Alcohol Research Group, Emeryville, CA, USA.
University of Auckland, Auckland, New Zealand.
Addiction. 2018 Nov;113(11):2031-2040. doi: 10.1111/add.14276. Epub 2018 Jul 6.
Societal-level volume and pattern of drinking and alcohol control policy have received little attention in the alcohol and injury literature. The aim of this study was to estimate the association between alcohol-related injury, individual-level drinking variables, country-level detrimental drinking pattern and alcohol policy.
Probability samples of emergency department (ED) patients from the International Collaborative Alcohol and Injury Study (ICAIS), which includes four collaborative ED studies on alcohol and injury, all using a similar methodology, were analyzed with multi-level modeling of individual-level drinking variables and aggregate-level variables (country drinking pattern and alcohol policy) on alcohol-related injury in 33 ED studies.
Sixty-two emergency departments in 28 countries covering five regions.
A total of 14 390 injured patients arriving to the ED within 6 hours following injury.
Alcohol-related injuries (self-reported drinking prior to the event and causal attribution of injury to drinking) were analyzed in relation to individual-level volume and pattern of drinking, study-level alcohol volume, country detrimental drinking pattern (DDP) and an alcohol policy measure, the International Alcohol Policy and Injury Index (IAPII). The IAPII includes four regulatory domains: availability, vehicular, advertising and drinking context.
Controlling for demographic characteristics, individual-level drinking and study-level volume, the IAPII was associated significantly with the proportion of both self-reported drinking [confidence interval (CI) = 0.97-0.99; P < 0.001] and causal attribution (CI = 0.97-0.99; P < 0.01) and DDP had little effect on these associations. All four domains were significantly predictive of self-reported drinking [availability (CI = 0.93-0.98, P < 0.01); vehicular (CI = 0.91-0.97, P < 0.001); advertising CI = 0.82-0.94, P < 0.01); and context (CI = 0.93-0.99, P < 0.01], while only the vehicular domain was significantly predictive of causal attribution (CI = 0.92-0.99; P < 0.05).
The more restrictive the alcohol policy in a country, the lower the rate of alcohol-related injury, with country-level drinking pattern having little effect on this relationship.
社会层面的饮酒量和饮酒控制政策模式在酒精与伤害文献中很少受到关注。本研究的目的是评估酒精相关伤害与个体饮酒变量、国家有害饮酒模式和酒精政策之间的关联。
本研究采用多水平模型分析了来自国际合作酒精与伤害研究（ICAIS）的概率样本，该研究包括四项关于酒精与伤害的合作急诊研究，均采用类似的方法，对个体饮酒变量和汇总水平变量（国家饮酒模式和酒精政策）进行了分析，以评估 33 项急诊研究中的酒精相关伤害。
28 个国家的 62 个急诊科，涵盖五个地区。
共有 14390 名受伤患者在受伤后 6 小时内到达急诊室。
根据个体饮酒量和饮酒模式、研究水平饮酒量、国家有害饮酒模式（DDP）和酒精政策措施（国际酒精政策和伤害指数（IAPII）），分析了酒精相关伤害（自我报告的饮酒事件和伤害归因于饮酒）与个体饮酒量和研究水平饮酒量的关系。IAPII 包括四个监管领域：供应、车辆、广告和饮酒环境。
在控制人口统计学特征、个体饮酒量和研究水平饮酒量后，IAPII 与自我报告的饮酒比例显著相关[置信区间（CI）=0.97-0.99；P<0.001]，DDP 对这些关联几乎没有影响。所有四个领域都与自我报告的饮酒显著相关[供应（CI=0.93-0.98，P<0.01）；车辆（CI=0.91-0.97，P<0.001）；广告（CI=0.82-0.94，P<0.01）；和环境（CI=0.93-0.99，P<0.01）]，而只有车辆领域与归因显著相关[CI=0.92-0.99；P<0.05]。
国家的酒精政策越严格，酒精相关伤害的发生率越低，国家饮酒模式对这种关系的影响很小。
