Interaction of marijuana and alcohol on fatal motor vehicle crash risk: a case–control study

被引：51
作者：
Chihuri S. [1 ,2 ]
Li G. [1 ,2 ,3 ]
Chen Q. [4 ]
机构：
[1] Center for Injury Epidemiology and Prevention, Columbia University Medical Center, 622 West 168th St, PH5-505, New York, 10032, NY
[2] Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY
[3] Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
[4] Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
来源：
Injury Epidemiology | / 4卷 / 1期
关键词：
Accidents; Alcohol; Case–control studies; Drug interaction; Marijuana; Motor vehicles; Safety; Traffic;
D O I：
10.1186/s40621-017-0105-z
中图分类号：
学科分类号：
摘要：
Background: Concurrent use of marijuana and alcohol in drivers is of increasing concern but its role in crash causation has not been well understood. Methods: Using a case–control design, we assessed the individual and joint effects of marijuana and alcohol use on fatal crash risk. Cases (n = 1944) were drivers fatally injured in motor vehicle crashes in the United States at specific times in 2006, 2007 and 2008. Controls (n = 7719) were drivers who participated in the 2007 National Roadside Survey of Alcohol and Drug Use by Drivers. Results: Overall, cases were significantly more likely than controls to test positive for marijuana (12.2% vs. 5.9%, p < 0.0001), alcohol (57.8% vs. 7.7%, p < 0.0001) and both marijuana and alcohol (8.9% vs. 0.8%, p < 0.0001). Compared to drivers testing negative for alcohol and marijuana, the adjusted odds ratios of fatal crash involvement were 16.33 [95% confidence interval (CI): 14.23, 18.75] for those testing positive for alcohol and negative for marijuana, 1.54 (95% CI: 1.16, 2.03) for those testing positive for marijuana and negative for alcohol, and 25.09 (95% CI: 17.97, 35.03) for those testing positive for both alcohol and marijuana. Conclusions: Alcohol use and marijuana use are each associated with significantly increased risks of fatal crash involvement. When alcohol and marijuana are used together, there exists a positive synergistic effect on fatal crash risk on the additive scale. © 2017, The Author(s).
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