Alcohol misuse and traffic accidents

In their Review (Dec 23/30, p 2231),1 Marc Moss and Ellen Burnham highlight the effect of alcohol abuse on inpatients who need admission to the intensive care unit. In our opinion, however, they paid little attention to the effect of alcohol intake on trauma caused by traffic accidents. Alcohol-impaired driving is a serious threat to health. In the USA, despite the significant reduction in alcohol-related traffic crashes in the past two decades, 40% of traffic deaths and 9% of traffic injuries are alcohol-related.2 Similarly, in the European Union, 30–50% of traffic accidents are related to alcohol intake.3 A prospective study4 that enrolled 2354 patients admitted to an Italian emergency department for an injury caused by a traffic crash showed that the blood alcohol concentration was above the legal limit (0·5 g/L) in 25·7% of them. Also, the proportion of patients “over the limit” increased progressively (from 14·4% to 30·8%) with trauma severity, and almost 30% of patients with multiple trauma were over the limit. Alcohol misuse still remains a paramount risk factor for hospital admission due to road accidents, and physicians have a great opportunity in this setting: a single warning to avoid alcohol intake before driving can reduce physical injuries and the associated medical costs caused by this risky behaviour.5