Estimates Of Alcohols Involvement

In emergency room (ER) studies, such as those conducted by Cherpitel (1988), patients testing positive for alcohol have had levels that ranged from 6 to 32 percent—established either directly or from a breath sample taken at the time of admission to the ER. In a review of ER studies, Cherpitel (1993 a) determined that this variation in blood alcohol level (BAL) or BLOOD ALCOHOL CONCENTRATION (BAC) is due to differences in the time that passed between the injury and arrival in the ER, to individual characteristics of the particular ER populations studied (such as age, sex, and socioeconomic status—all known to be associated with alcohol consumption in the general population) and to the mix of various types of injury in the ER caseload. For example, alcohol has been found to have a higher prevalence in injuries resulting from violence than from any other cause. In studies that have been restricted to weekend evenings, when one would expect a large proportion of the population to be consuming alcohol, the proportion of those testing positive for alcohol at the time of ER admission has been found to be close to 50 percent. In coroner studies, such as those conducted by Haberman and Baden (1978), alcohol-related fatalities were estimated to account for about 43 percent of all unintentional injuries. (However, the distinction between intentional and unintentional injury is not always readily apparent among victims of fatal injuries.) Studies that have compared estimated BAC between fatal and nonfatal injuries in the same geographic locality have found higher rates of positive BACs among fatal injuries (57%) compared to nonfatal injuries (15%) (Cherpitel, 1996). It is well known that many who drink also consume psychoactive drugs so the independent effect of alcohol on both fatal and nonfatal accidents is not possible to ascertain.

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