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Head injuries nearly double after alcohol sales resume after COVID-19 restrictions: NIMHANS study

A study showed head injury cases dropped significantly during lockdown

A study showed head injury cases dropped significantly during lockdown

A study by a team of doctors from NIMHANS found that head injuries decreased significantly during the COVID-19 lockdown, a period that saw a decrease in traffic volume, bans on the sale of alcohol and strict police surveillance.

There was a marked increase in head injury cases the same day liquor sales resumed in the state. In the 24 hours since the ban on the sale of alcohol was lifted, there were more than 50 cases of head injuries, almost double the number seen during the lockdown period.

The study titled “Traumatic brain injury during the COVID-19 pandemic – time series analysis of a natural experiment” was published in the British Medical Journal Open (BMJ Open) earlier this month.

Lekhansh Shukla, assistant professor at the Center for Addiction Medicine (CAM) at NIMHANS, who is the corresponding author of the study, said The Hindu that the study aimed to determine whether the incidence and pattern of traumatic brain injury (TBI) had changed during the pandemic.

This study, carried out jointly by researchers from the Department of Neurosurgery and CAM, covered data from December 1, 2019 to January 3, 2021, a total of 400 days, including all lockdowns.

Safety rules

“Our results showed that people were more observant of safety rules such as helmets/seatbelts during lockdown, likely due to stricter policing,” he said.

B. Indira Devi, Senior Professor, Department of Neurosurgery and Dean, Neurosciences, at the hospital, who is one of the lead authors, said head trauma is one of the leading causes of death and disability in life. “India is responsible for around a quarter of the world’s trauma-related deaths and head injuries. Road accidents are the most common cause of head trauma. Speeding, not wearing helmets/seat belts and drunk driving are risk factors for road accidents,” she said.

“We wanted to understand how much each of these factors contributes to the problem of head injuries. These factors are difficult to control and measure during typical hours. The COVID-19 pandemic and lockdown provided a natural experiment where we could study these factors,” she said.

Dr. Shukla said the research team used data that is routinely collected from all head trauma cases in the NIMHANS emergency department. “This gave us information on how many head injury cases occurred each day, the circumstances of the injury and whether alcohol consumption had been reported. We combined this data with daily road traffic data reported by Google Community Mobility reports. This data uses GPS signals to estimate the number of people on roads/parks etc. Google launched this service to help countries in their efforts to contain the spread of the virus. We have also used daily alcohol sales data from urban and rural districts of Bengaluru,” he explained.

Exposure to alcohol

“We were mainly interested in measuring the daily exposure to alcohol for the population of these neighborhoods. However, since there is no source for this data, we used daily sales data from Karnataka State Beverage Corporation Limited (KSBCL) records. It is the only agency that provides alcoholic beverages to vendors across the state. For Bangalore, the supply goes through 24 KSBCL depots (7 rural and 17 urban),” the doctor said.

“In summary, this study indicates that tighter drink-driving enforcement and road decongestion can significantly reduce crashes and head injuries,” the authors added.