Lesiones y alcohol: de la evidencia epidemiológica a la acción preventiva

Abstract

Injuries are one of the main causes of mortality, morbidity and disability in the world, and it is expected that they will undergo some of the largest negative increases in the next two decades. The implication of alcohol in the risk of an injury has been shown in many studies, especially for the case of traffic injuries, although this is also the case for injuries due to falls, fires and drowning. In the European Union alone, about 10,000 alcohol related injury deaths are estimated to occur yearly (1 in every 4 traffic injury deaths). Alcohol is also associated with a greater risk of hospital admission, and larger use of health care resources. In Spain –which shows intermediate alcohol related traffic mortality rates, estimates of blood alcohol levels (BAL) in fatal traffic injury cases vary substantially, between 37 and 77%. BAL in non fatal traffic injury cases are beyond legal limits in 30 to 51% of the patients attended at emergency rooms. There is a large amount of evidence regarding the effectiveness of strategies and programs to prevent alcohol-related injuries. Main ones include the raise of the legal minimal drinking age, zero tolerance laws, as well as laws setting maximum BAL below 0.8 gr/l, the reduction of legal BAL for traffic offenders, community prevention programs, alcohol screening and brief interventions in the emergency rooms, medical counselling in primary care, suspension of driving license and vehicle immobilisation. Despite the availability of technical solutions to face this serious public health problem, a debate is needed to put forward the essentially political and social nature of the decisions, which need to be rapidly and energically implemented.