Michelle Hobday

The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010

BACKGROUND AND AIMS Few studies have investigated the combined effects of alcohol sales, outlet numbers and trading hours on alcohol-related harms. This study aimed to test whether associations: (i) exist between alcohol-related emergency department (ED) injuries and alcohol sales and counts of outlets; (ii) vary between on- and off-premises outlets; and (iii) vary by trading hours conditions [extended trading permits (ETP) versus standard hours]. DESIGN Panel study using 117 postcodes over 8 years (2002-10): 936 data points. SETTING Perth, Australia. PARTICIPANTS ED injury presentations, aggregated to postcode-level. MEASUREMENTS Alcohol-related injuries were identified using time-based surrogate measures: night injuries (n=51,241) and weekend night injuries (n=30,682). Measures of alcohol availability included number of outlets with standard and extended trading hours and mean sales per postcode. Negative binomial regression modelling with random effects was used to examine associations between availability and alcohol-related injury, controlling for socio-demographic characteristics. FINDINGS (i) Night injuries were associated significantly with counts of on-premises outlets [incident rate ratio (IRR)=1.046; 95% confidence interval (CI)=1.014-1.078] and sales per off-premises outlet (IRR=1.019; 95% CI=1.004-1.035); (ii) counts of on-premises outlets were positively associated with alcohol-related injury while counts of off-premises outlets indicated a negative association; and (iii) weekend night injuries increased by about 5% per on-premises outlet with an ETP (IRR=1.049; 95% CI=1.015-1.084) and by less than 1% for outlets with standard trading hours (IRR=1.008; 95% CI=1.004-1.013). CONCLUSIONS Regions of Perth, Australia with greater off-premises alcohol sales and counts of on-premises alcohol outlets, particularly those with extended trading hours, appear to have higher levels of alcohol-related injuries.

A Population-Based Study Examining Injury in Older Adults with and without Dementia

To estimate the incidence of and risk factors for injuries in older adults with and without dementia.

Associations between alcohol outlets and emergency department injury presentations: effects of distance from the central business district.

Objective: To examine the effects of licensed outlets and sales on levels of alcohol‐related injuries presenting to emergency departments (EDs) in the Inner, Middle and Outer postcode zones of Perth, Australia.

Alcohol and non-alcohol-related motor vehicle crashes in Perth, Australia: Do alcohol outlets make a difference?

This study examined the effects of distance from alcohol outlets to motor vehicle crashes across the Perth metropolitan area. A retrospective population-based study was undertaken using measures of alcohol- and non-alcohol-related crashes, and their proximity to alcohol outlets, using a geographic information system. Two logistic regression models were developed with the following outcomes: i) crashes including drivers with BAC ≥ 0.05%, and ii) weekend single vehicle night-time crashes, a surrogate measure of alcohol-related crashes. The surrogate measures of non-alcohol-related crashes for these models were all day-time and single vehicle day-time crashes respectively. The major predictors of alcohol-related crashes were number of on-premise outlets and bottleshops in buffer zones up to 2 km, 2 km-5 km, 5 km-10 km and 10 km-20 km from crashes. The distance from the central business district (CBD) and sociodemographic factors were controlled for. The study included 341,467 crashes that occurred between 2005 and 2015. The highest crash incidence rates occurred in the CBD. The statistical models indicated that crashes with a higher number of on-premise outlets in adjacent buffer zones were more likely to be alcohol-related than non-alcohol-related crashes. Crashes with a higher number of on-premise outlets less than 2 km, 2 km-5 km, 5 km-10 km, and 10 km-20 km from the crashes were significantly more likely to be weekend single vehicle night-time crashes than day-time crashes (OR = 1.014; 95% CI:1.002-1.027, OR = 1.022; 95% CI:1.014-1.029, OR = 1.019; 95% CI:1.014-1.024, and OR = 1.017; 95% CI:1.014-1.020 respectively). There was some evidence that crashes with lower number of bottleshops in adjacent buffer zones were more likely to be alcohol-related crashes, although this was not consistent across both models and all buffer zones. When other predictors were controlled for, alcohol-related crashes were more likely to occur further from the CBD, than in the CBD. Recommendations about the timing and location of roadside alcohol testing are made.

Identification of high risk metropolitan intersection sites in Perth, Australia

As convergence points for road users approaching from multiple directions, intersections have more opportunities for conflicts, thus higher crash risk than other parts of the road network. Given the limited resources available for road safety, it is important to identify high risk intersections so that they can be prioritised for infrastructure improvement. This study used a three-stage approach to identify intersections in Perth, Western Australia: using Road Trauma Risk Analysis, then Comparative Safety Performance Analysis and finally ranking the intersections by the KSI (Killed and Serious Injury) metric. These methodologies were developed by Main Roads Western Australia. Crash data from 2011 to 2015 were used in the analyses. The results identify the top high risk intersections for each intersection type (by speed environment and control type). Recommendations are made for extensions to this process to improve identification of high risk intersections, and the use of a taxonomy to identify candidate treatments.

The effect of price increases on predicted alcohol purchasing decisions and choice to substitute

Abstract Introduction: Few studies have undertaken to explore whether people who consume particular alcoholic beverages have a greater tendency to substitute with cheaper alcohol in response to price increases. The aim of this study was to investigate the effect of price increases on alcohol purchasing decisions, specifically the influence on brand and cross-beverage substitution across demographic, drinking level and socio-economic factors. Method: Data on participants’ alcohol purchasing habits and consumption were collected via an online survey, including their reactions to three price increases to alcoholic beverages types previously purchased. Data were analysed using logistic regression, with substitution behaviour the dependent variable, controlling for demographic and socio-economic factors. Results: Responses to different price increases varied by drinking level, which was consistently and significantly associated with likelihood of substitution behaviour across beverage types. For a 50% increase in price, regardless of whether participants purchased beer, wine, bottled spirits or premixed spirits, drinking at levels which put participants at high risk of short-term harms was associated with a higher likelihood of substitution with cheaper brands or beverage types (OR: 1.729; OR: 1.787; OR: 1.729 and OR: 1.729, respectively). Conclusions: No consistent trends in responses occurred according to respondent characteristics, suggesting that increasing price may be an effective tool to influence purchasing behaviour across the population. Results also suggested that those who drink at levels which put them at high risk of short-term harms may be more likely to circumvent price increases by switching to a cheaper product.