Fatal Alcohol Poisonings and Traffic Accidents in Russia

IntroductionRoad traffic injuries are the eight leading cause of death globally, and the leading cause of death for children and young adults [1,2]. According to prognosis, the worldwide road traffic injuries rank among the causes of death will climb to the fifth place by 2030, resulting in an estimated 2.4 million fatalities each year [2]. It is estimated that in the European Union 1.3 million road traffic accidents occur each year, resulting in 1.7 million injuries and over 40 000 deaths annually [3]. The direct and indirect costs of these accidents sums up to 160 billion euro, equal to 2% of the gross national product of the EU [2].Alcohol has been identified as one of the most significant risk factors for road traffic crashes in many developed and developing countries of the world [4]. At the individual level, there is dose-response relationship between alcohol consumption and fatal road traffic accidents, with risk of death increas-. ing non-linearly with increasing alcohol consumption [3]. Zador estimated that each 0.02 increase in a driver's BAC nearly doubled the risk of fatal crash [5]. It has been also estimated that the likelihood of being a fatally injured driver was at least 9 times greater at BACs of 0.05 to 0.09% than at zero BAC [4].Several studies report the positive association between alcohol consumption and traffic fatalities at the aggregate level. Skog evaluated the effects of changes in aggregate alcohol consumption on fatal motor vehicle traffic accidents in 14 western European countries after 1950 [6]. For male traffic accidents, significant relationships were uncovered in central and southern Europe, but not in northern Europe. Among females the effect was significant only in central Europe [6]. A more recent time series analysis based on Belarusian data for the period from 1970 to 1999 reported a close link between vodka sales per capita and road traffic fatality rates [7].Russia has one of the world's highest road traffic fatality rates due to drunk driving, poor road conditions, an outdated vehicle fleet [8,9]. Each year, approximately 30 000 Russians die in road accidents - about the same as in the European Union [2]. Road safety has attracted attention at the top levels of Russian politics, receiving mention in Putin's 2006 Annual Address to the Federal Assembly and serves as the centerpiece of a national speech by Medvedev in August 2009 [9].There is common believe that high level of alcohol consumption in conjunction with binge drinking pattern is a major determinant of high violent mortality rates in Russia [7,10-12]. Over the past 10 years, almost 40 000 Russians have died in road accidents caused by drunk drivers [9]. A large retrospective case-control study in three Russian industrial cities found dose-response association between alcohol consumption and mortality from road accidents: drinking of three or more bottles of vodka per week was strongly associated with deaths from road accidents both among men (RR= 4.20; CI: 3.31-5.34) and women (RR= 4.48; CI: 3.385.96) [13]. Although drunk driving officially accounts for 7,2% of all road traffic crashes at the national level, its proportion increases to one-fifth in some federal regions [9]. Furthermore, the most recent individual-level estimates suggest that 46.1% of all deaths from road accidents (47.7% and 41.0% of deaths among men and women respectively) were attributable to alcohol consumption [14].In line with this evidence we assume that a combination of higher level of alcohol consumption per capita and binge drinking of vodka results in a close association between alcohol and mortality from road accidents in Russia. To test this hypothesis trends in mortality from road accidents and fatal alcohol poisoning rates from 1970 to 2013 in Russia were analyzed employing time-series analysis.Material and methodsDataThe data on sex-specific road traffic fatality and fatal alcohol poisoning rates per 1 000 000 of the population were taken from the Russian vital statistics registration system. …