Direct medical charges of all parties in teen-involved vehicle crashes by culpability.

BACKGROUND: Motor vehicle crashes among teen drivers often involve passengers in the teen's vehicle and occupants of other vehicles, and the full cost burden for all individuals is largely unknown. This analysis estimated direct hospitalisation and emergency department charges for teen-involved crashes by teen culpability, comparing charges for the teen driver, passengers and occupants of other vehicles. METHODS: Probabilistic linkage was performed to link the Iowa police crash reports with Iowa emergency department and Iowa hospital inpatient data. Teen drivers aged 14-17 involved in a crash from 2016 through 2020 were included. Teen culpability was determined through the crash report and examined by teen and crash characteristics. Direct medical charges were estimated from charges through linkage to the Iowa hospital inpatient and the Iowa emergency department databases. RESULTS: Among the 28 062 teen drivers involved in vehicle crashes in Iowa between 2016 and 2020, 62.1% were culpable and 37.9% were not culpable. For all parties involved, the inpatient charges were $20.5 million in culpable crashes and $7.2 million in non-culpable crashes. The emergency department charges were $18.7 million in teen culpable crashes and $6.8 million in teen non-culpable crashes. Of the $20.5 million total inpatient charges in which a teen driver was culpable, charges of $9.5 million (46.3%) were for the injured teen driver and $11.0 million (53.7%) for other involved parties. CONCLUSIONS: Culpable teen-involved crashes lead to higher proportions of injury and higher medical charges, with most of these charges covering other individuals in the crash.

Prevalence of workplace violence against young workers in the United States.

BACKGROUND: Workers under the age of 25 may be at particular risk for workplace violence, given their predominant employment in the high-risk retail and service industries. Little research exists, however, that estimates the scope of the problem within this population. To fill this gap, we conducted the first national study of workplace violence against young people in the United States. METHODS: We analyzed survey data collected via telephone interview from a national sample of 1031 young workers ages 14 through 24 who held a formal job in the last 12 months. Weighted frequencies were calculated and χ2 tests of significance were used to detect differences between groups. RESULTS: Many youth experience workplace violence (60%). Verbal abuse of the sort that made victims feel scared and unsafe (53%) and sexual harassment (24%) were the most commonly reported forms of violence. Females were more likely than males to experience workplace violence overall (p < 0.001) and sexual harassment (p < 0.001) in particular. Males were more likely to experience verbal abuse (p < 0.001). Workplace violence was most prevalent among workers in healthcare settings and eating and drinking places. The occupation with the highest prevalence of workplace violence was customer service. CONCLUSIONS: Workplace violence is common among young workers in the United States and more widespread than prior estimates have suggested. This study is the first to provide a true national prevalence estimate of the problem of workplace violence among young workers ages 14 to 24 in the United States. These findings should be used to locate areas of concern and target resources where they are needed most to address this significant problem.

Association of traumatic brain injury severity and time to definitive care in three low-middle-income European countries.

BACKGROUND: Low-middle-income countries experience among the highest rates of traumatic brain injury in the world. Much of this burden may be preventable with faster intervention, including reducing the time to definitive care. This study examines the relationship between traumatic brain injury severity and time to definitive care in major trauma hospitals in three low-middle-income countries. METHODS: A prospective traumatic brain injury registry was implemented in six trauma hospitals in Armenia, Georgia and the Republic of Moldova for 6 months in 2019. Brain injury severity was measured using the Glasgow Coma Scale (GCS) at admission. Time to definitive care was the time from injury until arrival at the hospital. Cox proportionate hazards models predicted time to care by severity, controlling for age, sex, mechanism, mode of transportation, location of injury and country. RESULTS: Among 1135 patients, 749 (66.0%) were paediatric and 386 (34.0%) were adults. Falls and road traffic were the most common mechanisms. A higher proportion of adult (23.6%) than paediatric (5.4%) patients had GCS scores indicating moderate (GCS 9-11) or severe injury (GCS 0-8) (p<0.001). Less severe injury was associated with shorter times to care, while more severe injury was associated with longer times to care (HR=1.05, 95% CI 1.01 to 1.09). Age interacted with time to care, with paediatric cases receiving faster care. CONCLUSIONS: Implementation of standard triage and transport protocols may reduce mortality and improve outcomes from traumatic brain injury, and trauma systems should focus on the most severe injuries.

