Alcohol use among pedestrians and the odds of surviving an injury: evidence from Florida law enforcement data.

Alcohol consumption by pedestrians is widely recognized as a factor influencing the risk of being hit by a motor vehicle, but its effect on the likelihood of dying, given that a collision has occurred, is more uncertain. Studies of drivers find that alcohol increases the risk. Unlike previous studies based on clinical data, the present study is population-based and takes into account indicators of crash severity. Using Florida law enforcement data, logistic regression models yielded a four to fivefold increase in the odds ratios associated with alcohol use, depending on the model. Findings from a model investigating the magnitude of the potential bias due to differential investigative behavior indicated bias may account for some but not all of the increase in the odds of dying. Recommendations include improving law enforcement procedures for identifying alcohol impairment and increasing public awareness of the risk involved in mixing heavy drinking and walking.