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Alcohol-related injuries

Definition of alcohol-related injuries

Alcohol-related injuries are injuries, which have been attributed to the effects of alcohol.1

Impact of alcohol-related injuries on Western Australia

Who does it impact?

In WA in 2012 alcohol was attributed to;2

  • 245 injury fatalities (17.5% of injury fatalities)
  • 5,911 injury hospitalisations (11.8% of injury hospitalisations)
  • 56,057 emergency department visits (32% of emergency department injury presentations)

In WA between 2000 and 2008, males accounted for 57% of all alcohol-related injury hospitalisations.2,3

In WA between 2000 and 2008 hospitalisations for alcohol-related injuries were highest within the age groups 65+ and 15 – 24.2

Alcohol contributed to 22.8% of injury hospitalisations for Aboriginal people in WA between 2000 and 2008, compared to 10.5% among non-Aboriginal people.2

What injury areas are most affected?

In WA between 2000 and 2008, alcohol was involved in;2

  • 3% of violence hospitalisations
  • 7% of self-harm hospitalisations
  • 5% of falls hospitalisations
  • 2% of land transport hospitalisations
  • 3% of drowning hospitalisations
  • 3% of fires, burns and scalds hospitalisations
  • 7% of poisoning hospitalisations.

Where does it occur?

In WA in 2012, the Kimberley had the highest proportion of alcohol-related injury hospitalisations compared to other regions in WA, with 20.2% of injury hospitalisations recorded as alcohol-related. This rate was followed by the Pilbara and Goldfields (16.5% and 13.9% of the alcohol-related injury hospitalisations, respectively).2

What is the impact on the health system?

In 2012, the total lifetime cost of alcohol-related injury in WA was an estimated $1.9 billion due to health care costs, longterm care needs, loss in paid productivity, and quality of life lost.2

In 2012 injury deaths and hospitalisations, which could be attributed to alcohol involvement, had a higher mean cost per event compared to those without alcohol involvement, at $211,694 compared to $138,455.2

Determinants of alcohol-related injuries (Risk / Protective Factors)

Social Determinants

Socio-economic status (SES)

Factors which have been proven to influence injury risk for an individual with a low SES, include; consumption of alcohol, poor housing, unsafe drinking environments and social drinking practices.4 In addition to these contributing factors, medical care is less likely to be available to those with a lower SES, resulting in alcohol-related injuries having greater consequences to individuals with a lower SES.4

Environmental, Community and Organisational Determinants

Location
The location of an injury has been highlighted as an influential factor in the incidence of alcohol-related injuries. An analysis of 45 worldwide Emergency Department studies indicated that alcohol-related injuries were most prevalent in a restaurant or bar and least likely to occur at a school / workplace.5 These findings support the need for legislation and other preventative measures to focus on locations where the incidence of alcohol-related injuries are higher.

Behavioural and Individual Determinants

Gender
In Western Australia between 2000 and 2008 males accounted for 57% of all alcohol-related community injury hospitalisations.3 The cause of alcohol-related injury also differs between genders, as falls, interpersonal violence and self-harm were the leading causes of female hospitalisation due to alcohol-related injury, while interpersonal violence, falls and road crashes were the leading injury causes for males.3

Ethnicity

A larger proportion of Aboriginal peoples have reported abstaining from consuming alcohol compared to the total population, however those who do consume alcohol have reported to do so at risky levels.6 Given this and other contributing risk factors including, addiction, social exclusion, stressful life events, homelessness, mental illness and community stressors, alcohol-related injuries significantly impact the Aboriginal population. 7 In Western Australia Aboriginal peoples were twice as likely to be hospitalised for alcohol-related injuries from 2000 to 2008 compared to non-Aboriginal people, with alcohol contributing to 22.8% of all community injury hospitalisations for Aboriginal peoples compared to 10.5% within non-Aboriginal peoples.3

Effective Interventions

Legislation, Policies, Standards and Codes of Practice

Policies
Reducing the availability of alcohol by monitoring outlet density, limiting opening hours, regulating prices and restricting licenses has proven to decrease alcohol-related injuries, in particular alcohol-related violence.8 The relationship between the opening hours of alcohol distributors and alcohol-related harm was supported in a New South Wales (NSW) study, with restrictions on pub opening hours reducing assault incidents by 37% in comparison to a control location.9

Western Australian example

The WA Liquor Control Act 1988 regulates the sale, supply and consumption of liquor to minimise harm or ill health caused to people or any group of people due to the use of liquor.8

Drink driving legislation
The risk for road crash incidents has shown to increase along with alcohol consumption levels and therefore no alcohol when driving is the safest option.10 Research indicates that legislations enforcing a BAC level of 0.05gm%, including the implementation of random breath tests, reduced fatal collisions in NSW by 8% and in Queensland by 18%.11

