title: Blood alcohol and injury in Bhutan: targeted surveillance in a national referral hospital emergency department.
abstract: Bhutan is a low-middle-income country with poor roads, rapidly increasing motor vehicle use and heavy alcohol consumption. We estimated the proportion of emergency department patients presenting with injury who had positive blood alcohol. We sought to breathalyse and interview all adult patients (≥18 years) presenting with injury at the Jigme Dorji Wangchuck National Referral Hospital in the capital city Thimphu, from April to October 2015. Breath tests and interviews were conducted with 339 (91%) of 374 eligible adult patients. A third (34%) were alcohol-positive and 22% had blood alcohol concentrations >0.08 g/dL. The highest alcohol-positive fractions were for assault (71%), falls (31%) and traffic crashes (30%). Over a third (36%) of patients had a delay of >2 h between injury and breath test. The results underestimate blood alcohol concentrations at the time of injury so the true prevalence of pre-injury alcohol impairment is greater than our estimates suggest. Countermeasures are urgently needed, particularly roadside random breath testing and alcohol controls.
authors.affiliation: School of Medicine & Public Health, University of Newcastle, Newcastle, New South Wales, Australia.|Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan.
authors.forename: Gampo
authors.initials: G
authors.lastname: Dorji
authors.affiliation: Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
authors.forename: Sona
authors.initials: S
authors.lastname: Pradhan
authors.affiliation: Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
authors.forename: Tashi
authors.initials: T
authors.lastname: Tenzin
authors.affiliation: School of Psychology, Deakin University, Geelong, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Miller
authors.affiliation: Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Jennie
authors.initials: J
authors.lastname: Connor
authors.affiliation: School of Medicine & Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Kypros
authors.initials: K
authors.lastname: Kypri
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood* / Q000453:epidemiology*; D001334:Automobile Driving / Q000706:statistics & numerical data*; D001631:Bhutan / Q000453:epidemiology; D000067401:Blood Alcohol Content; D001944:Breath Tests / Q000295:instrumentation; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D000431:Ethanol / Q000097:blood*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors; D014947:Wounds and Injuries / Q000139:chemically induced / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000067401:Blood Alcohol Content; D000431:Ethanol