Alcohol as a risk factor for train commuting fatalities

Master Thesis


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University of Cape Town

Railway fatalities are an important subset of transport-related fatalities, which account for about 60% of the fatal unintentional injuries occurring in Cape Town. The Medical Research Council reviewed three and a half years of rail injury data and found that alcohol was one of the main risk factors. Furthermore, 33% of South Africa’s national rail fatalities tested positive for alcohol in 1999. Despite the links between alcohol and all types of transport- related injury, prevention efforts have targeted motor vehicle (MV) drivers exclusively. This study aimed to clarify the relationship between alcohol and the risk of all types of transport-related injury (particularly rail injury). Post mortem reports for transport fatalities were collected retrospectively from the two cape Town mortuaries at Salt River and Tygerberg for the period 1 January 1994 to 31 December 1996. A case control study design was used with the cases comprising rail passenger and rail pedestrian fatalities, while motor vehicle drivers and passengers were the controls for the passenger group and motor vehicle pedestrians were the controls for rail pedestrians. Blood alcohol concentration was the dependent variable, the independent variables were age, sex, race, date of death, day of week, time of injury and mechanism of death and the odds ratio was used as the measure of relative risk The study showed that alcohol consumption is an important risk-factor for rail fatalities. The odds ratios imply that rail passengers are 5.23 or 2.3 times as likely to be intoxicated than motor vehicle passengers or motor vehicle drivers respectively, while rail pedestrians are 1.44 times more likely to be intoxicated than motor vehicle pedestrian fatalities. Alcohol plays as important a role, if not more so, for drunken rail passengers and pedestrians as it does for drunken drivers and road pedestrians. The role of alcohol in rail pedestrian fatalities is significant when compared to motor-vehicle pedestrians as a control group. The study has also demonstrated that data provided by the National injury Mortality Surveillance System can form the basis for analytic studies on the risk-factors of injury. The results complement a growing body of research that documents the adverse health effects of excessive alcohol consumption and provide more evidence for public health campaigners to tackle endemic alcohol abuse in South Africa.

Bibliography: leaves 53-58.