Relative Risk and Attributable Fraction of Injury due to Alcohol Use in the Americas

One important outcome to study the burden of disease due to alcohol is acute injury. Recently, work has been done to estimate the primary component of the Attributable Fraction (AF) of injury due to alcohol; the Relative Risk (RR) of injury. The present work examines RR and AF estimates for Argentina, Brazil, Mexico, and Vancouver and 5 Central American and Caribbean countries, including the Dominican Republic, Guatemala, Guyana, Nicaragua, and Panama. Using, the same 6 hour period the week prior as the control period, the overall RR estimate associated with any alcohol use 6 hours prior to the injury estimated combined across these 9 countries was 4.8. Along with the prevalence of drinking of any drinking 6 hours prior to the injury of 19.9%, the overall estimated AF of injury due to alcohol was 15.7%. RR estimates for each country separately were 3.3, 3.9, 4.2, 4.5, and 9.6 for Guyana, Panama, Nicaragua, Guatemala, and the Dominican Republic and 4.3, 5.3, 5.7, and 6.8 for Vancouver, Argentina, Brazil, and Mexico. Similarly, prevalence estimates for the same countries were 20.8%, 21.5%, 21.1%, 19.3% and 22.2%, 24.5%, 12.8%, and 17.2%. The resulting AF estimates for these same countries were 14.7, 15.5, 16.3, 16.5, 17.3 and 16.9, 19.9, 10.6, and 14.7. Overall AF estimates were surprisingly similar across the Americas with Mexico having the smallest and Brail the largest attributable fraction estimates. Each of the component estimates, prevalence rate and RR, as well as the AF can have important implications for alcohol policy.