Pediatric Unintentional Fall-Related Injuries in a Statewide Trauma Registry.

OBJECTIVES: The purpose of the study was to evaluate patterns of fall-related injury through childhood and identify risk factors for more severe fall-related injuries with the goal of informing targeted prevention strategies for different ages. METHODS: The study population consisted of pediatric patients in the Iowa Trauma Registry from January 1, 2010, to December 31, 2014, who sustained an unintentional fall-related injury (N = 3856 patients). Multinomial logistic regression analysis was used to predict injury severity. Adjusted odds ratios were calculated characterizing the relationship between fall severity and age, sex, race, and fall type. RESULTS: More males (62%) sustained a fall-related injury during the study period when compared with females (38%; P < 0.0001). Head injuries were the most common type of injury in the younger than 1 year age group (77%), whereas fractures were the predominant injury type in all other age groups, followed by head injuries. Those younger than 1 year (adjusted odds ratio, 4.0; 95% confidence interval, 2.36-6.90) and aged 15 to 18 years (adjusted odds ratio, 1.9; 95% confidence interval, 1.17-3.03) were more likely to have an Injury Severity Score of ≥16 than those aged 10 to 14 years. CONCLUSIONS: Recommendations and prevention strategies need to focus on specific risk factors to reduce the harm of multilevel falls. As we have shown, patterns of fall injuries presenting to trauma hospitals differ by age, thus suggesting that prevention strategies focus on specific age groups.

Farm Vehicle Following Distance Estimation Using Deep Learning and Monocular Camera Images.

This paper presents a comprehensive solution for distance estimation of the following vehicle solely based on visual data from a low-resolution monocular camera. To this end, a pair of vehicles were instrumented with real-time kinematic (RTK) GPS, and the lead vehicle was equipped with custom devices that recorded video of the following vehicle. Forty trials were recorded with a sedan as the following vehicle, and then the procedure was repeated with a pickup truck in the following position. Vehicle detection was then conducted by employing a deep-learning-based framework on the video footage. Finally, the outputs of the detection were used for following distance estimation. In this study, three main methods for distance estimation were considered and compared: linear regression model, pinhole model, and artificial neural network (ANN). RTK GPS was used as the ground truth for distance estimation. The output of this study can contribute to the methodological base for further understanding of driver following behavior with a long-term goal of reducing rear-end collisions.

Alcohol-involved motor vehicle crashes and the size and duration of random breath testing checkpoints.

OBJECTIVE: Sobriety checkpoints have strong empirical and theoretical support as an intervention to reduce alcohol-involved motor vehicle crashes. The purpose of this study was to examine whether checkpoint size (the number of police officers) and checkpoint duration (the amount of time in operation) affect associations between individual checkpoints and subsequent alcohol-related crash incidence. METHOD: Queensland Police Service provided latitude-longitude coordinates and date and time data for all breath tests that occurred in Brisbane, Australia, from January 2012 to June 2018. We applied hierarchical cluster analysis to the latitude-longitude coordinates for breath tests, identifying checkpoints as clusters of ≥25 breath tests conducted by ≥3 breath testing devices over a duration of 3 to 8 hours. Generalized linear autoregressive moving average (GLARMA) models related counts of alcohol-involved motor vehicle crashes to the number of checkpoints conducted per week, as well as 1 week prior and 2 weeks prior. RESULTS: A total of 3420 alcohol-related crashes occurred and 2069 checkpoints were conducted in Brisbane over the 6.5-year (339-week) study period. On average, checkpoints included a mean of 266.0 breath tests (SD = 216.3), 16.4 devices (SD = 13.7), and were 286.3 minutes in duration (SD = 104.2). Each 10 additional checkpoints were associated with a 12% decrease in crash incidence at a lag of 1 week (IRR = 0.88; 95%CI: 0.80, 0.97). We detected no differential associations according to checkpoint size or duration. CONCLUSIONS: Sobriety checkpoints are associated with fewer alcohol-related motor vehicle crashes for around 1 week. Checkpoint size and duration do not appear to affect this relationship.