Western Australian example

In Western Australia, for a full licence holder it is an offence to drive with a BAC level equal to or exceeding 0.05gm%.12

Environmental, Community and Organisational Initiatives

Holistic approach

Given the range of factors, which influence the prevalence of alcohol-related injuries, a holistic approach, including action from individuals, the community and organisations, is required to reduce injury incidence. Research supports that multicomponent interventions implemented in drinking environments may reduce alcohol-related injuries.13

Western Australian Example

The WA Health Promotion Strategic Framework 2017-2021 identifies that reducing the harmful levels of alcohol use in WA is a health priority and outlines three prevention strategies; changing community attitudes towards alcohol use, influencing the supply of alcohol and reducing the demand for alcohol.14

Campaigns

Carefully planned, well-executed mass media campaigns, conducted alongside other ongoing prevention activities are effective in reducing both drink driving and alcohol-related crashes.15 Previous Road Safety Commission campaigns in Western Australia have utilised television campaigns to communicate road safety messages. 16,17 Evaluation of the “Grow up” campaign indicated that the messages reminded 68% of respondents of the importance of not drink driving16, whilst in an additional campaign, evaluation found that the “Alcohol Interlocks Campaign” effectively influenced 8 in 10 people to restrict themselves from drink driving.17

Western Australian example

“Worried/Grow Up” is a campaign by the Road Safety Commission aimed at raising the awareness of the risks associated with drink driving through the emotional key message that even if you ‘think’ you’re ok to drive, you might not be.

Group and Individual Initiatives

Individual consumption
Both the volume of alcohol consumed and the pattern of drinking over time can influence injury risk. Even at moderate doses, alcohol consumption can impact risk-taking behaviour and psychomotor performance, including cognition, vision, co-ordination, and reaction time, which can influence injury risk.18

Support services

Alcohol and other drug programs and information lines can provide support to individuals and their families who are affected by the consumption of alcohol.

Western Australian example

The Alcohol and Drug Support Line offers confidential non-judgemental telephone counselling, information, referral and support for anyone seeking help for their own or another person’s alcohol or drug use.

Western Australian example

The Parent and Family Drug Support Line is a confidential, non-judgemental telephone counselling, information and referral service for anyone concerned about a loved one’s alcohol or drug use.

Alcohol interlocks

Installed into the ignition systems of vehicles, alcohol interlocks are breath-testing devices that prevent the vehicle from starting if the interlock detects blood alcohol content equal to or greater than 0.02% in the driver’s breath sample. A global literature review into alcohol interlock systems found that alcohol interlock systems can reduce drink driving recidivism by 35 – 90% with an average reduction in drink driving of 64% while the interlock is installed.19

Western Australia example

The Alcohol Interlock Scheme was introduced in Western Australia on 24 October 2016. If a driver who is convicted of an alcohol interlock offence is granted a driver’s licence they may only drive a vehicle with an alcohol interlock fitted.

Key stakeholders in Western Australia

Other Resources

References

  1. Department of Health, Western Australia. Injury Prevention in Western Australia: A review of statewide activity. Perth: Chronic Disease Prevention Directorate, Department of Health; 2015.
  2. Hendrie D, Miller T, Randall S, Brameld K, Moorin R. Incidence and costs of injury in WA 2012. Perth: Chronic Disease Prevention Directorate Department of Health WA; 2016.
  3. Ballestas T, Xiao J, McEvoy S, Somerford P. The Epidemiology of Injury In Western Australia, 2000 -2008. Perth: Department of Health WA; 2011.
  4. Roberts H, Meddings D. Violence and unintentional injury: equity and social determinants. In: Equity, social determinants, and public health programmes. Geneva, Switzerland: World Health Organization; 2010. p. 243–59.
  5. Macdonald S, Cherpitel CJ, DeSouza A, Stockwell T, Borges G, Giesbrecht N. Variations of alcohol impairment in different types, causes and contexts of injuries: Results of emergency room studies from 16 countries. Accid Anal Prev. 2006 Nov;38(6):1107–12.
  6. Claydon C, Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report 2013. Canberra, ACT: Australian Institute of Health and Welfare; 2014.
  7. Liquor Control Act 1988, WA [statute on the Internet]. c2017 [cited 2017 December 12]. Available from: https://www.slp.wa.gov.au/pco/prod/filestore.nsf/FileURL/mrdoc_29785.pdf/$FILE/Liquor%20Control%20Act%201988%20-%20%5B08-f0-03%5D.pdf?OpenElement

Printable Resource Kit

Click here to download a printable version of the alcohol-related injuries resource kit.