Opinion

Heavy drinking is widespread in Australian communities and amongst parents (Maloney et al., 2010). In Australia, in 2013, 79% of drinkers living with children consumed alcohol in their presence (FARE, 2013). Almost a third (31%) of respondents with children reported drinking five or more drinks on the one occasion at least monthly in the National Drug Strategy Household Survey (Maloney et al., 2010), although whether they drank this way when they were with their children was not asked. In another study 17% per cent of parents (or other carers) reported that their children had been verbally abused, exposed to domestic violence, poorly supervised or physically injured because of other adults’ drinking in the past year (Laslett et al., 2012a). A new study looks at the most serious effects of adults’ heavy drinking, child injury deaths.

Dr Anne-Marie Laslett and Professor Tanya Chikritzhs from the National Drug Research Institute and Dr Heng Jiang from the Centre for Alcohol Policy Research in Melbourne analysed 103 years of child injury deaths and adults’ alcohol consumption in Australia (1910-1923). They found that a 10% decrease in adult drinking over this time was associated with a 3% reduction in child injury deaths.

While many studies have previously identified a relationship between adult drinking and adult deaths, time series studies have not been used before to assess alcohol‘s harm to other people. In this novel approach, Laslett, Jiang and Chikritzhs measured (using the time-series method) the relationship between the amount of alcohol drunk per adult per year and the rate of child injury deaths. The study not only found evidence of a significant link between adult drinking and child injury deaths, but also provided evidence that alcohol control policies targeted at adults can be effective in reducing injury deaths of children.

The study looked at a number of particular policies aimed at reducing harms to drinkers, which also potentially have impacts on others. For example, they found that the co-introduction of compulsory seatbelts and random breath testing laws in the 1970s significantly reduced the number of child road traffic deaths. On the other hand, decreasing the minimum drinking age from 21 to 18 years of age was associated with an increase in child injury deaths.

It is surprising that this link has not been proven before. Injuries are among the leading causes of child and youth deaths worldwide (Patton et al., 2009; Peden, 2008). The physical effects of intoxication include decreased reaction time, lack of coordination, cognitive and memory adverse effects and eventually unconsciousness (Babor et al., 2010), none of which are compatible with supervision of children, the physical tasks involved in parenting and being emotionally available. Alcohol is theoretically linked to child harms via disinhibition and expectancy theories wherein drinkers act out of character and do things they wouldn’t otherwise, or perceive that with alcohol comes some relaxation (within limits) of the social norms they would usually follow (Källmén and Gustafson, 1998). Alcohol ‘myopia’ also may remove peripheral cues, as drinkers relax and focus on their own over others’ needs (Steele and Josephs, 1990).

Given that children are often passengers, pedestrians, and bicyclists they are at risk of alcohol-related traffic crashes, often in cars driven by their parents but also because of other adult drink-drivers (Margolis et al., 2000; Quinlan et al., 2014). Moreover, we know that child injuries, including accidental falls, drowning, burns and poisonings may result when parents’ supervision is compromised, their attention and priorities are diverted (Schnitzer et al., 2015), and parents’ or others’ usual controls are disarmed (Famularo et al., 1992; Fillmore, 2012). All of which are more likely when parents are caring for children in heavy drinking situations.

There are many reasons why children are more likely to be harmed when more alcohol is consumed by adults in proximity to children. This study provides strong evidence of the link between estimated alcohol consumption across Australia and child injury deaths.

This study has recently been published in the journal Drug and Alcohol Dependence and is available online here.

Laslett, A-M., Jiang, H., Chikritzhs, T. (2018) Child injury deaths linked with adult alcohol consumption: A time series analysis. Drug and Alcohol Dependence, DOI: 10.1016/j.drugalcdep.2017.11.024.

References

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Famularo, R., Kinscherff, R., Fenton, T., 1992. Parental substance abuse and the nature of child maltreatment. Child Abuse and Neglect 16(4), 475-483, https://doi.org/10.1016/0145-2134(92)90064-X.

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Källmén, H., Gustafson, R., 1998. Alcohol and Disinhibition. European Addiction Research 4(4), 150-162, http://www.karger.com/DOI/10.1159/000018948.

Laslett, A.-M., Ferris, J., Dietze, P., Room, R., 2012a. Social demography of alcohol-related harm to children in Australia. Addiction 107(6), 1082-1089, DOI: 10.1111/j.1360-0443.2012.03789.x.

Maloney, E., Hutchinson, D., Burns, L., Mattick, R., 2010. Prevalence and patterns of problematic alcohol use among Australian parents. Australian and New Zealand Journal of Public Health 34(5), 495-501, DOI: 10.1111/j.1753-6405.2010.00596.x.

Margolis, L.H., Foss, R.D., Tolbert, W.G., 2000. Alcohol and Motor Vehicle–Related Deaths of Children as Passengers, Pedestrians, and Bicyclists. Journal of the American Medical Association 283(17), 2245-2248, doi:10.1001/jama.283.17.2245.

Patton, G.C., Coffey, C., Sawyer, S.M., Viner, R.M., Haller, D.M., Bose, K., Vos, T., Ferguson, J., Mathers, C.D., 2009. Global patterns of mortality in young people: a systematic analysis of population health data. The Lancet 374(9693), 881-892, DOI: http://dx.doi.org/10.1016/S0140-6736(09)60741-8.

Peden, A.E., Franklin, R.C., Leggat, P.A., 2016. The hid.den tragedy of rivers: a decade of unintentional fatal drowning in Australia. PloS one 11(8), e0160709, https://doi.org/10.1371/journal.pone.0160709.

Peden, M., 2008. World report on child injury prevention. World Health Organization.

Quinlan, K., Shults, R.A., Rudd, R.A., 2014. Child Passenger Deaths Involving Alcohol-Impaired Drivers. Pediatrics 133(6), 966-972, 10.1542/peds.2013-2318.

Schnitzer, P.G., Dowd, M.D., Kruse, R.L., Morrongiello, B.A., 2015. Supervision and risk of unintentional injury in young children. Injury prevention 21(e1), e63-e70, DOI:  10.1136/injuryprev-2013-041128.

Steele, C.M., Josephs, R.A., 1990. Alcohol myopia: Its prized and dangerous effects. American Psychologist 45(8), 921-933, http://dx.doi.org/10.1037/0003-066X.45.8.921.