Approach to analysing correlated contextual factors: an application for studies on violence.

BACKGROUND: Numerous public health studies, especially in the area of violence, examine the effects of contextual or group-level factors on health outcomes. Often, these contextual factors exhibit strong pairwise correlations, which pose a challenge when these factors are included as covariates in a statistical model. Such models may be characterised by inflated standard errors and unstable parameter estimates that may fluctuate drastically from sample to sample, where the excessive estimation variability is reflected by inflated standard errors. METHODS: We propose a three-stage approach for analysing correlated contextual factors that proceeds as follows: (1) a principal components analysis (PCA) is performed on the original set of correlated variables, (2) the primary generated principal components are included in a multilevel multivariable model and (3) the estimated parameters for these components are transformed into estimates for each of the original contextual factors. Using school violence data, we examined the associations between school crime and correlated contextual school factors (ie, English proficiency, academic performance, pupil to teacher ratio, average class size and children on free and reduced meals). RESULTS: From models ignoring correlations, school crime was not reliably associated with any of the contextual school factors. When models were fit with principal components, school crime was found to be positively associated with a school's student to teacher ratio, average classroom size and academic performance but negatively associated with the proportion of children who were on free and reduced meals. CONCLUSION: Our multistep approach is one way to address multicollinearity encountered in social epidemiological studies of violence.

The prevalence of work-related suicides varies by reporting source from the National Violent Death Reporting System.

INTRODUCTION: Both suicides overall and work-related suicides are increasing in the United States, and efforts to reduce suicide risk will require an understanding of the frequency and role of work in suicides. This study examines the incidence of occupational suicides using the National Violent Death Reporting System (NVDRS), which identified the role of work in suicides using the traditional death certificate as well as from death investigations. METHODS: NVDRS suicides among those aged 16 through 65 from 2013 through 2017 were examined to determine if the death certificate identified the death as work-related, if the death investigation identified a job problem as a suicide circumstance, and if the death investigation indicated that the job problem was a crisis at the time of the suicide. RESULTS: Overall, 1.13% of death certificates identified the suicides as work-related, 2.34% of suicides included a job crisis, and 11.2% a job problem, and proportions did not vary over the years of the study. Overlap between the death certificate and death investigation was very low, with only 0.21% of suicides identified as related to work by both sources. Identification of work-relatedness varied by source for demographic characteristics, mechanism of suicide, and occupation. For example, the death certificate identified 2.1% of suicides among those working in protective services as work-related, but death investigations identified 15.2% as having a job problem. CONCLUSION: Work-related factors may be associated with a far higher proportion of suicides than previously documented.

Determining occupation for National Violent Death Reporting System records: An evaluation of autocoding programs.

BACKGROUND: Suicide is a leading cause of death for working-age adults. Suicide risk varies across occupations. The National Violent Death Reporting System (NVDRS) collects information about violent deaths occurring in the United States. Occupation can be determined using autocoding programs with NVDRS data. The objective of this analysis is to determine the accuracy of autocoding programs for assigning occupations in the NVDRS. METHODS: Deaths from suicide were identified in NVDRS for individuals age 16 and older from 2010 to 2017. Occupations were assigned after processing job description free text with autocoding programs. Job assigned by autocoding program were compared with the occupation code recorded on the death certificate. RESULTS: Assignment of major occupation group had substantial agreement (Cohen's kappa > 0.7) for the two autocoding programs evaluated. Agreement of assigned code varied across race/ethnicity and occupation type. CONCLUSIONS: Autocoding programs provide an efficient method for identifying the occupation for decedents in NVDRS data. By identifying occupation, circumstances of suicide and rates of suicide can be studied across occupations.

Steering Teens Safe: translation to a workplace wellness program in the USA.

Parent-based teen driving interventions have been shown to increase safe teen driving but few have been translated beyond the research setting. As employers focus more on total worker health, the workplace offers a unique opportunity to implement a safe teen driving program into a workplace wellness program. The aim of this study was to adapt the evidence-based, parent-focused teen safe driving program Steering Teens Safe (STS) into workplace wellness programs, and to evaluate the implementation process and effect on parent-teen communication. The Replicating Effective Programs framework was used to modify STS to fit the workplace setting. The implementation process of the STS workplace wellness program was measured using direct observation and recordings of parent communication trainings while the effectiveness was measured by parent questionnaires. Forty-five parent employees across three businesses participated in the study. STS trainers were skilled in training parents in effective communication, including using open-ended questions and reflections. Parents reported increased success in conversations with their teens regarding safe driving through increased affection, receptivity, trust and equality in conversations. Workplaces may play a key role in assisting parents with teaching their children about safe driving.

State-level teen dating violence education laws and teen dating violence victimisation in the USA: a cross-sectional analysis of 36 states.

BACKGROUND: Approximately 10% of teens report experiencing sexual dating violence (SDV) or physical dating violence (PDV), collectively represented as teen dating violence (TDV). This study examines the association between laws incorporating TDV education in schools on TDV prevalence. METHODS: TDV prevalence was estimated using data contributed by 36 states that participated in the 2015 Youth Risk Behavioral Surveillance Survey (YRBS). Presence of TDV laws was determined using Westlaw, a legal search engine. The adjusted odds of TDV victimisation was estimated by the presence or absence of a state law and length of time the law was in effect using hierarchical regression modelling, clustering on state, controlling for individual-level and state-level covariates and incorporating the YRBS-weighted survey design. RESULTS: After controlling for individual-level and state-level covariates, the presence of a law was not associated with TDV (adjusted OR (aOR) 0.97; 95% CI 0.88 to 1.06), PDV (aOR 1.12; 95% CI 0.95 to 1.33) or SDV (aOR 0.99; 95% CI 0.91 to 1.08). These odds did not differ across the length of time the policies were in effect. CONCLUSIONS: This study suggest that just the presence of a law incorporating TDV education in schools is not associated with reduced TDV victimisation but further research is needed to understand the association of the content of these laws and their implementation on TDV victimisation.

Safety seat and seat belt use among child motor vehicle occupants, Cluj-Napoca, Romania.

BACKGROUND: Use of seat belts and car seats for children are among the most effective interventions to reduce injury severity when a crash occurs. The use should be enforced in order to have an increase in wearing these restraints. Romania has the lowest rate of using seatbelts in the backseat, 16%. The purpose of the study is to describe the use of child safety restraints and compare it with existing standards of good practice. METHODS: An observational study on child safety restraint was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Observational sites included 38 schools and kindergartens and three commercial areas, where drivers (n=768) and child passengers (n=892) were observed. Observations were conducted as vehicles parked or pulled to a stop and were followed by driver surveys on knowledge and attitudes towards restraint legislation and child safety behaviour as car occupants. RESULTS: The proportion of observed child motor vehicle occupants wearing some type of restraint was 67.4% (n=601). The majority of children (82.6%) were in the back seat, and 14.2% of infants were in a rear-facing child seat. The proportion of restrained children declined with age, with children 5 years old or younger being almost five times more likely to be properly restrained (OR 4.87, 95% CI 2.93 to 8.07) when compared with older children. CONCLUSIONS: Although minimum legal requirements of child motor vehicle occupant safety were in place in Romania at the time of the study, the rates of using children restraints was low compared with other middle-income and high-income countries.

Racial disparities in pedestrian-related injury hospitalizations in the United States.

BACKGROUND: Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity. METHODS: Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries. RESULTS: The annual average of pedestrian-related deaths exceeded 5000 per year and hospitalizations exceeded 47,000 admissions per year. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89-1.94) and 1.20 (95% CI: 1.19-1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%). CONCLUSIONS: Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

Differences in Postinjury Psychological Symptoms Between Collegiate Athletes With Concussions and Orthopedic Injuries.

