Alcohol as a risk factor for injury or death resulting from accidental falls: a review of the literature.

An examination of the English language literature published from 1950 to 1985 on the subject of alcohol consumption and falls yielded 21 studies. Those identified represented four types. Type I studies examined alcohol exposure among fall cases. The percentage of fatal falls related to alcohol exposure ranged from 21 to 77%; for nonfatal falls the range was 17-53%. Among Type II studies comparing fatal falls among alcoholics to the standard population, ratios of observed to expected deaths ranged from 2.9 to 16. Type III studies compared blood alcohol levels (BALs) of fall patients and disease patients treated medically. Those studies yielded odds ratios from 2.5 to 10. In the single Type IV study comparing BALs of fall subjects with nonfall controls relative risks were 1 (BALs, 50-100 mg/dl), 3 (BALs, 100-150 mg/dl) and 60 (BALs, greater than 160 mg/dl). We conclude that there is substantial evidence that alcohol increases risks for falls, but that more case-control studies (Type IV) are required to evaluate the exact magnitude of this risk and intervention studies are needed to assess methods to reduce the risk.