Risk of violence-related injury from alcohol consumption and its burden to society in Latin America and the Caribbean

Objective. To determine the relative risk (RR) and societal burden of injury related to alcohol-attributable intentional interpersonal violence (alcohol-attributable fraction or AAF), and the dose-response relationship, in Latin America and the Caribbean (LAC), where both the RR and AAF for violence-related injuries are believed to be particularly high. Methods. A probability sample of 1 024 emergency department patients from 10 LAC countries who reported an intentional interpersonal violence-related injury (IVRI) was analyzed using case-crossover fractional polynomial analysis of the number of drinks consumed prior to the event. Results. A dose-response relationship with a sixfold increase in risk (RR = 5.6) for up to two drinks prior to injury was observed. Risk was higher for 1) females versus males at more than 10 drinks and 2) males and females 30+ years old versus those younger than 30 at all volume levels. Overall, 32.7% of the 1 024 intentional IVRIs were attributable to alcohol. The AAF was three times larger for males (38%) than for females (12.3%). Conclusions. A dose-response relationship between the volume of alcohol consumed prior to the event and the risk of intentional IVRI was found. Risk was not uniform across gender or age. Females were at greater risk of injury compared to males at higher volumes of drinking but had a lower AAF due to their lower prevalence of drinking at higher levels.