THE RELATIONSHIP BETWEEN ALCOHOL INTOXICATION, STRESSORS AND INJURY IN URBAN VIOLENCE

The relationships between alcohol consumption and intoxication, stressors and injury in urban violence were investigated in parallel case control and cohort studies of injured people presenting at a large Accident and Emergency Department. Alcohol intoxication and consumption were assessed using the breath analysis and diary method, stressors were assessed using the Holmes and Rahle Life Style Score for the periods up to one week; more than one week but less than one month; more than one month but less than one year; and more than a year prior to injury, and injury severity was calculated by means of four injury severity indices. The Glasgow Coma Score was recorded as a measure of the effect of alcohol on brain function. Cases could not be differentiated from controls on the basis of experience of major life events or minor stressors in the period prior to injury, or on the basis of age, employment status, social class or the types of relationship formed with peers or sexual partners. Cases drank more during an average weekend than controls, drank more on each weekend drinking session than controls, and were more likely to binge drink (consume more than ten units) compared to controls. Consumption of more than ten units of alcohol in the six hours prior to assault and blood alcohol levels of greater than 160 mgm per 100 ml were associated with injury. A predominance of facial injuries was found. While blood alcohol concentration and injury severity were significantly related to levels of alcohol consciousness, there was no significant relationship between injury severity and blood alcohol concentrations. The results of this study suggest that heavy binge drinking increases vulnerability to injury.