title: Alcohol intake, marijuana use, and sleep deprivation on the risk of falls occurring at home among young and middle-aged adults: a case-crossover study.
abstract: OBJECTIVE
  This study investigated whether hospitalised fall-related injuries among young and middle-aged adults were associated with short term effects of alcohol intake, marijuana use and sleep deprivation.
  
  
  METHODS
  A case-crossover design was used to study 690 adults (aged 20 to 64 years) admitted to public hospitals within 48 hours of a fall-related injury, occurring at home, in three regions of New Zealand during August 2008 to December 2009. A matched-pair interval method of analysis was used to compare alcohol intake, marijuana use and sleep deprivation before the event with similar information in two control periods: 24 hours-before and 1 week-before the time of injury.
  
  
  RESULTS
  After adjustment for other paired exposures, the estimated risk of injury was substantially higher after consuming alcohol within the preceding 6 hours, with a dose response gradient. After adjusting for confounding variables, the data did not support a significantly elevated risk of fall-related injury associated with sleep deprivation (<6 hours sleep in the preceding 24 hours), or marijuana use in the preceding 3 hours.
  
  
  CONCLUSIONS
  The findings support the expansion of efforts to reduce the harmful effects of alcohol intake in the home environment.
authors.forename: Simon
authors.initials: S
authors.lastname: Thornley
authors.affiliation: Section of Epidemiology and Biostatistics, The University of Auckland, Tamaki Campus, 261 Morrin Road, Glen Innes, Auckland 1072, New Zealand. b.kool@auckland.ac.nz.
authors.forename: Bridget
authors.initials: B
authors.lastname: Kool
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Marshall
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D018592:Cross-Over Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D008875:Middle Aged; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications*; D055815:Young Adult