The proportion of the 545000 trauma cases admitted to hospital each year which is associated with alcohol is not known but two useful studies of BACs (blood alcohol concentration) in admissions to Accident and Emergency (A&E) Departments in Great Britain are available, at Salford and at Broxburn in Scotland. Of the casualties at the English hospital, 13.2 percent had positive BACs and 18.3 percent of the Scottish study: 9.3 percent of the Salford cases were over the legal limit for driving, 10.2 percent of the Broxburn study. The two studies give similar figures for the source of the accidents. For road accidents, 14.22 percent of the casualties had positive BACs with 11-17.4 percent over the legal limit. This compares with 38 percent positive and 28 percent over the legal limit in driver fatalities, and 20 percent over the legal limit in roadside screening breath tests where drivers had been involved in an accident. The accumulated evidence strongly supports an association between alcohol and accidents leading to injury, but association does not necessarily mean causation. Causation is plausible from the known effects of alcohol on human performance. The decrements in performance with alcohol found in a range of perceptual and motor tasks result more from impaired information processing rather than from decreased sensory responsiveness or motor ability. The decrements are progressive with increasing BAC. Above all, adequate research is needed into the uncertainty about the relationship between acute and chronic alcohol misuse on the one hand, and on the other, the immediate mortality, the severity of injuries as measured by a suitable injury severity score, and the outcome of the injuries in terms of survival, length of stay in hospital and disability. (Secondary source)
Samenvatting