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

Abstract

INTRODUCTION: Research examining the effects of alcohol outlet density on alcohol-related harms has rarely included concurrent data on alcohol sales and extended trading hours. This study aimed to examine the effects of licensed outlets, alcohol sales and extended trading hours on levels of alcohol-related injuries presenting to Emergency Departments (EDs) in Perth, Australia. METHODS: The retrospective population-based study used ED data from 2002 to 2010. ED alcohol-related injuries were derived using validated time-based surrogate measures. Measures of alcohol availability included sales, trading hours and number of alcohol outlets per postcode. Negative binomial regression modelling with random effects was used to examine the relationship between availability and alcohol-related injury, controlling for postcode-level sociodemographic characteristics and distance from the CBD. RESULTS: Weekend night-time injuries increased by 4.9% (95% CI: 1.015-1.084) for each additional on-premise outlet with extended trading hours, accounting for potential confounders. The risk of weekend night-time injury was lower among on-premise outlets with standard trading hours (IRR=1.008; 95% CI: 1.004-1.013). An additional 10,000l of pure alcohol purchased per off-premise outlet was associated with a 1.9% increase in weekend night-time injuries (95% CI: 1.004-1.035).CONCLUSIONS: The association between alcohol-related injury and higher off-premise sales was likely to be due to greater physical and economic availability (more outlets with longer trading hours increasing access and reducing purchase costs). The relationship between injury and higher counts of on-premise outlets may be via the amenity effect (the negative effects that outlets have on neighbourhoods, as catalysts for violence) and is consistent with previous Australian research. These findings support the adoption of a precautionary approach toward liquor licensing in the future, including restrictions on numbers of outlets and reduced trading hours.