{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:53:11Z","timestamp":1791096791929,"version":"4.1.0"},"reference-count":40,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012663","name":"Davee Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01AA028552"],"award-info":[{"award-number":["R01AA028552"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["5T32ES007322-21"],"award-info":[{"award-number":["5T32ES007322-21"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["5T32ES007322-22"],"award-info":[{"award-number":["5T32ES007322-22"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Columbia Center for Injury Science and Prevention, Centers for Disease Control and Prevention","award":["R49CE003094"],"award-info":[{"award-number":["R49CE003094"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2024,12,18]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The association between alcohol consumption and increased injuries from falls is well established, but there is a lack of data on the prevalence of substance use by fall type. This study aims to describe the distribution of alcohol and drug involvement in injurious falls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the 2019 National Emergency Medical Services (EMS) Information System data set, we identified 1 854 909 patients injured from falls requiring an EMS response and determined the fall location (eg, indoors or on street\/sidewalk). We analysed data on the EMS clinician\u2019s notation of alcohol or drug involvement and Glasgow Coma Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, for 7.4% of injurious falls, there was a notation of substance use: 6.5% for alcohol alone, 0.6% for drugs and 0.3% for alcohol and drugs. 21.2% of falls that occurred on a street or sidewalk had a notation of substance use. Substance use prevalence was highest, at 30.3%, in the age group 21\u201364 years, for falls occurring on streets and sidewalks, without syncope or heat illness as contributing factors. Reported substance use involvement was more frequent for men compared with women for each location type. Glasgow Coma Scale scores indicative of moderate or severe trauma were more prevalent among falls involving alcohol and\/or drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, one in five injurious falls on streets and sidewalks and requiring EMS attention involved substance use, and these numbers likely underestimate the true burden. As cities seek to expand nightlife districts, design strategies to protect pedestrians from falls should be enacted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2024-045447","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T13:20:11Z","timestamp":1735824011000},"page":"772-779","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence of indications of alcohol and drug use among patients treated for injurious falls by Emergency Medical Services in the USA"],"prefix":"10.1136","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5076-3522","authenticated-orcid":false,"given":"Nicole G","family":"Itzkowitz","sequence":"first","affiliation":[{"name":"Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn G","family":"Burford","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remle P","family":"Crowe","sequence":"additional","affiliation":[{"name":"ESO Solutions, Austin, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry E","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander X","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"},{"name":"Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G","family":"Rundle","sequence":"additional","affiliation":[{"name":"Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"2026092808102186000_32.5.772.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2023.04.013"},{"key":"2026092808102186000_32.5.772.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2020.06.001"},{"key":"2026092808102186000_32.5.772.3","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2021-044513"},{"key":"2026092808102186000_32.5.772.4","doi-asserted-by":"crossref","DOI":"10.1186\/s40621-023-00414-z","article-title":"A methodology for the public health surveillance and epidemiologic analysis of outdoor falls that require an emergency medical services response","volume":"10","author":"Rundle","year":"2023","journal-title":"Inj Epidemiol"},{"key":"2026092808102186000_32.5.772.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198904203201606"},{"key":"2026092808102186000_32.5.772.6","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.1994.1130"},{"key":"2026092808102186000_32.5.772.7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2001.49115.x"},{"key":"2026092808102186000_32.5.772.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.03234.x"},{"key":"2026092808102186000_32.5.772.9","unstructured":"Wickham M . 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