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      Breathalysing and surveying river users in Australia to understand alcohol consumption and attitudes toward drowning risk

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          Little is known about people’s river usage, a leading drowning location. This study examines alcohol consumption patterns of river users and their attitudes to drowning risk.


          A convenience sample of adult (18+ years) river users were surveyed at four river locations. The survey covered eight domains: demographics; river attendance frequency; frequency of engaging in water activities; drinking patterns; alcohol and water safety knowledge; alcohol and water safety attitudes; alcohol consumption; and Blood Alcohol Concentration (BAC). For BAC, participants were asked to record time since their last alcoholic drink and were then breathalysed to record an estimate of their BAC. BAC was examined by BAC reading (negative, positive, ≥0.050%). Hazardous lifetime drinking levels were calculated and their impact on drowning risk evaluated. Univariate and chi square analysis (95% confidence interval) was conducted.


          Six hundred eighty four people participated (51.6% female; 49.0% aged 18–34 years). Sixteen percent (15.9%) had a positive BAC (Mean + BAC = 0.068%; SD ± 0.08; Range = 0.001–0.334%), with 7.2% ≥0.050% (Mean BAC ≥0.050% =0.132%; SD ± 0.06). Those significantly more likely to record a BAC ≥0.050% at the river were: aged 18–34 years, resided in inner regional and low socio-economic areas, visited the river in the afternoon, with friends, on days with higher maximum air temperatures, frequent river users (11+ times in the last 30 days) and those who spend longer in the water (301+ minutes). River users who recorded a BAC ≥0.050% were more likely to self-report engaging in risky activities (i.e. diving into water of unknown depth and jumping into the river from height). River users on Australia day (a national public holiday) were significantly more likely to drink heavily (Mean BAC ≥0.05% = 0.175%; SD ± 0.09).


          Despite males accounting for 85% of alcohol-related river drowning deaths, similar numbers of males and females were consuming alcohol at the river. This study has addressed a gap in knowledge by identifying river usage and alcohol consumption patterns among those at increased drowning risk. Implications for prevention include delivering alcohol-related river drowning prevention strategies to both males and females; at peak times including during hot weather, afternoons, public holidays and to river users who swim.

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          The online version of this article (10.1186/s12889-018-6256-1) contains supplementary material, which is available to authorized users.

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          Most cited references 40

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          Risk-taking and the adolescent brain: who is at risk?

          Relative to other ages, adolescence is described as a period of increased impulsive and risk-taking behavior that can lead to fatal outcomes (suicide, substance abuse, HIV, accidents, etc.). This study was designed to examine neural correlates of risk-taking behavior in adolescents, relative to children and adults, in order to predict who may be at greatest risk. Activity in reward-related neural circuitry in anticipation of a large monetary reward was measured with functional magnetic resonance imaging, and anonymous self-report ratings of risky behavior, anticipation of risk and impulsivity were acquired in individuals between the ages of 7 and 29 years. There was a positive association between accumbens activity and the likelihood of engaging in risky behavior across development. This activity also varied as a function of individuals' ratings of anticipated positive or negative consequences of such behavior. Impulsivity ratings were not associated with accumbens activity, but rather with age. These findings suggest that during adolescence, some individuals may be especially prone to engage in risky behaviors due to developmental changes in concert with variability in a given individual's predisposition to engage in risky behavior, rather than to simple changes in impulsivity.
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            Evidence for a closing gender gap in alcohol use, abuse, and dependence in the United States population.

            Descriptively, male-female differences in alcohol consumption and alcohol use disorders appear to have decreased in birth cohorts reaching adulthood since the 1970s compared to earlier birth cohorts. However, such birth cohort effects on gender differences have never been statistically tested in nationally representative data. The aim of this study was to test the hypothesis that gender differences in alcohol consumption, abuse, and dependence are decreasing over time. Face-to-face survey conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions among those aged <90 (N=42,693). Birth cohort was divided into four categories: 1913-1932, 1933-1949, 1950-1967, 1968-1984. Outcomes included lifetime largest drinks, frequent binge drinking, DSM-IV defined alcohol abuse, and alcohol dependence, measured with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-IV). Birth cohort and gender interacted significantly in predicting lifetime largest drinks (F=27.6, [d.f.=3], p<0.0001), frequent binge drinking (F=40.0, [d.f.=3], p<0.0001), alcohol abuse (F=62.0, [d.f.=3], p<0.0001) and alcohol dependence (F=15.3, [d.f.=3], p<0.0001). Cohort-specific ORs indicated monotonic decreases in the gender ratio in more recent birth cohorts for all outcomes. These results suggest that gender differences in the prevalence of all four outcomes are decreasing in younger age cohorts. While these changes are consistent with a cohort effect, the possibility of age and period effects cannot be ruled out but suggest important avenues for more specific hypothesis testing. Further, women in younger cohorts may be in need of new targeted prevention and intervention efforts.
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              Social-desirability bias and the validity of self-reported values


                Author and article information

                +61 2 8217 3133 ,
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                19 December 2018
                19 December 2018
                : 18
                [1 ]Royal Life Saving Society – Australia, PO Box 558, Broadway, NSW 2007 Australia
                [2 ]ISNI 0000 0004 0474 1797, GRID grid.1011.1, College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, , James Cook University, ; Townsville, Queensland 4811 Australia
                [3 ]School of Public Health, Faculty of Health Sciences, University of the Witwatersand, Johannesburg, South Africa
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2018

                Public health

                health promotion, public health, injury, exposure, breathalysing, alcohol, drowning


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