title: On-Premise Alcohol Establishments and Ambulance Calls for Trauma, Assault, and Intoxication.
abstract: Alcohol contributes to intentional and unintentional injury. We explored on-premise licensed alcohol establishments (LAEs) and emergency medical service (EMS) ambulance calls.We completed a retrospective population-based study in the Region of Peel, Ontario, 2005 to 2014, where alcohol sales are tightly regulated and healthcare is universally available. We included participants age ≥ 19 years. Longitude-latitude coordinates of all 696 LAEs and all 267,477 EMS ambulance calls were ascertained, and then assigned to 1 of 1568 dissemination areas (DA) in Peel. Relative risks (RRs) described the association between density of on-premise LAEs (by DA deciles) and the rate of EMS calls, adjusted for material deprivation, and density of beer/liquor stores in each DA.There was a curvilinear relation between LAE density and EMS calls for trauma, rising from 45.3 per 1000 in DAs with no LAEs to 381.0 per 1000 in decile-10 (adjusted RR 7.83, 95% confidence interval [CI] 6.15-9.97). This relation was more pronounced for alcohol-focused LAEs, and highest among younger males. Calls for assault (RR 2.67, 95% CI 1.26-5.65) and intoxication (RR 4.00, 95% CI 1.41-11.38) were more likely on the last day of the month and the day thereafter, compared to 1 week prior. At 02:00 hours, when LAEs must stop selling alcohol, there was a considerable rise in assault-related calls in DAs with LAE but not in DAs without LAEs.On-premise LAEs contribute to EMS calls for trauma and assault, especially among young males, around last call, and when monthly pay cheques are cashed.
authors.affiliation: From the Department of Medicine, St. Michael's Hospital, University of Toronto (JGR); Sunnybrook Centre for Prehospital Medicine, Sunnybrook Health Science Centre (LT, BR); Centre for Research on Inner City Health, St. Michael's Hospital (PG, FIM, ALP); and University of Toronto (EB), Toronto, Ontario.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Ray
authors.forename: Linda
authors.initials: L
authors.lastname: Turner
authors.forename: Piotr
authors.initials: P
authors.lastname: Gozdyra
authors.forename: Flora I
authors.initials: FI
authors.lastname: Matheson
authors.forename: Burgess
authors.initials: B
authors.lastname: Robert
authors.forename: Emily
authors.initials: E
authors.lastname: Bartsch
authors.forename: Alison L
authors.initials: AL
authors.lastname: Park
mesh_terms: D000328:Adult; D000434:Alcoholic Beverages; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D000552:Ambulances / Q000706:statistics & numerical data*; D003132:Commerce / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult