Abstract
BackgroundAlcohol is a contributing cause of unintentional injuries, such as motor vehicle crashes. Prior research on the association between alcohol use and violent injury was limited to survey-based data, and the inclusion of cases from a single trauma centre, without adequate controls. Beyond these limitations was the inability of prior researchers to comprehensively capture most alcohol sales. In Ontario, most alcohol is sold through retail outlets run by the provincial government, and hospitals are financed under a provincial health care system. We assessed the risk of being hospitalized due to assault in association with retail alcohol sales across Ontario.Methods and FindingsWe performed a population-based case-crossover analysis of all persons aged 13 years and older hospitalized for assault in Ontario from 1 April 2002 to 1 December 2004. On the day prior to each assault case's hospitalization, the volume of alcohol sold at the store in closest proximity to the victim's home was compared to the volume of alcohol sold at the same store 7 d earlier. Conditional logistic regression analysis was used to determine the associated relative risk (RR) of assault per 1,000 l higher daily sales of alcohol. Of the 3,212 persons admitted to hospital for assault, nearly 25% were between the ages of 13 and 20 y, and 83% were male. A total of 1,150 assaults (36%) involved the use of a sharp or blunt weapon, and 1,532 (48%) arose during an unarmed brawl or fight. For every 1,000 l more of alcohol sold per store per day, the relative risk of being hospitalized for assault was 1.13 (95% confidence interval [CI] 1.02–1.26). The risk was accentuated for males (1.18, 95% CI 1.05–1.33), youth aged 13 to 20 y (1.21, 95% CI 0.99–1.46), and those in urban areas (1.19, 95% CI 1.06–1.35).ConclusionsThe risk of being a victim of serious assault increases with alcohol sales, especially among young urban men. Akin to reducing the risk of driving while impaired, consideration should be given to novel methods of preventing alcohol-related violence.
Highlights
Intentional injury is a widespread cause of death, disability, property damage, demand for emergency medical service, and grief [1]
Akin to reducing the risk of driving while impaired, consideration should be given to novel methods of preventing alcohol-related violence
We considered alcohol sales the day before the assault based on the notion that the alcohol would be ingested on the day and/or evening of its purchase, and that the assault admission would follow after midnight [20]
Summary
Intentional injury is a widespread cause of death, disability, property damage, demand for emergency medical service, and grief [1]. While there is more than a 12-fold higher risk of committing a criminally violent act within 24 h of alcohol consumption, preliminary data suggest that recent alcohol intake is prevalent among victims of intentional injury [7]. Alcohol may impair both judgment [8] and the interpretation of facial expressions of others [9], and may place persons at higher risk of being pushed, hit, or assaulted [10]. Alcohol consumption is an important factor in unintentional injuries, such as motor vehicle crashes, and in violent criminal behavior. There is some evidence that suggests that the victims as well as the perpetrators of assaults have often been drinking recently, possibly because alcohol impairs the victim’s ability to judge potentially explosive situations
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