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Biomedical subjects

R W Hingson

Publications and source records attributed to R W Hingson.

16 recordsLinked to original sources
PubMed2000

Age of drinking onset and unintentional injury involvement after drinking.

CONTEXT: In 1997, unintentional injury was the leading cause of death for persons aged 1 to 34 years. Approximately one third of deaths due to unintentional injury in the United States are estimated to be alcohol related. Onset of drinking at an early age has been found to be associated with alcohol dependence, but whether early-onset drinking increases risk for unintentional injury while drinking is unknown. OBJECTIVE: To explore whether persons who started drinking at an early age are more likely to have experienced unintentional injuries while under the influence of alcohol. DESIGN AND SETTING: The National Longitudinal Alcohol Epidemiology Survey, a cross-sectional survey conducted in 1992 of a representative sample of the US population. PARTICIPANTS: A total of 42,862 randomly selected adults (response rate, 90%; mean age, 44 years). MAIN OUTCOME MEASURES: Unintentional injury involvement while under the influence of alcohol by age of drinking onset (categorized as <14 years, each age from 14-20 years, or >/=21 years). RESULTS: Relative to respondents who began drinking at age 21 years or older, those who started before age 14 years as well as those who started at each intervening age up to 21 years were significantly more likely to have been injured while under the influence of alcohol, even after controlling for history of alcohol dependence, heavy drinking frequency during the period that they drank most, family history of alcoholism, and other characteristics associated with earlier onset of drinking. After adjusting for these variables, odds ratios for having been injured while under the influence of alcohol were as follows: for younger than 14 years, 2.98 (95% confidence interval [CI], 2.29-3.89); age 14 years, 2.96 (95% CI, 2.26-3.88); age 15 years, 3.14 (95% CI, 2.48-3.97); age 16 years, 2.38 (95% CI, 1.90-2.98); age 17 years, 2.12 (95% CI, 1.66-2.71); age 18 years, 1. 33 (95% CI, 1.08-1.64); age 19 years, 1.42 (95% CI, 1.07-1.89); and age 20 years, 1.39 (95% CI, 1.01-1.91). CONCLUSION: Drinking onset at ages younger than 21 years is associated with having experienced alcohol-related injuries. JAMA. 2000;284:1527-1533

Accidents↗
PubMed1999

Preventing impaired driving.

Although moderate drinking does not necessarily increase a person's blood alcohol concentration (BAC) to the level at which driving is legally prohibited in the United States, any drinking can impair driving tasks. In addition to laws establishing lower legal BAC limits for drivers, legislative approaches for reducing alcohol-impaired driving include imposing sanctions for drinking and driving and restricting alcohol's availability.

Accidents, Traffic↗
PubMed1997

Sunbathing habits and sunscreen use among white adults: results of a national survey.

OBJECTIVES: This study assessed current levels of sunbathing and sunscreen use in the United States. METHODS: From a general-population telephone survey of aquatic activities among adults in 3042 US households, we examined responses by the 2459 Whites. RESULTS: Most adults (59%) reported sunbathing during the past year, and 25% reported frequent sunbathing. Of the subsample who reported sunbathing during the month before the interview, 47% routinely used sunscreen. Of these individuals, almost half did not use sunscreens with a solar protection factor of 15 or higher. CONCLUSIONS: About a quarter of US White adults report frequent sunbathing, and only about a quarter of sunbathers use sunscreens at recommended levels. These results should help focus future sun protection educational efforts.

Adolescent↗
PubMed1992

The impact of a physician's warning on recovery after alcoholism treatment.

