Hangovers and Traffic Injuries: Is Alcohol's Influence Greater Than Expected?

宿醉和交通伤害：酒精的影响是否比预期更大？

• 批准号: 8460877
• 负责人: Gordon Stephen Smith
• 金额: $ 50.87万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8460877
• 关键词: Acute; Admission activity; Alcohol abuse; Alcohol consumption; Alcoholic Intoxication; Alcoholism; Alcohols; Beverages; Biological Assay; Biological Markers; Blood; Blood alcohol level measurement; Cessation of life; Clinical assessments; Critical Care; Cross-Over Studies; Data Analyses; Data Sources; Death Records; Development; Disease; Documentation; Elderly; General Population; Glucuronides; Goals; Heavy Drinking; High Prevalence; Hospitals; Impairment; Individual; Injury; Interview; Intoxication; Lead; Link; Maryland; Medical Examiners; Methods; Monitor; Motor Vehicles; Patient Self-Report; Patients; Pattern; Performance; Pharmaceutical Preparations; Police; Policies; Population Attributable Risks; Positioning Attribute; Prevalence; Prevention; Preventive Intervention; Procedures; Regulation; Reporting; Research; Residual state; Risk; Risk Factors; Role; Safety; Shock; Stratification; Symptoms; Systems Analysis; Technology Assessment; Testing; Time; Transportation; Trauma; Universities; Urine; Variant; Vehicle crash; Work; Workplace; alcohol effect; alcohol involvement; alcohol related problem; alcohol screening; case control; clinical practice; college; diethyl sulfate; drinking; drinking behavior; experience; hangover; hazardous drinking; high risk; improved; injured; injury prevention; innovation; instrument; intervention program; medical schools; new technology; novel; patient population; prevent; programs; public health relevance; research study; screening; sobriety; substance abuse prevention; substance abuse treatment; tool; trafficking; trauma centers

DESCRIPTION (provided by applicant): Hangover symptoms and other residual effects of intoxication (hence-forth called residual effects) may be an important but poorly recognized risk factor in many injuries. The long term goal of this study is to reduce alcohol-related injuries through expanding the understanding of alcohol's role in injury risk to also include residual effects of intoxication. We intend to use this information for preventing further injuries and/or hazardous drinking by including recent intoxication assessments as part of routine screening programs for alcohol problems in critical care. We will identify and quantify the role of residual effects in traffic injuries by assessing biomarkers of recent alcohol consumption in urine among Motor Vehicle Crash (MVC) drivers admitted to the University of Maryland R. Adams Cowley Shock Trauma Center (STC) as well as all driver deaths from the medical examiner for the entire state of Maryland for 4 years. This study is an innovative use of two alcohol consumption biomarkers, ethyl glucuronide (EtG) and ethyl sulfate (EtS) in urine as indicators of residual effects even when blood alcohol is zero. The specific hypotheses behind the proposed research are: 1) impairment from residual effects of intoxication increases the risk of traffic injuries; and 2) the prevalence of residual effects of intoxication is elevated among those injured drivers with a zero BAC who were responsible for causing their crash compared to those determined not responsible. Aim 1 defines the quantitative relationship between biomarkers for residual effects, self-reported recent drinking behavior and alcohol problems, time of last drink, and symptom scores from the validated "Hangover Scale" among drivers able to be interviewed in hospital. Interviews will include information on current drinking patterns, CAGE, and hangover symptoms and linked to biomarker results to cross-validate the EtG/EtS estimates of residual effects. Drinking patterns including the place of last drink will also be conducted. Aim 2 quantifies risk factors for injury associated with residual effects using a case-crossover study among interviewed patients. This case-control variant compares drinking during the day immediately prior to the injury (case period) with drinking on the same day the preceding week (control) and can estimate injury risks associated with residual effects. Testing for other drugs allows stratification of results by presence or absence of drugs causing impairment. Aim 3 identifies the extent to which injured zero BAC drivers with biomarker evidence of residual effects are likely to be responsible for causing their crash, compared with zero-BAC drivers without biomarker evidence. This risk factor study involves linkage with police crash reports. Aim 4 determines the prevalence of elevated biomarkers for recent alcohol consumption among BAC zero MVC admissions and deaths. Aim 5 establishes the contribution of residual effects to all alcohol-involved serious MVC injuries and deaths and seeks to improve estimates of the alcohol-attributable fraction for traffic injuries. This novel use of biomarkers provides an unparalleled opportunity to advance understanding of the expanded role of alcohol in traffic injuries.

描述（由申请人提供）：宿醉症状和其他中毒残留效应（以下称为残留效应）可能是许多伤害中一个重要但尚未得到充分认识的危险因素。这项研究的长期目标是通过扩大对酒精在伤害风险中的作用的理解来减少酒精相关的伤害，也包括中毒的残留效应。我们打算将这些信息用于预防进一步的伤害和/或危险饮酒，将最近的中毒评估作为重症监护酒精问题常规筛查计划的一部分。我们将通过评估马里兰大学R. Adams Cowley休克创伤中心（STC）接收的机动车碰撞（MVC）驾驶员近期尿液中酒精消耗的生物标志物，以及整个马里兰州4年来法医提供的所有驾驶员死亡数据，来确定和量化残留效应在交通伤害中的作用。这项研究创新性地使用了尿液中的两种酒精消耗生物标志物，即葡萄糖醛酸乙酯（EtG）和硫酸乙酯（EtS），作为血液酒精含量为零时残留效应的指标。该研究的具体假设是：1)醉酒残留效应导致的损伤增加了交通伤害的风险；2)与那些被确定为不负责任的受伤司机相比，那些酒精浓度为零的受伤司机中中毒残留效应的患病率升高。目的1定义了残留效应的生物标志物、自我报告的近期饮酒行为和酒精问题、最后一次饮酒的时间和经过验证的“宿醉量表”的症状评分之间的定量关系，这些评分来自能够在医院接受采访的司机。访谈将包括当前饮酒模式、CAGE和宿醉症状的信息，并与生物标志物结果相关联，以交叉验证EtG/EtS对残留影响的估计。喝酒的方式，包括最后喝酒的地点也会被记录下来。目的2通过对受访患者进行病例交叉研究，量化与残留效应相关的损伤危险因素。这个病例对照变量比较了受伤前一天（病例期）和前一周同一天（对照组）的饮酒情况，并可以估计与残余影响相关的伤害风险。对其他药物的检测可以根据是否存在导致损伤的药物对结果进行分层。目标3确定与没有生物标志物证据的零BAC驾驶员相比，有残留影响生物标志物证据的受伤零BAC驾驶员可能对造成车祸负责的程度。这项风险因素研究涉及到与警方撞车报告的联系。目的4确定BAC零MVC入院和死亡中近期饮酒生物标志物升高的流行程度。目标5确定了残留效应对所有与酒精有关的MVC严重伤害和死亡的贡献，并力求改进对酒精导致的交通伤害比例的估计。这种生物标记物的新应用为进一步了解酒精在交通伤害中的作用提供了前所未有的机会。