Background: Alcohol is a major cause of morbidity and mortality, much of it due to injury. About 45 % of alcohol-related deaths and 80 % of alcohol-related years of productive life lost are due to injury, and a substantial proportion of non-fatal injury is attributable to alcohol. Objectives: 1) To further quantify the association between acute alcohol exposure and the risk of injury, including the relative risk at low levels of alcohol consumption. 2) To examine the relationship between chronic alcohol involvement and injury risk, with and without simultaneously including acute alcohol exposure in the model. 3) To define the extent of confounding due to other background variables such as personality traits in the association between alcohol and injury. 4) To explore patients' attributions regarding their injury using qualitative methods. Design: A case-crossover study, in which each injured person is both a case (at one point in time) and a control (at prior times), within a population-based case control study. Setting: All three hospital emergency centers in Boone County, Missouri. Participants: Cases will be patients presenting for care within 48 hours of an acute injury. Cases will also serve as controls, with drinking on the day of injury compared to drinking the previous day, the same day of the week in the previous four weeks, and the previous 28 days. Two other controls will be matched to each case by sex, age group, and time: 1) General population controls, recruited by random-digit dialing. 2) Patients presenting to the same emergency centers with a medical illness. Analysis: Odds ratios will be calculated using conditional logistic regression. Subgroup analyses will compare groups by age and sex, and by mechanism and severity of injury. Comparison between case-control and case-crossover findings will provide an estimate of the extent of confounding by stable personal factors. Goals: The proposed study is the first major attempt to control for stable between-subject variables, such as willingness to take risks, in examining the relationship between alcohol and injury. The results may lead to important new information regarding risk at low alcohol levels, helping define """"""""safe drinking"""""""" limits more precisely, and may contribute to a better understanding of the relative contributions to injury risk of chronic alcohol involvement and acute alcohol exposure.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA011078-03
Application #
2894136
Study Section
Clinical and Treatment Subcommittee (ALCP)
Program Officer
Yahr, Harold
Project Start
1997-08-01
Project End
2001-07-31
Budget Start
1999-08-01
Budget End
2000-07-31
Support Year
3
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Missouri-Columbia
Department
Family Medicine
Type
Schools of Medicine
DUNS #
112205955
City
Columbia
State
MO
Country
United States
Zip Code
65211
Vinson, Daniel C; Kruse, Robin L; Seale, J Paul (2007) Simplifying alcohol assessment: two questions to identify alcohol use disorders. Alcohol Clin Exp Res 31:1392-8
Edmonds, Jason N; Vinson, Daniel C (2007) Three measures of sleep, sleepiness, and sleep deprivation and the risk of injury: a case-control and case-crossover study. J Am Board Fam Med 20:16-22
Vinson, Daniel C (2006) Marijuana and other illicit drug use and the risk of injury: A case-control study. Mo Med 103:152-6
Vinson, Daniel C; Arelli, Vineesha (2006) State anger and the risk of injury: a case-control and case-crossover study. Ann Fam Med 4:63-8
Spurling, Maria C; Vinson, Daniel C (2005) Alcohol-related injuries: evidence for the prevention paradox. Ann Fam Med 3:47-52
Canagasaby, Andrea; Vinson, Daniel C (2005) Screening for hazardous or harmful drinking using one or two quantity-frequency questions. Alcohol Alcohol 40:208-13
Vinson, Daniel C; Reidinger, Carol; Wilcosky, Timothy (2003) Factors affecting the validity of a Timeline Follow-Back interview. J Stud Alcohol 64:733-40
Vinson, Daniel C; Borges, Guilherme; Cherpitel, Cheryl J (2003) The risk of intentional injury with acute and chronic alcohol exposures: a case-control and case-crossover study. J Stud Alcohol 64:350-7
Vinson, Daniel C; Maclure, Malcolm; Reidinger, Carol et al. (2003) A population-based case-crossover and case-control study of alcohol and the risk of injury. J Stud Alcohol 64:358-66
Williams, R; Vinson, D C (2001) Validation of a single screening question for problem drinking. J Fam Pract 50:307-12