Abstract: OBJECTIVE: Most studies on alcohol as a risk factor for injuries have been mechanism specific, and few have considered several mechanisms simultaneously or reported alcohol-attributable fractions (AAFs)-which was the aim of the current study. METHOD: Data from 3,592 injured and 3,489 noninjured patients collected between January 2003 and June 2004 in the surgical ward of the emergency department of the Lausanne University Hospital (Switzerland) were analyzed. Four injury mechanisms derived from the International Classification of Diseases, 10th Revision, were considered: transportation-related injuries, falls, exposure to forces and other events, and interpersonal violence. Multinomial logistic regression models were calculated to estimate the risk relationships of different levels of alcohol consumption, using noninjured patients as quasi-controls. The AAFs were then calculated. RESULTS: Risk relationships between injury and acute consumption were found across all mechanisms, commonly resulting in dose-response relationships. Marked differences between mechanisms were observed for relative risks and AAFs, which varied between 15.2% and 33.1% and between 10.1% and 35.9%, depending on the time window of consumption (either 6 hours or 24 hours before injury, respectively). Low and medium levels of alcohol consumption generally were associated with the most AAFs. CONCLUSIONS: This study underscores the implications of even low levels of alcohol consumption on the risk of sustaining injuries through any of the mechanisms considered. Substantial AAFs are reported for each mechanism, particularly for injuries resulting from interpersonal violence. Observation of a so-called preventive paradox phenomenon is discussed, and prevention or intervention measures are described.

Abstract: Objective: To investigate the relationship between usual and acute alcohol consumption among injured patients and, when combined, how they covary with other injury attributes. Methods: Data from a randomised sample of 486 injured patients interviewed in an emergency department (Lausanne University Hospital, Switzerland) were analysed using the χ2 test for independence and cluster analysis. Results: Acute alcohol consumption (24.7%) was associated with usual drinking and particularly with high volumes of consumption. Six injury clusters were identified. Over-representations of acute consumption were found in a cluster typical of injuries sustained through interpersonal violence and in another formed by miscellaneous circumstances. A third cluster, typical of sports injuries, was linked to a group of frequent heavy episodic drinkers (without acute consumption). Conclusions: Among injured patients, acute alcohol consumption is common and associated with usual drinking. Acute and/or usual consumption form part of some, but not all, injury clusters.

Abstract: The harmful use of alcohol creates a significant disease burden and in many countries causes public health problems leading to a substantial health, social and economic burden. Reducing the harmful use of alcohol is becoming a priority on the national, regional and global levels; it can be done by implementing strategies of proven effectiveness. This report presents the latest data from the WHO European Region on alcohol consumption and harm and the responses made to them in countries. It summarizes the situation in the Region as a whole and gives profiles of its 53 countries, presenting consolidated tables and graphs with data on some of the key indicators from the 2009 survey on alcohol and health. In addition, the report describes the WHO instruments and activities that are available to support countries in building on the gains they have already made in this area. Alkoholmissbrauch ist für eine erhebliche Krankheitslast verantwortlich und stellt in vielen Ländern das Gesundheitswesen vor Probleme, die eine beträchtliche Belastung für Mensch, Gesellschaft und Wirtschaft darstellen. Die Bekämpfung des Alkoholmissbrauchs wird zu einer Priorität auf nationaler, regionaler und globaler Ebene und kann durch Umsetzung von nachweislich wirksamen Strategien erfolgen. In diesem Bericht werden die neuesten Daten aus der Europäischen Region der WHO über Alkoholkonsum und dadurch bedingte Schäden sowie die in den Ländern ergriffenen Gegenmaßnahmen präsentiert. Neben einer Zusammenfassung der Situation in der Region insgesamt werden auch Profile der 53 Mitgliedstaaten erstellt; dies geschieht mittels konsolidierter Tabellen und Grafiken mit Daten zu einigen der wichtigsten Indikatoren aus der Studie von 2009 über Alkohol und Gesundheit. Darüber hinaus werden in dem Bericht die Instrumente und Aktionen geschildert, mit denen die WHO die Länder dabei unterstützen kann, an den auf diesem Gebiet bereits erzielten Erfolgen anzuknüpfen. L’usage nocif de l’alcool est à l’origine d’une importante charge de morbidité. Dans beaucoup de pays, il cause des problèmes de santé publique venant grever le fardeau sanitaire, social et économique. Réduire l’usage nocif de l’alcool devient une priorité aux niveaux national, régional et mondial. À cette fin, des stratégies à efficacité avérée peuvent être adoptées. Ce rapport compile les dernières données de la Région européenne de l’OMS en ce qui concerne la consommation d’alcool et ses effets nocifs, ainsi que les mesures de lutte prises dans les pays. Il résume la situation régionale dans son ensemble et présente le profil de ses 53 États membres, à l’aide de tableaux et de graphiques récapitulatifs qui illustrent les données relatives à plusieurs indicateurs essentiels provenant de l’étude menée en 2009 sur l’alcool et la santé. En outre, le rapport décrit les instruments et activités de l’OMS qui sont disponibles pour aider les pays à consolider les gains déjà réalisés dans ce domaine. Во многих странах вредное употребление алкоголя связано со значительным бременем болезней, приводя к негативным медицинским, социальным и экономическим последствиям. Поэтому сокращение вредного употребления алкоголя становится одной из приоритетных задач на национальном, региональном и глобальном уровнях. Эта цель может быть достигнута путем реализации стратегий, эффективность которых уже доказана. В настоящем докладе представлены последние данные по Европейскому региону о потреблении алкоголя и наносимом им вреде, а также об ответных действиях на уровне стран. В нем дается краткое описание ситуации в Регионе в целом, и приведены профили всех 53 государств – членов Региона, в том числе в виде сводных таблиц и графиков с данными по ряду ключевых показателей, взятыми из проведенного в 2009 г. обследования по вопросам алкоголя и здоровья. Кроме того, в докладе дается описание документов и мероприятий ВОЗ, которые могут оказать поддержку странам в развитии тех успехов, которых они уже добились в этой области.