Adolescent drinking is associated with a higher risk of acute harm

In a recent study published in EClinicalMedicine, researchers determined the dose-response association between alcohol consumption and the risk of hospital visits due to alcohol consumption-related unintentional injuries among Danish adolescents.

Study: Associations between alcohol intake and hospital contacts due to alcohol and unintentional injuries in 71,025 Danish adolescents – a prospective cohort study. Image Credit: zeljkodan/Shutterstock.com

Background 

Over 4 million deaths were attributed to injuries in 2019, representing 11% of the total loss of healthy life. Among those aged 10-24, unintentional injuries, frequently associated with alcohol, were a second major cause of mortality and disability.

Despite its dangers, binge drinking is popular among Western youth, placing them at risk of self-harm, violence, and unintentional injuries, as alcohol is known to cause loss of balance, impaired motor skills, and increased risky behaviors.

Past studies suggest alcohol increases the odds of self-reported injuries, but biases exist in these reports. While adults grapple with long-term alcohol risks, adolescents face immediate dangers.

In Denmark, where heavy drinking is prevalent in youth, the precise risk from regular alcohol consumption remains unclear, necessitating further research.
About the study

The present study cohort included 71,025 teenagers from Danish high schools; their data were collected from the Danish National Youth Study 2014 (DNYS), and they were followed up from 2014 to 2019. DNYS is a web-based survey conducted at various educational institutions in Denmark in 2014, targeting students aged 15 to 25.

The researchers used the Danish National Patient Register (NPR) to track hospital contacts for five years after the initial survey. The NPR maintains records of all interactions with public hospitals in Denmark.

In Denmark’s welfare society, hospitals must document reasons for any patient contact due to injuries, intentional or not. Students younger than 15 and older than 24 were excluded from the study.
The study’s key predictor was weekly alcohol consumption, with students grouped based on their average weekly intake and a “standard drink” containing 12 grams of pure alcohol. The primary outcomes investigated were alcohol-related hospital contacts and unintentional injuries, including head injuries.

The study used statistical tools to evaluate the association between alcohol intake and injury risk, considering factors like age, gender, ethnicity, education level, and more.
Results

The median age of the participants was 17.9 years, with females making up 58.9%. A significant proportion (41%) of the students were in their initial study year, while 93.5% attended high school; 90% of the students identified as Danish.

Approximately 90% of the participants reported drinking alcohol, and 10.5% had never consumed alcohol. Men reported a median weekly alcohol intake of 11 drinks, while for women, it was eight drinks. Consumption patterns showed that most students either drank less than seven drinks (36.0%) or between seven and 13 drinks (30.0%) weekly.
In the year after the baseline, the first-time hospital visits due to alcohol-related complications were 3.85 per 1,000 person-years for males and 3.41 for females, consistent across age groups.

During the five years of follow-up, 901 participants (1.3%) were hospitalized due to alcohol intake, primarily for acute intoxication. Notably, in the first year from baseline, the population-attributable risk for unintentional injuries was 14% (886) in the study cohort.
There was a pronounced correlation between alcohol intake and hospital visits. Hospital contact risks surged, particularly for those consuming 0-7 weekly drinks, and for every ten additional drinks per week, the risks escalated sharply.

Almost one-third of the participants experienced unintentional injuries over the five-year follow-up period, with males (31%) more affected than females (24%).

The predominant injuries were to the wrist and hand, ankle and foot, and head, with higher alcohol intake escalating the risks of unintentional injuries.
The study also spotlighted a significant correlation between alcohol consumption and head injuries, particularly intracranial ones, which accounted for 15.9% of all head injuries.

One in eight injuries was head injuries, the third most common injury (12.4%). Head injury risks became notably significant, with weekly intakes surpassing 14 drinks.

Conclusions 

To summarize, the present study among a large cohort of 71,025 Danish youth provided crucial insights into a dose-response relationship between alcohol consumption and unintentional injuries leading to hospital contacts.

The findings showed increased weekly alcohol consumption is linked to a higher risk of hospital visits due to alcohol-induced incidents and unintentional injuries.

The data revealed that 90% of Danish adolescents drank alcohol, averaging ten drinks weekly, and they exceeded European averages in both alcohol consumption and intoxication rates.
The researchers found no safe lower limit of alcohol intake in this vulnerable study population. Interestingly, both genders displayed similar alcohol intake-related injury risk rates.

Previous studies support these findings; however, this study’s unique data from hospital registers underscore the need for urgent preventive measures and offer a robust framework for future research.

The authors emphasized that even moderate alcohol consumption can cause significant harm to youth, and policymakers must leverage these insights when crafting youth-centric health strategies and public health interventions.