OBJECTIVE: To study whether alcoholic workers had seen physicians during the year they were identified by their company, whether they recalled physicians' warnings about drinking, and whether such warnings affected outcomes 2 years later. DESIGN: Workers were interviewed at intake and 2 years later: subgroups who did and did not see physicians and who did and did not recall warnings were compared. SETTING: A company-union employee assistance program. PARTICIPANTS: Two hundred problem drinkers, newly identified on the job, predominantly male, blue-collar workers. OUTCOMES: Drinking, drunkenness, average daily alcohol consumption, and impairment score. RESULTS: Among the 200 participants, 74% saw physicians in the index year; only 22% recalled warnings. Recall of a warning was associated with liver disease, continued drinking while ill, supervisors' job warnings, older age, and marijuana use. Two years later, those warned were more likely to be abstaining, and sober, and were less impaired. CONCLUSIONS: Recalling a physician's warning at intake into alcoholism treatment was associated with better prognosis 2 years later. However, among this group of employees whose drinking was serious enough to be identified on the job, fewer than a quarter recalled physicians' warnings, even though more than three quarters had seen physicians in the year preceding intake.

Adult↗
PubMed1991

A randomized trial of treatment options for alcohol-abusing workers.

BACKGROUND: Employee-assistance programs sponsored by companies or labor unions identify workers who abuse alcohol and refer them for care, often to inpatient rehabilitation programs. Yet the effectiveness of inpatient treatment, as compared with a variety of less intensive alternatives, has repeatedly been called into question. In this study, anchored in the work site, we compared the effectiveness of mandatory in-hospital treatment with that of required attendance at the meetings of a self-help group and a choice of treatment options. METHODS: We randomly assigned a series of 227 workers newly identified as abusing alcohol to one of three rehabilitation regimens: compulsory inpatient treatment, compulsory attendance at Alcoholics Anonymous (AA) meetings, and a choice of options. Inpatient backup was provided if needed. The groups were compared in terms of 12 job-performance variables and 12 measures of drinking and drug use during a two-year follow-up period. RESULTS: All three groups improved, and no significant differences were found among the groups in job-related outcome variables. On seven measures of drinking and drug use, however, we found significant differences at several follow-up assessments. The hospital group fared best and that assigned to AA the least well; those allowed to choose a program had intermediate outcomes. Additional inpatient treatment was required significantly more often (P less than 0.0001) by the AA group (63 percent) and the choice group (38 percent) than by subjects assigned to initial treatment in the hospital (23 percent). The differences among the groups were especially pronounced for workers who had used cocaine within six months before study entry. The estimated costs of inpatient treatment for the AA and choice groups averaged only 10 percent less than the costs for the hospital group because of their higher rates of additional treatment. CONCLUSIONS: Even for employed problem drinkers who are not abusing drugs and who have no serious medical problems, an initial referral to AA alone or a choice of programs, although less costly than inpatient care, involves more risk than compulsory inpatient treatment and should be accompanied by close monitoring for signs of incipient relapse.

Adult↗
PubMed1991

Associations between alcohol and cocaine use in a sample of problem-drinking employees.

Increases in cocaine use have created a new and challenging cohort of problem drinkers with dual or multiple addictions. As part of a randomized trial comparing alternative alcoholism treatments at a 10,000-employee industrial plant, we interviewed 224 new alcoholic clients of an employee assistance program (EAP); 40% used cocaine during the 6 months just prior to EAP intake. Compared to employees reporting no recent cocaine use, the cocaine users were younger, less often married and reported heavier drinking and more alcohol-related problems, on the job and off. Even after controlling for demographic and occupational factors, and drinking indicators, cocaine users reported more binges (being drunk 24 hours or more), more blackouts (marginally significant, p = .06), more absenteeism and more warnings about unacceptable job performance. Alcoholic EAP clients who use cocaine appear to engage in riskier drinking and to have more trouble on the job than do those who report no cocaine use, and this seems to be a difference specifically attributable to their use of cocaine.

Adult↗
PubMed1991

Knowledge about HIV and behavioral risks of foreign-born Boston public school students.

In 1990, 3049 Boston public middle and high school students were surveyed anonymously in English, Spanish, Vietnamese, Chinese, French, or Haitian Creole. Significantly fewer immigrant students, 35% of those surveyed, knew the principal modes of human immunodeficiency virus transmission. Fewer immigrants reported having sexual intercourse (31% vs 53% of nonimmigrants), but among the sexually active only 38% always used condoms, and more immigrants reported intercourse with intravenous drug users (4% vs 1% of non-immigrants). AIDS education should be taught to immigrant students in their native languages.

