Abstract
Objective. Road injuries are the leading injury-related cause of death among people aged 15-44. A clear dose-effect relationship has been demonstrated for drug and alcohol use and road traffic accidents. The objective of our study was to estimate the prevalence of drug and/or alcohol use in subjects admitted for road traffic accidents to an Emergency Department.
Methods. In this study, conducted between January and April
2006, 100 patients of both sexes (age 18-65) examined after
road traffic accidents were consecutively enrolled. A commercial
rapid urine test was used to detect drugs by the Emergency
Department staff. The alcohol concentration was determined
from a blood sample at the central laboratory.
Results. Most of the patients were drivers under 35 years of age.
67/100 road traffic accidents occurred at the weekend (Friday-
Sunday), nearly 60% between 24:00-09:00 hrs; on non-weekend
days about 80% of road traffic accidents were recorded between
14:00-24:00 hrs (p inf. 0.0001). With the alcoholemia test and
urine test for drugs detection 43/100 patients showed a single
or multiple positivity. Alcohol and drug presence is relevant
during the weekend (37/43 cases), in contrast with non weekend
(6/43 cases) [OR 3.04 (95% CI 1.43; 6.46)]. Alcohol was
the most frequently detected abuse substance (72%), followed
by benzodiazepines (42%), tetrahydrocannabinol (21%) and
cocaine (14%).
Discussion. 43% of patients examined were under the influence
of psychotropic substances (alcohol, drugs or both). The
greater part of road traffic accidents in positive test patients
occurred during the week-end, in particular during the late
night/early morning hours, probably after recreational time.
The high incidence of alcohol and/or drug abuse may have
caused physical and/or psychological problems, therefore the
high number of road traffic accidents, especially if taken in
combination.
Conclusion. The rapid urine test used cannot represent a diagnosis,
and requires a confirmation test. It can be used for medical
purposes as an easy and fast preliminary response which
enables a faster diagnostic and therapeutic guideline, but it
cannot be used for sanctions. Further studies are advisable with
an increase of number of patients, in a wider temporal range,
including control subjects, and using confirmation tests.
