80-6. doi: 10.1016/j.ypmed.2014.06.006. Epub 2014 Jun 16.
To examine whether alcohol and cannabis consumption increase crash risk among non-fatally injured bicyclists (N=393) seen in three Canadian emergency departments, between April 2009 and July 2011.
Employing a case-crossover design, cannabis and alcohol were identified through blood sample or by self-report. All cyclists involved in a crash and exposure status (cannabis and alcohol) were compared between case period (current crash) and two control periods: prior to the last time the victim cycled around the same time of day; and the typical use prior to bicycling. Crash risk was assessed through conditional fixed effects logistic regression models.
Approximately 15% of cyclists reported using cannabis just prior to the crash, and 14.5% reported using alcohol. Cannabis use identified by blood testing or self-report in the case period and by self-report in the control period yielded a crash risk of 2.38 (1.04-5.43); however, when self-report was used for both the case and control periods the estimate was 0.40 (0.12-1.27). Alcohol use, as measure either in blood or self-report, was associated with an odds ratio of 4.00 (95% CI: 1.64-9.78); results were similar when alcohol was measured by self-report only.
Cannabis and alcohol use each appear to increase the risk of a non-fatal injury-related crash among bicyclists, and point to the need for improved efforts to deter substance use prior to cycling, with the help of regulation, increased education, and greater public awareness. However, cannabis results should be interpreted with caution, as the observed association with crash risk was contingent on how consumption was measured.
研究2009年4月至2011年7月期间，在加拿大三个急诊科就诊的非致命受伤自行车骑行者（N = 393）中，饮酒和吸食大麻是否会增加撞车风险。
采用病例交叉设计，通过血样或自我报告来确定是否吸食大麻和饮酒。将所有发生撞车事故的骑行者及其暴露状态（大麻和酒精）在病例期（当前撞车事故）与两个对照期进行比较：受害者在一天中相同时间最后一次骑车之前；以及骑车前的典型使用情况。通过条件固定效应逻辑回归模型评估撞车风险。
约15%的骑行者报告在撞车事故前刚吸食过大麻，14.5%报告饮酒。在病例期通过血液检测或自我报告确定的大麻使用情况，以及在对照期通过自我报告确定的大麻使用情况，得出撞车风险为2.38（1.04 - 5.43）；然而，当病例期和对照期均使用自我报告时，估计值为0.40（0.12 - 1.27）。无论是通过血液检测还是自我报告测量的饮酒情况，其优势比均为4.00（95%置信区间：1.64 - 9.78）；仅通过自我报告测量酒精时结果相似。
吸食大麻和饮酒似乎都会增加自行车骑行者非致命伤害相关撞车事故的风险，并表明需要通过监管、加强教育和提高公众意识等措施，加大力度在骑行前阻止物质使用。然而，大麻的结果应谨慎解释，因为观察到的与撞车风险的关联取决于消费的测量方式。