Adolescent↗
PubMed1990

Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents.

In August 1988, 1,773 Massachusetts 16-19-year-olds were surveyed by telephone using anonymous random digit dialing; response rate 82 percent. Logistic regression tested whether alcohol and drug use, perceived susceptibility to human immunodeficiency virus (HIV), severity of HIV if infected, effectiveness of condoms in preventing infection, barriers to condom use, and behavioral cues such as exposure to media or personal communication about acquired immunodeficiency syndrome (AIDS) were independently related to condom use. Among sexually active respondents, (61 percent of those interviewed) 31 percent reported always using condoms. Respondents who believed condoms are effective in preventing HIV transmission and worried they can get AIDS were 3.1 and 1.8 times, respectively, more likely to use condoms all the time. Respondents who carried condoms and who had discussed AIDS with a physician were 2.7 and 1.7 times, respectively, more likely to use them. Those who believed condoms do not reduce sexual pleasure and would not be embarrassed if asked to use them were 3.1 and 2.4 times, respectively, more likely to use condoms. Teens who averaged five or more drinks daily or used marijuana in the previous month were 2.8 and 1.9 times, respectively, less likely to use condoms. Among respondents who drink and use drugs, 16 percent used condoms less often after drinking and 25 percent after drug use. Those counseling adolescents about HIV should assess and discuss beliefs outlined in the Health Belief Model, as well as their alcohol and drug use.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Employee drinking patterns and accidental injury: a study of four New England states.

The relationship between alcohol use and accidental injury was examined in an anonymous telephone survey of 1740 randomly sampled employed adults (49% men) residing in four New England states in 1982 and 1983. Respondents reported 383 accidents requiring medical attention during the year prior to the interview, 34 involving hospitalization. Of the accidents, 41% occurred at work, 32% during recreational and other activities, 19% at home and 8% in traffic incidents. Respondents were stratified by self-reported levels of alcohol consumption and were compared on accident rates. Drinking at work was also examined for an association with accident involvement. Logistic regression analyses controlled for variability associated with age, sex, marital status, occupation and drug use. Drinking at work was not significantly or independently associated with job accidents but an average daily intake of 5+ drinks elevated the relative risk, compared with abstainers, as follows: 1.7 for any accidental injury, 3.8 for injuries requiring hospitalization and 2.0 for job-based accidental injuries. The relative risks associated with the use of other psychoactive drugs were 1.7 for work accidents and 2.4 for accident-associated hospitalizations. Of the respondents, 13% reported having ever had a drug or alcohol problem and 2% reported a current problem. Fourteen percent reported that there were counselors at their jobs to help with such problems. Of those who had ever experienced a problem, 11% had sought help from outside programs and only 4% had sought help at work.

Accidents, Occupational↗
PubMed1985

Where to refer employees for treatment of drinking problems. The limited lessons from empirical research.

Although employee assistance programs appear to be spreading rapidly, much remains to be discovered about how they should proceed. A critical review of the literature undergirding these programs reveals wide gaps in knowledge about the relative efficacy of a variety of alternative strategies. In particular, empirical data on the question of where to refer employees for treatment of drinking problems are urgently needed. As medical scientists with ties to industry, occupational health professionals can play a decisive role in the articulation of central research questions and in the design and implementation of key studies that will begin to yield the blueprint for an efficient and effective system of care for alcohol problems.

Alcoholism↗
PubMed1984

Legislation raising the legal drinking age in Massachusetts from 18 to 20: effect on 16 and 17 year-olds.

The 1979 Massachusetts law raising the legal drinking age from 18 to 20 is examined--the effects on the drinking, drinking and driving, and nonfatal and fatal crash involvement of 16-17 yr-olds, teenagers immediately younger than those targeted by the law. Data from Massachusetts are compared with those from New York State, where the drinking age remained at 18. A total of 3 yr of survey data from the two states and 6 yr of data from the Department of Transportation's Fatal Accident Reporting System provide for pre- and postlaw comparisons. The findings suggest that raising the drinking age had minimal effects on the drinking behavior of Massachusetts teenagers. Although there was a significant reduction in nonfatal crashes in Massachusetts compared with New York, no decline in single-vehicle nighttime fatal crashes or in overall fatal crashes was observed. It is suggested that changes in the drinking age may offer some reduction in teenage driving after drinking and traffic crash involvement, but that teenage drinking and driving after drinking remain serious problems even in states that raise their drinking ages.

