The effect of beverage type on fatal accidents rate in Russia

(ProQuest: . denotes formulae omitted.)IntroductionIt is widely recognized that acute alcohol intoxication is associated with an increased risk for almost all categories of accidents and injuries. [1,2] In many countries alcohol plays a significant role in accidental falls, accidents caused by fire, accidental drowning. [3] A causal link between alcohol and injuries has been established from both individual and population level studies. [4,5] A systematic review of emergency department studies, published between 1995 and 2005, revealed that injured patients were more likely to be positive for BAC at the time they were admitted and to report drinking within six hours prior to the injury event compared with those who had not reported any injuries. [5,6] Of all alcohol-attributable deaths globally, WHO identified 12% as being a result of intentional injuries and 29.6% as being a result of unintentional injuries. [7] There is a dose-response relationship between alcohol and injury, with risk increasing with the increasing amount of alcohol consumed. [3] Alcohol-related accidents and injuries are more closely related to pattern of drinking than to the overall volume consumed. [4,7] There are several studies indicating that binge drinking is associated with high risk of trauma. [8,9] Savola and coauthors [10] reported that binge drinking is a major risk factor for head trauma among trauma patients and that the relative risk for head injury markedly increases with the increasing blood alcohol level. A study from Finland showed an excess of head traumas during weekends and this excess was associated with heavy episodic drinking. [11] Similar weekly variations of head trauma have been reported in other countries where heavy episodic drinking is also the prevailing drinking pattern. [9]The strong support for a causal role of alcohol in accident mortality comes from the aggregate-level studies. Both longitudinal and cross-sectional aggregate-level studies have reported elsewhere a significant temporal co-variation between per capita alcohol consumption and accident mortality rates. [12] An analysis of time-series data for Canada covering the period 1950-1998 revealed a statistically significant association between per capita alcohol consumption and overall fatal accidents rate. [13] Nevertheless, the crosscountry comparisons demonstrate heterogeneity with respect to strength of association between population drinking and accidental mortality. [12] In countries where high level of intoxication is an integral part of the drinking culture, the etiological significance of alcohol seems to be larger. A time series analysis, based on the data for the period from 1950-95 covering 14 European Union countries suggests that an increase in population drinking had the largest impact on accident mortality in northern Europe than in mid-Europe and southern Europe. [6] These findings provided support for the hypothesis, that the effect of alcohol on accident mortality rate is stronger in the northern European spirits countries characterized by a low per capita consumption with the bulk of consumption concentrated on a few occasions (binge drinking pattern), or "dry" drinking cultures, than in the southern European wine countries with a high average consumption which is more evenly distributed throughout the week, or "wet" drinking cultures. Similarly, the results of recent study suggest that changes in per capita consumption have a significant impact on injury mortality in 6 eastern European countries, but the strength of the association tends to be stronger in countries where intoxicationoriented drinking pattern prevails. [14]There is common belief that high level of alcohol consumption in conjunction with binge drinking pattern is a major determinant of accident mortality crisis in Russia. [15] The findings suggest that population drinking and accidental deaths rate are positively related at the population level in Russia. …