A Cross-national Meta-analysis of Alcohol and Injury: Data from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP)

Aims: To examine the relationship of acute alcohol consumption with an injury compared to a non-injury event in the emergency room across ERs in five countries.

Design: Meta-analysis was used to evaluate the consistency and magnitude of the association of a positive blood alcohol concentration (BAC) at the time of arrival in the ER and self-reported consumption within 6 hours prior to the event with admission to the ER for an injury compared to a non-injury, and the extent to which contextual (socio-cultural and organizational) variables explain effect sizes.

Findings: When controlling for age, gender and drinking five or more drinks on an occasion at least monthly, pooled effect size was significant and of a similar magnitude for both BAC and self-reported consumption, with those positive on either measure over half as likely again to be admitted to the ER with an injury compared to a medical problem. Effect sizes were found to be homogeneous across ERs for BAC, but not for self-report. Trauma center status and legal level of intoxication were positively predictive of self-reported consumption effect size on injury.

Conclusions: These data suggest a moderate, but robust association of a positive BAC and self-report with admission to the ER with an injury, and that contextual variables also appear to play a role in the alcohol-injury nexus.