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Perspectives in Disease Prevention and Health Promotion Alcohol and Fatal Injuries -- Fulton County, Georgia, 1982

Because homicides, suicides, and fatal injuries are among the leading causes of premature loss of life in the United States (1), a surveillance system was recently initiated in several counties in Georgia to identify the extent to which factors such as alcohol and drug abuse are associated with fatal injuries. As an initial effort, a retrospective survey was conducted to ascertain the blood alcohol content (BAC) of all victims of fatal injury events that occurred in Fulton County* in 1982.

Investigators' reports from the Fulton County Medical Examiner's office were reviewed for all persons classified as homicides, suicides, or victims of unintentional fatal injuries. Ninety-five percent of victims who died within 6 hours of the injury event had BACs obtained by the medical examiner and were included in data analysis. (BAC has been shown less likely to be obtained and if obtained, less meaningful, when death occurs more than 6 hours after the injury event (2,3).) The Georgia Department of Public Safety's accident report forms were also reviewed to obtain information on the BACs of drivers involved in motor vehicle accidents (MVAs) that resulted in fatal injuries to pedestrians or vehicle occupants.

Sixty-six (51%) of 129 homicide victims who died within 6 hours of injury were legally intoxicated (BAC 0.1 g% or greater) at the time of death (Figure 1); 80% were male, and 82% were black. Seventy-seven percent of black males and 71% of white males had been drinking before the injury event (BAC greater than 0). Of those who committed suicide, 18 (20%) of the 90 victims were legally intoxicated at the time of death (Figure 2), and 34 (38%) had been drinking. Sixty-five percent of the 90 victims were white males.

In 1982, 78 Fulton County MVA victims died within 6 hours of the event. At least one driver was legally intoxicated in 39 (85%) of 46 MVAs in which drivers' BACs were collected (Figure 3), and 42 (91%) involved drivers who had been drinking. Thirty-two (82%) of legally intoxicated drivers were at least 25 years old, and 30 (77%) were male. Six (38%) of 16 pedestrian victims were legally intoxicated.

For nonvehicular accidents (NVA), the data base is small; six of 10 victims of fire, eight (57%) of 14 victims of accidental drug ingestion or overdose, three (27%) of 11 victims of carbon monoxide poisoning, and five (36%) of 14 victims of drowning were legally intoxicated. Overall, for NVAs, 27 (38%) of 71 victims were legally intoxicated, and 34 (48%) had been drinking. Reported by Georgia Epidemiology Report (Sept. 1983), RK Sikes, DVM, State Epidemiologist, Georgia Dept of Human Resources; Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: The significance of alcohol as a contributor to fatal injuries may vary from place to place and over time. These data suggest that, in Fulton County in 1982, alcohol abuse may have factored in many of the fatal injuries, both intentional and unintentional. The striking differences in the frequencies of homicide and suicide between blacks and whites may reflect differences in the socioeconomic status of these groups in Fulton County.

A major 1990 Health Objective for the Nation is reduction of the adverse health consequences associated with alcohol abuse, which includes injury and death to others as well as to the individual who misuses alcohol (e.g., MVAs, fires, carbon monoxide poisonings) (4). At a local level, ongoing surveillance of alcohol-related fatal injuries can increase public awareness of the extent of the problem and provide mental- and physical-health programs, law-enforcement agencies, and policymakers with an increased ability to plan intervention strategies and to monitor the effectiveness of programs designed to deter alcohol misuse.


  1. CDC. Premature death--United States. MMWR 1983;32:118-9.

  2. Adelson L. The pathology of homicide: a vade mecum for pathologist, prosecutor and defense counsel. Springfield, Illinois: Charles C. Thomas, 1974:883-918.

  3. Haddon W Jr, Valien P, McCarroll JR, Umberger CJ. A controlled investigation of the characteristics of adult pedestrians fatally injured by motor vehicles in Manhattan. J Chron Dis 1961;14:655-78.

  4. U.S. Public Health Service. Promoting health/preventing disease: objectives for the nation. U.S. Public Health Service, 1980.

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