Abstract
BackgroundWe analyzed population-based injury trends and the association between injury and alcohol consumption patterns in Thailand, a middle-income country undergoing rapid social change.MethodsA nationwide cohort of 42 785 Thai adult Open University students, who were aged 15 to 87 years at enrolment, participated in cross-sectional assessments at baseline (2005) and 8 years later (2013). Incident non-fatal traffic and non-traffic injuries were recorded. Alcohol consumption patterns were categorized as follows: non-drinkers, occasional light drinkers, occasional heavy drinkers, regular drinkers, and ex-drinkers. Logistic regression was used to assess associations in 2005 and 2013 between injuries and alcohol consumption. We adjusted odds ratios (ORs) for socio-demographic factors, stress, health behaviors, and risk-taking behaviors.ResultsIncidence estimates in 2013 were standardized to the age structure of 2005: the standardized rates were 10% (95% confidence interval [CI], 9.32–9.89) for participants with at least one non-traffic injury and 5% (95% CI, 4.86–5.29) for those with at least one traffic injury. Both standardized incidences for non-traffic and traffic injuries were significantly lower than corresponding rates in 2005 (20% and 6%, respectively). Alcohol consumption was significantly associated with non-traffic injury in 2005, but the association disappeared in 2013. For example, non-traffic injury was associated with regular drinking (adjusted OR 1.17; 95% CI, 1.01–1.40) in 2005, but not in 2013 (adjusted OR 0.89; 95% CI, 0.73–1.10). In both survey years, traffic injury was not associated with occasional heavy drinking when adjusted for health and risk-taking behavior.ConclusionsWe examined non-fatal injury and the health-risk transition in Thailand in 2005 and 2013. Our data revealed decreases in alcohol consumption and non-fatal injury in the Thai Cohort between 2005 and 2013. Alcohol-related injury in Thailand today could be amenable to preventive intervention.
Highlights
Injury in developing countries is a public health problem
Given the relatively high alcohol consumption in Thailand and its importance to disability-adjusted life years (DALYs) lost, we focused on connections between alcohol and injury across socio-geographic groups, noting and interpreting the changes occurring over an 8-year period
About one third of cohort members had urbanized since age 12; proportions were similar between sexes and in survey years (Table 1)
Summary
Injury in developing countries is a public health problem. In middle-income countries of Southeast Asia, includingThailand, road injury is one of the top 10 causes of death.[1,2] In addition, alcohol consumption is broadly associated with the risk of injury. Alcohol and Injury Trends in Thailand in 2009.3 A major barrier to addressing the problem in low- to middle-income countries is the lack of information about injuries and related demographic, psychosocial, and personal risk-taking factors. We analyzed population-based injury trends and the association between injury and alcohol consumption patterns in Thailand, a middle-income country undergoing rapid social change. Results: Incidence estimates in 2013 were standardized to the age structure of 2005: the standardized rates were 10% (95% confidence interval [CI], 9.32–9.89) for participants with at least one non-traffic injury and 5% (95% CI, 4.86–5.29) for those with at least one traffic injury. Nontraffic injury was associated with regular drinking (adjusted OR 1.17; 95% CI, 1.01–1.40) in 2005, but not in 2013 (adjusted OR 0.89; 95% CI, 0.73–1.10) In both survey years, traffic injury was not associated with occasional heavy drinking when adjusted for health and risk-taking behavior. Alcoholrelated injury in Thailand today could be amenable to preventive intervention
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