Contents lists available at ScienceDirect Accident Analysis and Prevention journal homepage: www.elsevier.com/locate/aap Consistent association between hypnotics/sedatives and non-traffic injuries. Results from a national household survey María del Mar Martín-Rodríguez a , José Pulido b,c, ⁎ , Eladio Jiménez-Mejías c,d,e , Juan Hoyos c , Pablo Lardelli-Claret c,d,e , Gregorio Barrio b a Servicio de Medicina Preventiva, Complejo Hospitalario Universitario Insular-Materno Infantil, Avenida Marítima, s/n. 35016. Las Palmas. Spain b Escuela Nacional de Sanidad. Instituto de Salud Carlos III. Avenida Monforte de Lemos, 3-5, Pabellón 7, 28029. Madrid, Spain c CIBER Epidemiología y Salud Pública (CIBERESP). Avenida Monforte de Lemos, 3-5. Pabellón 11. 28029 Madrid. Spain d Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada. Granada, Avenida de Madrid, 11. 18012. Granada, Spain e Instituto de Investigación Biosanitaria de Granada. C/ Doctor Azpitarte 4 4ª Planta. Edificio Licinio de la Fuente, 18012 Granada. Spain ARTICLE INFO Keywords: Non-traffic injuries Psychostimulants Hypnotics and sedatives Alcoholism Cross-sectional study Spain ABSTRACT Aim: To quantify the relationship between patterns of psychostimulants, hypnotics/sedatives and alcohol con- sumption and the frequency of unintentional non-traffic injuries (UNTIs) requiring medical assistant in Spain. Methods: We carried out a cross sectional study using a randomized pooled sample from two household surveys on psychoactive drugs use (n = 51,649 subjects aged 15–64 years). We estimated the magnitude of the asso- ciation between the use of psychostimulants and hypnotics/sedatives in the last 12 months as well as alcohol consumption in the last 30 days with the occurrence of UNTIs in the last 12 months (falls, knocks/bumps and cuts) by building several logistic regression models, which took into account the effect of sociodemographic characteristics and the use of other psychoactive drugs (including cannabis). The presence of interactions be- tween age or gender with drug use was also assessed. Results: Psychostimulants use was associated with a higher frequency of UNTIs (aOR = 1.24; 95%CI:1.03–1.49). The strongest association was found with cuts (aOR = 1.64; 95%CI:1.10–2.43). An association between hyp- notics/sedatives and UNTIs was also found in each type of injury and was higher with regular use (> =30 days) than with non-regular use (< 30 days). The age modified the association between hypnotic/sedatives and knocks/bumps, being higher in the 35–64 years group (aOR = 2.34; 95%CI:1.78–3.06) than in the 15–34 years group (aOR = 1.59; 95%CI:1.14–2.21). Regarding alcohol, an increased risk of UNTIs was also observed in all types of UNTIs, even with moderate use, being the association higher for cuts in heavy drinkers (aOR = 2.41; 95%CI:1.63–3.57). Conclusions: Our results reveal a consistent relationship between hypnotics/sedatives and UNTIs, especially in regular users. Additional research should apply longitudinal designs to establish causal relationships and to gain an in-depth knowledge in this area in order to specific public health interventions. 1. Introduction Injuries are one of the main causes of death and disability among people aged under 60 years worldwide (World Health Organization, 2011) and the leading cause of death among children, adolescents and young adults in Europe (EuroSafe, 2013). In 2030, it is expected that mortality due to injuries will reach 10% (World Health Organization, 2015). In Spain, injuries are the leading cause of mortality among people aged from 1 to 39 years (INE, 2016). Furthermore, in developed countries, for each injury-related death, about 30 injured people are hospitalized and over 300 are attended by skilled health staff (Espitia- Hardeman and Paulozzi, 2005). Health burden related to psychoactive substance abuse or depen- dence is constantly increasing (by 52% between 1990 and 2010, mea- sured in disability-adjusted life years for illicit drugs, according to Degenhardt et al., 2013). Regarding injuries, an increased risk of road crashes related to driveŕs use of psychoactive drugs has been con- sistently observed in many previous studies (Dassanayake et al., 2011; European Monitoring Center for Drugs and Drug Addiction, 2014a; Penning et al., 2010). However, there are few studies that assess this association for unintentional non-traffic injuries (UNTIs), a much more frequent subgroup of injuries. Road crash injuries only account for 10% http://dx.doi.org/10.1016/j.aap.2017.06.016 Received 23 June 2016; Received in revised form 24 May 2017; Accepted 22 June 2017 ⁎ Corresponding author at: Escuela Nacional de Sanidad. Instituto de Salud Carlos III. C/ Monforte de Lemos, 3-5. 28029 Madrid. Spain. E-mail address: jpulido@isciii.es (J. Pulido). Accident Analysis and Prevention 106 (2017) 379–384 0001-4575/ © 2017 Elsevier Ltd. All rights reserved. MARK