Alcohol Related Deaths Amongst Drivers, Passengers, Pedestrians Andcyclists In Nairobi

Abstract

Introduction Alcohol and its effects on persons have use in both civil and criminal litigation. In terms of civil matters alcohol has impact in the insurance industry as relates to road traffic accidents, personal accidents claims and also life insurance claims. Excessive alcohol has been blamed as a cause of many deaths resulting from road traffic accidents, assault, stab .wounds, crime and drowning (I).This has been taken to be so. This has largely remained unverified by scientific research in Kenya. The purpose of the study is to determine the incidence of alcohol related deaths in road traffic accidents by measuring alcohol levels in vitreous humor. Clinical studies have been conducted in this area but there has not been a forensic pathology study in this area. Hypothesis Most deaths of road users in Nairobi are alcohol related. Study Objects The study objectives were broadly to determine alcohol related deaths amongst drivers, passengers, pedestrians and cyclists between January 2007 and March 2007, specifically to determine the presence and levels of exogenous alcohol levels in vitreous humors of dead bodies from road traffic accidents; to determine the presence of microorganism in vitreous humor as a marker of presence of endogenous alcohol and so as a quality control and to establish the prevalence of alcohol related deaths in road traffic accidents. Study Design A descriptive cross sectional study Study setting The study was conducted at the City Mortuary in Nairobi. It is the biggest mortuary in Nairobi and receives most of the deceased persons involved in road traffic accidents in Nairobi and its environs. Methodology The study subjects consisted of dead bodies of those who died due to road traffic accidents in Nairobi and were selected consecutively. The study involved collection of vitreous humor from the deceased persons. The sample for alcohol estimation was put into a fluoride bottle which was tightly closed and sealed with cellotape and transported in a cooler box and stored at -4 degrees Celsius until time of analysis. The samples for microbiology were inoculated immediately at the site of collection into Robertson's cooked media, sobourrounds dextrose agar media and blood agar. Results The study established that out of the 101 subjects 21 had presence of alcohol in the vitreous humor. Of the 21 subjects 6 had microorganisms grown from their vitreous humor and were excluded from further analysis. Exogenous alcohol was therefore established in 15 subjects which was 15.8%. The class of persons involved were distributed as passengers who were 7 out of a total of 36 (46.7%), cyclists who were 3 out of a total of 24 (20%),pedestrians who were 3 out of a total of 24 (20%) and drivers 2 drivers out of a total of 17 (13.3%).Amongst the males sampled 22.9% had exogenous alcohol while amongst the females those that had exogenous alcohol were 16.1%. Conclusion The prevalence of exogenous alcohol in bodies from road traffic accidents was 15.8% this would form a basis for social interventions. Passengers contributed a larger percentage of the class of persons involved. The total percentage of death from road traffic accidents was 40% for pedestrians and cyclists. Recommendations There is need to structure roads to provide space for pedestrian and cyclists to reduce contact with motor vehicles. Drivers and passengers composed 60% of those found to have exogenous alcohol it is therefore recommended that there be policies on alcohol intake and driving which would set the legally acceptable drink and drive levels.