Accidents, Traffic↗
PubMed1983

Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20.

On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York City and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the law's enactment and twice at yearly intervals after the law to assess the law's impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar.

Accidents, Traffic↗
PubMedDate not supplied

Effects of legislative reform to reduce drunken driving and alcohol-related traffic fatalities.

From 1980 through 1985, considerable progress was made across the Nation in reducing drunken driving and fatal automobile crashes. More than 400 chapters of local citizen groups concerned with reducing drunken driving were formed. New media coverage, measured in number of stories, increased fiftyfold from 1980 to 1984. More than 500 legislative reforms were passed. All States now have adopted a legal drinking age of 21. Many also adopted criminal and administrative per se laws and instituted penalty increases for drunken driving. By 1985, the total number of fatal crashes declined to 39,168, a decrease of 6,116, or 16 percent, from the 1980 level of 45,284. Single-vehicle fatal crashes occurring at night, those most likely to involve alcohol, declined by 20 percent, with 3,674 fewer crashes in 1985 than in 1980. Among teenage drivers, declines in fatal crashes were steeper: Fatal crashes decreased 26 percent, and single-vehicle night fatal crashes were down 34 percent. After 1984, however, the number of new citizen groups established and the number of stories appearing in the media began to decline. In 1986, after decreasing for several years, the number of fatal crashes rose 5 percent, and single-vehicle night fatal crashes rose 7 percent, up 1,060 from 1985. Among teenage drivers, the increase in single-vehicle night fatal crashes was even higher, up 17 percent. In 1987, single-vehicle night fatal crashes declined slightly but still remained higher than in 1983, 1984, or 1985. Legal changes, while helpful in reducing drunken driving crashes, may not be sufficient to achieve optimal long-term declines.To sustain the progress of the early 1980s, we need to:* Refocus community and media attention on the drunken driving problem. * Increase police enforcement and public support for enforcement of laws against drunken driving.* Heighten educational and enforcement efforts that target risky traffic behaviors more common among drunken drivers-particularly speeding and failure to wear seatbelts.* Develop educational efforts aimed at all segments of the population to increase informal social pressure to discourage drunken driving and riding in vehicles with drivers who are drunk.Traffic accidents remain the leading cause of death among persons ages I to 34; 52 percent of the 46,050 traffic fatalities in 1986 involved ad river or pedestrian who had been drinking. Without renewed attention to the problems posed by drunken driving, we may be unable to sustain the dramatic progress of the early 1980s.

Accidents, Traffic↗
PubMedDate not supplied

Mandatory seatbelt law support and opposition in New England--a survey.

Less than one-fifth of the U.S. population consistently wears automobile seatbelts. Automatic seatbelts or air bags will be required in all new cars, unless States whose total population equals two-thirds of the nation's adopt mandatory seatbelt use laws by 1989, according to the U.S. Department of Transportation. In July 1984, New York State passed the first mandatory seatbelt law in the nation, followed by New Jersey, Illinois, Missouri, Michigan, and New Mexico. A telephone survey of 2,982 randomly selected drivers examined belt use and support for mandatory belt use laws in the six New England States. Drivers with little education and low income, younger drivers, and drivers who drove after heavy drinking or marijuana use, or both, were least likely to wear seatbelts. Beliefs that seatbelts are not effective in reducing injury risk and are uncomfortable were more common among those not wearing belts. Sixty percent of drivers favored a mandatory seatbelt use law. The most important predictors of opposition to a belt use law were beliefs that seatbelts are ineffective, inconvenient, and uncomfortable. Opposition was also more likely among persons who reported that they drove after marijuana use, or heavy drinking, or both, drove more miles per year, exhibited a low frequency of seatbelt use, and perceived a low probability of personal crash involvement.

Adolescent↗