Prevalence of alcohol and drugs in urine of patients involved in road accidents.
OBJECTIVE
Road injuries are the leading injury-related cause of death among people aged 15-44. A clear dose-effect relationship has been demonstrated for drug and alcohol use and road traffic accidents. The objective of our study was to estimate the prevalence of drug and/or alcohol use in subjects admitted for road traffic accidents to an Emergency Department.


METHODS
In this study, conducted between January and April 2006, 100 patients of both sexes (age 18-65) examined after road traffic accidents were consecutively enrolled. A commercial rapid urine test was used to detect drugs by the Emergency Department staff The alcohol concentration was determined from a blood sample at the central laboratory.


RESULTS
Most of the patients were drivers under 35 years of age. 67/100 road traffic accidents occurred at the weekend (Friday-Sunday), nearly 60% between 24:00-09:00 hrs; on non-weekend days about 80% of road traffic accidents were recorded between 14:00-24:00 hrs (p < 0.0001). With the alcoholemia test and urine test for drugs detection 43/100 patients showed a single or multiple positivity. Alcohol and drug presence is relevant during the weekend (37/43 cases), in contrast with non weekend (6/43 cases) [OR 3.04 (95% CI 1.43; 6.46)]. Alcohol was the most frequently detected abuse substance (72%), followed by benzodiazepines (42%), tetrahydrocannabinol (21%) and cocaine (14%).


CONCLUSIONS
43% of patients examined were under the influence of psychotropic substances (alcohol, drugs or both). The greater part of road traffic accidents in positive test patients occurred during the week-end, in particular during the late night/early morning hours, probably after recreational time. The high incidence of alcohol and/or drug abuse may have caused physical and/or psychological problems, therefore the high number of road traffic accidents, especially if taken in combination.


CONCLUSIONS
The rapid urine test used cannot represent a diagnosis, and requires a confirmation test. It can be used for medical purposes as an easy and fast preliminary response which enables a faster diagnostic and therapeutic guideline, but it cannot be used for sanctions. Further studies are advisable with an increase of number of patients, in a wider temporal range, including control subjects, and using confirmation tests.
Toxicology Unit, Emergency Department, Verona Hospital (OCM), Verona, Italy.
G
G
Ricci
S
S
Majori
W
W
Mantovani
A
A
Zappaterra
G
G
Rocca
F
F
Buonocore
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D002492:Central Nervous System Depressants / Q000097:blood; D004635:Emergency Medicine; D000431:Ethanol / Q000097:blood; D005260:Female; D006761:Hospitals; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000652:urine; D016482:Urinalysis
D002492:Central Nervous System Depressants; D011619:Psychotropic Drugs; D000431:Ethanol