Higher volume sales from off-premises and the number of local on-premises alcohol outlets were associated with increased risk of A&E attendance with drinking-related problems, in a study from Australia. The risk was substantially increased when extended hours trading was in place.

The authors used multiple data sources. First, information on emergency department attendance between 2002 and 2010 was obtained from the nine public hospitals in the Perth area, focusing on wholly alcohol-related attendance and presentations with a range of injuries. Attendees were identified by their place of residence using postcode data.

Second, the authors identified the numbers of licensed alcohol outlets in localities, alcohol volume purchased from wholesalers for each outlet (an indirect measure of alcohol sold), and data relating to extended hours trading permits at outlets during the study period.

In analysing the data a framework was adopted to take into account differences in road networks, congestion levels and travel patterns between localities.

It has long been established that alcohol use is associated with increased risk of injury and presentation for emergency treatment.

The authors were surprised to find that counts of off-premises outlets were associated negatively with alcohol-related injury, with a 3.9-4.9% lower risk for each additional outlet. They postulated that areas with more alcohol off-premises may be associated with reduced travel distances to buy alcohol and therefore less risk of travel-related injury or that people were more likely to drink at home than go out for a drink.

However, the study found positive associations between alcohol-related injuries and both counts of on-premises alcohol outlets and with the volume of sales from off-premises outlets.

The risk was increased with extended hours trading such that at postcode level each additional on-premises outlet with extended trading hours was associated with an increase in both night-time injuries (4.6%) and weekend night injuries (4.9%).

During the season of good cheer, GPs whose practice is adjacent to a pub with extended opening hours may need to bear this in mind when preparing Christmas duty rotas.

Dr Jez Thompson

• Hobday M, Chikritzhs T, Liang W, Meuleners L. The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010. Addiction 2015;110:1901–09