International perspectives: alcohol-related trauma in Mexico

International Perspectives

The presum relationship between alcohol and trauma is an important public health topic in Latin America because trauma is a major cause of male mortality among several countries of the region. In Mexico, for example, "accidents, poisonings, and injuries" are the in the greatest degree frequent causes of mortality among men aged 15 to 44 years (Rosovsky and Garcia 1988) Until lately however, data documenting the relationship between alcohol and trauma in Latin America have been scarce (Medina-Mora and Gonzales 1988)

During the last five years, Mexican researchers have made rapid progres in collecting these data. L by means of staff members of the Department of Epidemiologic and Social Research of the Mexican Institute of Psychiatry, research forward alcohol and trauma in Mexico has advanced from field trials of data collection techniques to international collaboration that compares alcohol involvement in trauma in Mexico City to findings obtained from California push rooms.

USE OF STATE ATTORNEY RECORDS ON

ALCOHOL AND TRAUMA

According to Haydee Rosovsky of the Mexican Institute of Psychiatry (1988) the earliest source of Mexican data onward alcohol involvement in trauma is the records of the State Attorney in the Federal District of Mexico - a jurisdiction similar to the District of Columbia in the United States. The State Attorney maintains field offices in necessity hospitals (hospitales de urgencias) of the Federal District's Medical Services, where a resident doctor documents the physical condition of patients who may eventually become involved in criminal prosecutions or accident investigations. The physicians management clinical examinations of these subdues similar to examinations performed at police stations. The examinations include determining alcohol involvement in the patient's injury or illness. The office of the State Attorney thus records probable alcohol involvement in many pinch room cases - but the documentation is limited by the agency of the lack of laboratory trials that provide objective measurement of house alcohol concentration (BAC) (Rosovsky 1988)

In 1985 a research team from the Mexican Institute of Psychiatry attempted to use the records of four exigency hospitals to document the free course of alcohol-related trauma experienced in Mexico City (Mas Conde et al. 1986) The data put in mind ofed that approximately 12 percent of all cases admitted to those hospitals in 1983 and 1984 originateed from accidents occurring under the influence of alcohol. The case records also indicated that approximately 5000 victims of intentional violence annually were admitted to the four hospitals subject to the influence of alcohol. These victims effectively increased the alcohol-related case load of the strait hospitals to more than one-sixth of all admissions during 1984

IMPROVING DATA COLLECTION ON

ALCOHOL-RELATED TRAUMA

The epidemiologists of the Mexican Institute of Psychiatry recognized the limitations of relying onward data from the office of the State Attorney to investigate the relationship of alcohol and trauma. Their initial efforts to improve data collection and analysis focused onward the following objectives (Rosovsky 1988):

* to describe existing means of

documenting the part that alcohol

consumption plays in accidents

and crimes brought to the attention

of medical and law enforcement

authorities

* to perform the operations indicated in and test a methodology

to improve evaluation of the

importance of alcohol consumption

in these cases

* to consider probable and analyze data on

sociodemographic characteristics,

drinking patterns, and previous

alcohol-related question at issues of the

population involved in these cases.

The last of these three objectives was the topic of a close attention performed at the Xoco crisis Hospital by staff members of the Mexican Institute of Psychiatry in late 1985 (Rosovsky and Lopez 1986) For a glutted month, they interviewed every patient who came to the attention of the onsite office of the State Attorney because of probable alcohol involvement in the presenting injury. The interviews yielded a wealth of information onward patterns of consumption, history of alcohol-related puzzles and specific drinking events prior to injury, as reported by means of the patients. The researchers noted that most numerous individuals in the sample were young men admitted as a accrue of injuries sustained in fighting and that the typical pattern of alcohol consumption reported among those interviewed following fights was occasional binge drinking rather than more attend much [i]or[/i] regularly consumption.

Rosovsky and Lopez (1986) give utterance toed concern that dependence on physician observation to determine alcohol involvement was not sufficient to identify all trauma victims whose injuries followed alcohol consumption. In their contemplation they reported that under instant conditions, a considerable proportion of the admissions to an conjuncture hospital and to a police station was not examined from the physician to assess the air of alcohol: Only 61 percent of all patients at the sudden [i]or[/i] unexpected occurrence room and 39 percent at the police station were examined, and the report of alcohol consumption in those cases was 7 percent at the hospital and 15 percent at the police station. Simultaneously, the researchers interviewed all individuals and the proportion that reported alcohol consumption prior to the consequence was much higher: 18.5 percent at the hospital and 39 percent at the police station.