CSR, Incorporated, Sterling, Virginia.
CSR, Incorporated, Sterling, Virginia.
Am J Prev Med. 2022 Aug;63(2):286-300. doi: 10.1016/j.amepre.2022.03.025. Epub 2022 May 15.
The proportion of fatal nontraffic injuries that involve high levels of alcohol use or alcohol intoxication was assessed by cause of injury to generate alcohol-attributable fractions. Updated alcohol-attributable fractions can contribute to improved estimates of the public health impact of excessive alcohol use.
Peer-reviewed and gray literature for 1995-2019 on 15 causes of fatal nontraffic injuries in the U.S., Canada, or Mexico were systematically reviewed, and state data systems were queried for available estimates of fatalities with recorded blood alcohol concentration levels and proportions of decedents with blood alcohol concentrations ≥0.10 g/dL by cause of injury. For each injury cause, alcohol-attributable fractions across studies were synthesized by meta-analysis of single proportions using generalized linear mixed models.
In total, 60 published studies and 40 additional population-level data points from 6 state data systems were included. The meta-analyzed alcohol-attributable fractions by cause of injury are as follows: air-space transport (0.03), aspiration (0.24), child maltreatment (0.09), drowning (0.31), fall injuries (0.37), fire injuries (0.34), firearm injuries (0.24), homicide (0.29), hypothermia (0.29), motor vehicle nontraffic crashes (0.42), occupational and machine injuries (0.08), other road vehicle crashes (railroad trespasser injuries) (0.63), poisoning (not alcohol) (0.20), suicide (0.21), and water transport (0.27), yielding an overall median alcohol-attributable fraction of 0.27.
Excessive alcohol use is associated with substantial proportions of violent and nonviolent injury deaths. These findings can improve the data used for estimating alcohol-attributable injury deaths and inform the planning and implementation of evidence-based strategies (e.g., increasing alcohol taxes, regulating alcohol outlet density) to prevent them.
通过损伤原因评估涉及大量饮酒或酒精中毒的非交通伤害致死的比例，以产生酒精归因分数。更新的酒精归因分数有助于提高对过量饮酒对公共健康影响的估计。
系统回顾了 1995 年至 2019 年在美国、加拿大或墨西哥的 15 种非交通伤害致死原因的同行评审和灰色文献，并查询了州数据系统，以获取按损伤原因记录血液酒精浓度水平和血液酒精浓度≥0.10g/dL 的死者比例的可用死亡率估计值。对于每种损伤原因，通过使用广义线性混合模型对单一比例进行荟萃分析，综合研究间的酒精归因分数。
共纳入 60 项已发表研究和来自 6 个州数据系统的 40 个额外人群水平数据点。按损伤原因分析的荟萃分析酒精归因分数如下：气腔运输（0.03）、吸入（0.24）、儿童虐待（0.09）、溺水（0.31）、跌倒伤（0.37）、火灾伤（0.34）、火器伤（0.24）、杀人（0.29）、体温过低（0.29）、机动车非交通碰撞（0.42）、职业和机器伤（0.08）、其他道路车辆碰撞（铁路侵入者伤）（0.63）、中毒（非酒精）（0.20）、自杀（0.21）和水运（0.27），产生总体中位数酒精归因分数为 0.27。
过量饮酒与暴力和非暴力伤害死亡的比例相当大。这些发现可以改善用于估计酒精归因伤害死亡的数据，并为预防这些死亡的循证策略的规划和实施提供信息（例如，提高酒精税，调节酒精销售点密度）。
