Antecedence to Injury | Illumination

Antecedence to Injury. Story by Alan Bavley.

Alcohol abuse and dependence is a growing problem. It affects more than 17 million adults in the United States, up from about 14 million just a decade ago. With trauma responsible for 40 percent of the 85,000 alcohol-related deaths each year, injury prevention was a subject urgently in need of more study.

Vinson had become interested in alcohol research while treating alcoholic patients as an inpatient attending resident at University Hospital. In the summer of 1994, he and a team of medical students did a small pilot study at the hospital's emergency room. That led to a $1.1 million grant from the National Institute on Alcohol Abuse and Alcoholism to pursue the research on a larger scale.

Late in the winter of 1998, Vinson and his research team descended on the emergency departments of University Hospital, Boone Hospital Center and Columbia Regional Hospital. They interviewed more than 2,500 injured patients: People with workplace injuries and sports injuries; people who had fallen down stairs or cut themselves with a kitchen knife; and people with sprained ankles, mild concussions or cuts needing stitches.

The patients were asked about their alcohol consumption immediately before their injury and what they had to drink the day before. Each interview lasted about half an hour and resulted in page after page of data. "The beauty of this approach is that it controls for everything that is stable from day to day, such as a person's age, sex, economic status," Vinson says. "It's perfectly controlled because it's the same person."

Vinson also employed professional phone interviewers to collect similar information from about 1,800 people randomly dialed in Boone and surrounding counties. Then came the data analysis, which Vinson concedes was "somewhat tedious," to compare the patients' experiences on the day of their injury and the day before to the experiences of the control group reached by telephone.

The results, Vinson found, were anything but boring. In fact, he says, they were remarkably consistent. "The association of alcohol and injury is strong and clean and it's consistent over race and gender," And the risks kicked in much faster than Vinson expected.

Having just two drinks over a period of six hours -- not much by most social drinkers' standards -- doubled the risk of injury. "I'm not sure that's a public health message the country is ready to hear," Vinson said. "We're not talking about people who are falling down drunk."

With additional alcohol, the risks of injury took exponential leaps. Three to four drinks were associated with a four-to six-fold increase in risk. Five or six drinks with a 10-fold risk. Many of alcohol's effects may account for these risks, Vinson says. Alcohol is known to impair judgment and hand-eye coordination, to increase reaction time and to reduce attention span and attentiveness.

Published by the Office of Research.