OBJECTIVE: To describe the differences in postinjury psychological symptoms among Division I collegiate student athletes who sustained concussions versus orthopedic injures and to examine the effects of injury type on postinjury psychological symptoms during the course of recovery. DESIGN: A prospective cohort study with repeated measures. SETTING: Two Big 10 Conference universities. PARTICIPANTS: Student athletes who were at least 18 years old and participated in one of 9 National Collegiate Athletic Association (NCAA) Division I-sponsored sports during the 2007 to 2011 seasons. MAIN OUTCOME MEASURES: Baseline depressive symptoms and anxiety were measured at enrollment. On identification of an eligible injury, follow-up surveys were conducted among injured athletes at multiple intervals until the injured athlete returned to play. Depressive symptoms, anxiety, fear of return-to-play, and fear of reinjury were measured at the postinjury follow-ups. RESULTS: The concussion group had significantly lower scores of fear of return-to-play (B = -0.94, P = 0.0278) and fear of reinjury (B = -1.11, P = 0.0152) compared with the orthopedic injury group. The concussion group scored higher on depressive symptoms than the orthopedic injury group at 1 month after injury (P = 0.0264), although both groups scored similarly at baseline (P = 0.9729) and at 1 week after injury (P = 0.1475). CONCLUSIONS: Patterns of psychological disturbance differ after concussions and orthopedic injures. Further research is warranted to identify the factors contributing to these differences and to develop effective intervention programs to prevent these symptoms.

Factors contributing to homicide-suicide: differences between firearm and non-firearm deaths.

The primary aim of this study is to determine the relationship between situational factors, method of death, and homicide-suicide deaths, specifically comparing method of death (firearm vs. nonfirearm) across these factors. We used data from the national violence death reporting system, a reporting system for violent deaths that links data from multiple sources. We included incidents that involved at least one homicide death followed by perpetrator suicide in the 42 states from 2013 to 2016. In addition to univariate analyses, we compared proportions of incidents that included a firearm to non-firearm incidents by incident, victim, and perpetrator characteristics. By far, firearm-related injuries were the most frequent cause of death for victims (85.6%) and for perpetrators (89.5%). Women, Hispanic individuals, individuals with a current mental health issue, and individuals with recent depression symptoms had lower odds of using a firearm, as did perpetrators who killed both an intimate partner and other family member. Individuals who had recently been in a fight had increased odds of using a firearm. Despite these differences, the overwhelming majority of homicide-suicide deaths involved firearms, which supports the need for adequate, appropriate firearm control measures to prevent these tragedies.

More than time and money: A mixed-methods study of the barriers to safer cattle handling practices.

BACKGROUND: Cattle are responsible for more injuries and fatalities than any farm animal, and cattle-related nonfatal injuries are some of the costliest, requiring more time off work than other injuries. Though research has improved our understanding of cattle behavior, developed low-stress handling practices, and determined how facilities can be safer, injury rates remain high. This project identified the types of equipment commonly used on farms and assessed farmer perceptions of safety and barriers to implementing changes. METHODS: A mixed-methods design was used for this study. The study was comprised of a survey (N = 66) and four site visits conducted at operations focusing on different types of beef production in Iowa, United States. Information collected included descriptive characteristics of the operator and operation, tasks carried out on the farm, handling facility components and design, and incidents of handling-related injuries. RESULTS: Most farms indicated that they utilized equipment like alleyways, a manual headgate, a sorting/diverter gate, and a manual squeeze chute. Farmers cited the cost of equipment, lack of necessity (their setup worked well already), and lack of time as being the main reasons they have not implemented changes in their operations. However, qualitative responses provided additional details and nuance, illuminating farmers' anxieties related to farm transitions, knowledge, and trust of equipment sales personnel. CONCLUSION: This study provides health and safety professionals with additional details about why beef cattle producers may choose not to invest in safer handling equipment, even when they recognize the safety benefits of doing so.

