Alcohol consumption and fatal accidents

Major new research carried out in Canada shows a strong connection between alcohol trauma, including traffic accidents, and per capita consumption.

Published recently in Addiction*, the work by Ole-Jorgen Skog of the Centre for Advanced Study, the University of Oslo, studied data covering almost fifty years from all the provinces of Canada. Skog shows that the increase in the consumption of alcohol by Canadians over the second half of the twentieth century has had a major effect on most types of fatal accidents. He further shows that this is comparable with Europe over the same period.

These findings are particularly important at the moment, especially in countries like the United Kingdom and Australia which are formulating national alcohol strategies and, at least in the case of the former, the government has "set its face" against a population-based alcohol policy, in the words of one Health Department official.

In an editorial in the edition of Addiction in which Professor Skog's work is published, Howard Holder of the Pacific Institute of Research and Evaluation based at Berkeley, California, says: "The evidence is now clear that countries with high per capita alcohol consumption have higher rates of alcohol harm and countries with lower per capita alcohol consumption have lower rates of harm. The scientifically demonstrated effects of higher retail alcohol prices, limits on hours and days of alcohol sales and limits on alcohol purchasing ages have confirmed both the importance and relevance of a public health approach to alcohol policy."

Professor Skog's previous work in Europe indicated much the same relationship between per capita consumption and accidents (5.2 deaths per 100,000 inhabitants as opposed to the 5.9 he found in Canada). In Southern and Central Europe it was found that there was a stronger link between alcohol and traffic accidents than other types of accident, whereas in Northern Europe this was reversed. Skog's explanation for this phenomenon is that there is stronger compliance with national drink-driving laws in northern than in southern Europe.

"The Canadian data," says Professor Skog, "seem to suggest that alcohol is quite strongly associated with both types of accidents. This might suggest that Canadian drinking patterns are closer to the ones found in Northern Europe, while at the same time Canada does not profit from the same level of compliance with BAC [blood alcohol concentration] laws. If this is correct, Canada may be combining 'the worst of two worlds' in respect to alcohol related accidents."

Accident mortality rates were stable for Canadian men until the middle of the 1970s and began to decline thereafter. If the observed association between alcohol consumption and fatal accidents is causal, there is an explanation for this trend.

Alcohol consumption in Canada was increasing until the middle of the 1970s and "pulled in the direction of increasing accident mortality rates. This force apparently was counterbalanced by other forces, pulling in the opposite direction, towards reduced mortality (e.g. different sorts of accident prevention measures).

Consequently, fatal accident rates did not change greatly. When alcohol consumption started to decrease towards the end of the 1970s both forces were pulling in the same direction, and accident mortality rates started to decrease."

It appears, therefore, that alcohol consumption is an important factor in explaining the changes in accidents rates over a period of time. Of course, differing drinking patterns – as those between Northern and Southern Europe, for example – are also important. It is crucial, as Professor Skog implies, that further studies are carried out – some have already been implemented – into how specific measures, such as the price of alcohol, can have the desired effect on accident rates. Given the increased penetration of alcohol marketing in the developing world and the culture of youth binge drinking elsewhere, the issue requires urgent attention if governments are to avoid marked increases in fatal accidents resulting from alcohol consumption.

* Alcohol consumption and fatal accidents in Canada, 1950-98, Ole-Jorgen Skog, Centre for Advanced Study, The Norwegian Academy of Science and Letters, the Department of Sociology, University of Oslo, Norway, Addiction, Volume 98, Number 7, July, 2003.