County of San Diego Division of Emergency Medical Services EMS Alcohol Related Motor Vehicle, Pedestrian, and Pedalcycle Injury in San Diego County Edward M. Castillo, PhD Alan M. Smith, MPH Barbara M. Stepanski, MPH Leslie Upledger Ray, MA, MPPA Patti A. Murrin, RN, MPH County of San Diego Health and Human Services Agency Division of Emergency Medical Services (EMS) Research Data Systems

County of San Diego Division of Emergency Medical Services EMS Background Motor Vehicle Crashes –40% of all traffic fatalities are alcohol related –310,000 persons injured in alcohol-related crashes –3 in every 10 Americans will be involved in an alcohol-related crash

County of San Diego Division of Emergency Medical Services EMS Background (cont) Pedestrian crashes –Drastic effect on individuals and communities –Account for 12% of all deaths related to motor vehicle crashes in the US –Alcohol involvement among pedestrians in such crashes is 37 percent

County of San Diego Division of Emergency Medical Services EMS Previous Outlet Research Treno et al. (2001) –alcohol outlet density related to self-reported injury Escobedo et al. (2002) –alcohol outlet density related to suicide, alcohol- related crash (fatal and non-fatal) Gruenewald et al (2002) –alcohol outlet density related to self-reported drinking and driving

County of San Diego Division of Emergency Medical Services EMS Research Questions How do the patterns of alcohol-involved motor vehicle, motorcycle, pedestrian, and pedalcycle crashes differ? Is there a relationship between on-site alcohol consumption sites and these types of crashes?

County of San Diego Division of Emergency Medical Services EMS Data Sources Statewide Integrated Traffic Records System (SWITRS) –Statewide database for motor vehicle related injury crashes in California San Diego Association of Governments (SANDAG) –Population Estimates State of California, Department of Alcoholic Beverage Control –Alcohol license data

County of San Diego Division of Emergency Medical Services EMS Methods SWITRS Data –One or more of the party types involved is determined by the officer to have been drinking Fault of crash is assigned by the officer –Includes motor vehicle occupant, motorcycle, pedestrian, and pedalcycle Alcohol Outlets –5270 of 5281 (99.7%) alcoholic beverage licenses in San Diego County were geocoded using ArcView 3.2A 3432 on-site 1838 off-site

County of San Diego Division of Emergency Medical Services EMS Methods Crash data evaluated by type, time of crash (crash data not victim data) Crash mapped in relation to onsite alcohol consumption outlet –Buffer zones created around outlets 200,500,1000 meters –Comparison of crashes in and out of buffer zones

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS San Diego County 2.8 million population Diverse population living in urban, suburban, and rural areas Popular tourist location - 15 million overnight tourists annually Largest military installation in continental US World’s busiest border crossing

County of San Diego Division of Emergency Medical Services EMS Type of Crashes in SD County

County of San Diego Division of Emergency Medical Services EMS Involvement of Alcohol Type of CrashTotal Alcohol- Involved At Fault (w/alcohol) Motor Vehicle (13%)1624 (92%) Motorcycle (11%)67 (70%) Pedestrian (14%)73 (50%) Pedalcycle (8%)44 (68%)

County of San Diego Division of Emergency Medical Services EMS Hour of Day: Motor Vehicle

County of San Diego Division of Emergency Medical Services EMS Fault and Time of Day: Pedestrian and Pedalcycle

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS

County of San Diego Division of Emergency Medical Services EMS Conclusions Patterns of alcohol-involved crashes –Male, young to middle age –MV crashes increase until ‘closing time’ –Pedestrian/pedalcycle crashes most common between 4 and 10PM Relationship between crashes and on- site consumption sites –Pedestrian/pedalcycle crash and on-site outlet association (at 200 meters) –No other association noted

County of San Diego Division of Emergency Medical Services EMS Limitations Ecologic Study Design –Hypothesis generating –Confounding factors Surveillance Data –Limitations for research

County of San Diego Division of Emergency Medical Services EMS Future Research Utilizing additional data, such as SES, prehospital, or medical examiner Additional subjects –Injury –Violence More rigorous study methodologies

County of San Diego Division of Emergency Medical Services EMS Acknowledgements The data collection efforts of the police and sheriff deputies throughout San Diego County are gratefully acknowledged, as is the cooperation of State staff for providing the SWITRS data to San Diego County.

County of San Diego Division of Emergency Medical Services EMS Contact Information Edward M. Castillo, PhD County of San Diego Health and Human Services Agency Emergency Medical Services 6255 Mission Gorge Road San Diego, CA (619) phone (619) fax