Characteristics of agricultural and occupational injuries by workers' compensation and other payer sources.

BACKGROUND: Workers' compensation claims data are routinely used to identify and describe work-related injury for public health surveillance and research, yet the proportion of work-related injuries covered by workers' compensation, especially in the agricultural industry, is unknown. METHODS: Using data from the Iowa Trauma Registry, we determined the sensitivity and specificity of the use of workers' compensation as a payer source to ascertain work-related injuries requiring acute care comparing agriculture with other rural industries. RESULTS: The sensitivity of workers' compensation as a payer source to identify work-related agricultural injuries was 18.5%, suggesting that the large majority of occupational agricultural injuries would not be accurately identified through workers' compensation records. For rural nonagricultural, rural occupational injuries, the sensitivity was higher (64.2%). Work-related agricultural injuries were most frequently covered by private insurance (39.6%) and public insurance (21.4%), while rural nonagricultural injuries were most frequently covered by workers' compensation (65.2%). CONCLUSIONS: Workers' compensation claims data will not include the majority of work-related agricultural injuries.

Workplace violence victimization in young workers: An analysis of the US National Crime Victimization Survey, 2008 to 2012.

BACKGROUND: The aim of this study was to measure the frequency of workplace violence (WPV) victimization in 16 to 24-year olds in the United States and compare rates by occupation and demographics. METHODS: As an open cohort, participants 12 years or older in the National Crime Victimization Survey were interviewed at 6-month intervals over a 3-year period from 2008 to 2012. WPV victimization rates were calculated. Weighted, multilevel Poisson regression was used to compare WPV victimization rates by occupation and demographics. RESULTS: The rate of WPV victimization was 1.11 incidents per 1000 employed person-months (95% confidence interval: 0.95-1.27). The highest rates of WPV were in protective service occupations (5.24/1000 person-months), transportation (3.04/1000 person-months), and retail sales (2.29/1000 person-months). Compared with their respective counterparts, lower rates of WPV victimization were found among younger, black, and rural/suburban workers. CONCLUSIONS: Findings identify occupations and target populations in need of future research and evidence-based interventions to improve the working conditions for young workers.

How the science of injury prevention contributes to advancing home fire safety in the USA: successes and opportunities.

BACKGROUND: In the decades since the landmark report-America Burning-was published in 1973, the number of home fire deaths has shrunk from >5500 per year to 2650 in 2015. This paper: (1) describes how science and practice in injury prevention and fire and life safety contributed to successful interventions, and (2) identifies emerging strategies and future opportunities to prevent home fire-related deaths. METHODS: The aims are addressed through the lens of population health research, with a focus on the work of selected Centers for Disease Control and Prevention-funded Injury Control Research Centers. Results are organised using the Haddon Matrix and an ecological model. RESULTS: We found evidence to support interventions that address all components of both the matrix and the model, including: reduced ignition propensity cigarettes, stop smoking campaigns, housing codes, residential sprinkler systems, smoke alarms, community risk reduction, school-based educational programmes, and fire and burn response systems. Future reductions are likely to come from enhancing residential sprinkler and smoke alarm technology, and increasing their utilisation; expanding the use of community risk reduction methods; and implementing new technological solutions. Despite the successes, substantial disparities in home fire death rates remain, reflecting underlying social determinants of health. CONCLUSION: Most of the evidence-supported interventions were focused on changing the policy and community environments to prevent home fires and reduce injury when a fire occurs. Future prevention efforts should give high priority to addressing the continued disparities in home fire deaths.

Alcohol-Related Injuries Among Eastern Croatian University Students.

The aim of this study was to describe the alcohol consumption patterns and to identify the association of injury with excess drinking among Croatian students. This cross-sectional study was conducted among 845 university students by the use of the WHO AUDIT questionnaire. A total of 39.9% of the university students reported some level of excess drinking and 21.3% reported that injury to themselves or others occurred as a result of their alcohol use. Conclusively, these results demonstrate a significant need for comprehensive programs to reduce alcohol intake and associated alcohol problems, as well as programs to reduce injuries among Croatian university students.