title: Hazardous birthday drinking among young people: population-based impacts on emergency department and in-patient hospital admissions.
abstract: OBJECTIVE
  There is growing concern about the possible adverse health impacts of binge drinking during birthday celebrations among adolescents and young adults. We estimate the impacts of birthday alcohol use on adolescent and young adult in-patient/emergency department (ED) hospital admissions.
  
  
  METHODS
  We employed Autoregressive Integrated Moving Average (ARIMA) intervention analysis to assess whether the rate of ICD-10 alcohol-use-disorder (AUD) events per 1000 in-patient/ED admissions increased significantly during birthday weeks.
  
  
  METHODS
  All in-patient/ED admissions in Ontario, Canada from 1 April 2002 to 31 March 2007.
  
  
  METHODS
  Individuals aged 12-30 years.
  
  
  METHODS
  AUD events per 1000 in-patient/ED admissions by age in weeks.
  
  
  RESULTS
  Multiple increases were found. The largest occurred during the birthday week of 19 years of age, the beginning of the minimum legal drinking age (MLDA) in Ontario: AUD admission rates increased (spiked) by 38.30 per 1000 total admissions [95% confidence interval (CI) = 34.66-41.94] among males (a 114.3% increase over baseline), and by 28.13 (95% CI = 25.56-30.70) among females (a 164.0% increase). Among both genders, the second largest birthday-week spikes occurred during ages 20-22 years, followed by somewhat lower but still pronounced birthday-week spikes during ages 23-26 years and 30 years (all these spikes: P < 0.05). Birthday-week spikes occurred as early as age 16 years for males and 14 years for females (both spikes: P < 0.05).
  
  
  CONCLUSIONS
  There appears to be an increase in alcohol-related adverse events from drinking around the time of one's birthday among young adults in Canada.
authors.affiliation: Northern Medical Program, University of Northern British Columbia (UNBC), Prince George, British Columbia, Canada; Human Brain Laboratory, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Callaghan
authors.forename: Marcos
authors.initials: M
authors.lastname: Sanches
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Gatley
authors.forename: Lon-Mu
authors.initials: LM
authors.lastname: Liu
authors.forename: James K
authors.initials: JK
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000328:Adult; D000846:Anniversaries and Special Events; D063425:Binge Drinking / Q000453:epidemiology*; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D055815:Young Adult
keywords: Adolescents; alcohol; binge drinking; birthday celebrations; emergency department; hospitalization; morbidity