University of Iowa, Department of Emergency Medicine, Iowa City, Iowa.
University of Iowa, Carver College of Medicine, Iowa City, Iowa.
West J Emerg Med. 2023 Feb 25;24(2):210-217. doi: 10.5811/westjem.2022.11.58766.
In 2021, a large Midwestern university began selling alcohol to spectators within the football stadium for the first time. The stadium routinely hosts >65,000 spectators, and drinking alcohol is highly prevalent at pre-game tailgating events. Our goal in this study was to determine the impact of in-stadium alcohol sales on the incidence of alcohol-related emergency department (ED) visits and local emergency medical services (EMS) calls. We hypothesized that the availability of alcohol throughout the stadium would lead to an increase in alcohol-related patient presentations.
This was a retrospective study including patients who used local EMS and presented to the ED on football Saturdays in the 2019 and 2021 seasons. There were 11 Saturday games with seven home games each year. The 2020 season was excluded due to the impact of COVID-19- related restrictions on attendance. Trained extractors using predefined criteria reviewed records for each patient to determine whether the visit was alcohol related. Using logistic regression analysis we examined the odds of an EMS call and ED visit being alcohol-related before and after the start of stadium alcohol sales. We compared characteristics of visits before and after the onset of stadium alcohol sales using Student's t-test for continuous variables and chi-square test for categorical variables.
In 2021, after the onset of in-stadium alcohol sales, there were a total of 505 emergency calls to local EMS on football Saturdays (home and away), and 29% of them were for alcohol-related incidents down from 36% of 456 calls in 2019. After adjustment for covariates, the odds of a call being alcohol-related were lower in 2021 than 2019, but this difference was not significant (adjusted odds ratio [aOR] 0.83, 95% CI 0.48-1.42). Looking specifically at the seven home games each season, the difference was more pronounced (31% of calls in 2021 compared to 40% in 2019) but not statistically significant after adjustment for covariates (aOR 0.54, 95% CI 0.15-2.03). In the ED, 1,414 patients were evaluated on game days in 2021 and 8% of them for alcohol-related reasons. This is similar to 2019, when 9% of the 1,538 patients presented due to alcohol-related complaints. After adjustment for covariates, the odds of an ED visit being alcohol-related were similar in 2021 and 2019 (aOR 0.98, 95% CI 0.70-1.38).
There was a decrease in alcohol-related EMS calls on home game days in 2021, although the result was not statistically significant. In-stadium alcohol sales had no significant impact on the frequency or proportion of alcohol-related ED visits. The reason for this outcome is unclear, but it is possible that fans drank less at tailgate parties knowing they could consume more once the game started. Long lines and a two-beverage limit at stadium concessions may have kept patrons from consuming excessively. The results of this study may inform similar institutions regarding the safe implementation of alcohol sales during mass-gathering events.
2021 年，一所中西部的大型大学首次在橄榄球场馆内向观众出售酒精饮料。该体育场通常可容纳超过 65000 名观众，赛前的场外停车场活动中饮酒现象非常普遍。我们的研究目标是确定体育场内销售酒精饮料对酒精相关急诊（ED）就诊和当地紧急医疗服务（EMS）呼叫发生率的影响。我们假设，整个体育场都提供酒精饮料会导致与酒精相关的患者就诊人数增加。
这是一项回顾性研究，包括在 2019 年和 2021 年橄榄球周六使用当地 EMS 并在 ED 就诊的患者。每年有 11 个周六比赛，其中 7 个主场比赛。由于 COVID-19 相关限制对出勤率的影响，2020 年赛季被排除在外。受过培训的提取器使用预定义标准审查每位患者的记录，以确定就诊是否与酒精有关。使用逻辑回归分析，我们在体育场内开始销售酒精之前和之后检查了 EMS 呼叫和 ED 就诊与酒精有关的可能性。我们使用学生 t 检验比较了就诊前和就诊后特征，用于连续变量，使用卡方检验用于分类变量。
2021 年，在体育场内开始销售酒精饮料后，橄榄球周六（主场和客场）共接到当地 EMS 505 次电话，其中 29%与酒精有关，而 2019 年的这一比例为 36%。在调整了协变量后，2021 年与酒精有关的电话的可能性低于 2019 年，但差异无统计学意义（调整后的比值比[OR]0.83，95%CI0.48-1.42）。具体来看，每个赛季的 7 个主场比赛，差异更为明显（2021 年的电话中有 31%与酒精有关，而 2019 年的电话中有 40%与酒精有关），但在调整了协变量后，差异无统计学意义（调整后的比值比[OR]0.54，95%CI0.15-2.03）。在 ED，2021 年有 1414 名患者在比赛日就诊，其中 8%因酒精相关原因就诊。这与 2019 年相似，当时因酒精相关投诉而就诊的 1538 名患者中有 9%。在调整了协变量后，ED 就诊与酒精有关的可能性在 2021 年和 2019 年相似（调整后的比值比[OR]0.98，95%CI0.70-1.38）。
2021 年主场比赛日与酒精有关的 EMS 电话数量有所减少，尽管结果无统计学意义。体育场内的酒精销售对酒精相关 ED 就诊的频率或比例没有显著影响。这种结果的原因尚不清楚，但有可能是球迷们知道一旦比赛开始就可以多喝酒，因此在停车场的派对上喝得更少了。体育场摊位的长队和两种饮料的限制可能使顾客无法过度消费。这项研究的结果可能为类似的机构提供有关在大规模集会活动中安全实施酒精销售的信息。
