Drinking patterns and alcohol-related injury in the emergency department in three Asian countries

Background: While drinking in the event is an important factor in injury occurrence, pattern of usual drinking may also be important in risk of injury.  Methods: Alcohol-related injury is examined using Hierarchical Linear models, taking into account individual usual volume of consumption over the past 12 months, as well as aggregate-level detrimental drinking pattern (DDP) and alcohol policy measures, in a sample of 5986 injured patients across 26 emergency department sites in China, Korea, and Taiwan, comprising three collaborative studies on alcohol and injury, all of which used a similar methodology.  Alcohol-related injury was measured, separately, by self-reported drinking within six hours prior to injury, a positive BAC and self-reported causal attribution of injury to drinking.  Results: While individual usual volume strongly predicted an alcohol-related injury, usual drinking pattern also predicted an alcohol-related injury (controlling for volume), with episodic heavy and frequent heavy drinking both more predictive of alcohol-related injury than other drinking patterns. When individual usual volume and drinking pattern were controlled, DDP was no longer a significant predictor of alcohol-related injury. Alcohol policy measures were also found to be predictive of alcohol-related injury (the stronger the policy the lower the rates of alcohol-related injury). Conclusions: While individual-level and societal-level drinking patterns may be difficult to influence by preventive measures to reduce alcohol-related injury, alcohol control policy appears to be an important area for future exploration.