Cross-National Emergency Department Studies Offer Valuable Insight into Alcohol Use and Injuries


This year’s National Public Health Week focuses on injury prevention. Debates on how to best prevent injuries often circle back to alcohol use, which is now widely recognized as an important contributing factor. This is due, in large part, to researchers like Dr. Cheryl Cherpitel, who has been investigating the relationship between alcohol and injury around the world for decades.

Dr. Cherpitel, who is associate director of the Alcohol Research Group at the Public Health Institute, started studying alcohol use and injuries in emergency departments (EDs) almost 30 years ago. She recognized that EDs were a potential data gold mine since many who suffer significant injuries end up in one. The clinical encounters in EDs provide access to a population often difficult to reach.

However, significant barriers existed to using data from EDs to study alcohol-related injuries internationally. Surprisingly few ED studies were conducted and they were largely limited to Western countries. Different study designs and methodologies made it difficult to compare data or draw conclusions across studies.

Cherpitel set out to overcome both barriers. She developed what would later be called the “Cherpitel model” for conducting ED studies on alcohol and injury. Among key features of this model is that probability samples of patients are included so that the data are representative of the emergency department in which they are collected. Patients are asked about their drinking in the six hours before the injury event and an estimate of blood alcohol is taken on arrival at the ED.

Between 1984 and 2002 the Cherpitel model was implemented in seven countries for the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP). In 2000 the World Health Organization adopted the model for their 12-country Collaborative Study on Alcohol and Injuries. Combined, these studies provided an unprecedented body of standardized data on alcohol use and injury from EDs around the world.

Alcohol and Injuries: Emergency Department Studies in an International Perspective summarizes what these studies revealed about how and why the association between alcohol and injury can vary across countries and among individuals. It also highlights efforts to use screening and brief intervention in the ED to reduce harmful drinking.

Use of the Cherpitel model continues to grow. Currently, the National Institute on Alcohol Abuse and Alcoholism and the Pan American Health Organization employ the Cherpitel model in numerous other studies around the world. In fact, Cherpitel is now analyzing data sets from over 96 EDs in 27 countries – a far cry from the initial seven-country ERCAAP.

Countries will continue to grapple with how to prevent injuries long after National Public Health Week is over. Because of researchers like Cheryl Cherpitel, we better understand alcohol’s pernicious association with injury worldwide – and what we can do about it.

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Comment by Anne Sunderland on April 11, 2011 at 11:11am

Estelle- the Alcohol Research Group should be a good resource for this. Also, here's a current example from Maryland:

Proposal to raise sales tax on alcohol among most contentious on Md. Legislature’s Final Days:




Comment by Estelle Menz on April 11, 2011 at 1:13am
I found this article interesting.  Do you know if there is a tax on alcohol in the U.S. or a state in the U.S.?  I 've heard that there is a move afoot to tax soda.  Is it difficult to pass these types of taxes in the U.S?
Comment by Anne Sunderland on April 8, 2011 at 2:58pm
Thanks, Jeff. Absolutely. There's a chapter in Alcohol and Injuries, although not based on Cherpitel's research in EDs, that estimates that 40 percent of alcohol-attributable deaths due to unintentional injuries worldwide were the result of traffic accidents. Forty three percent of alcohol-attributable DALYs due to unintentional injuries were the result of traffic accidents. Great tie-in to your blog post on Wednesday about the increasing public health burden caused by traffic accidents in developing countries.
Comment by Jeff Meer on April 8, 2011 at 12:30pm
Interesting.  It would be good to know if these results also pertain to injuries from drunk driving.  It seems like this would be a major category of alcohol-related injuries.

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