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Researchers find more ambulance calls in areas with lots of licensed alcohol establishments; calls peak at the end of the month; assaults linked to last call

Toronto, May 13, 2016

By Leslie Shepherd

Dr. Joel Ray
Dr. Joel Ray

Researchers found a 7.8 times higher risk of ambulance calls for patients with trauma in areas with the highest density of bars and restaurants licensed to serve alcohol, compared to a low density of such establishments.

The risk for trauma was especially pronounced among young males and in areas with a high density of establishments specifically focused on the sale of alcohol, such as sports bars, night clubs, pool halls and gaming facilities.

The findings, by Dr. Joel Ray, a physician at St. Michael’s Hospital and a researcher in its Li Ka Shing Knowledge Institute, were published today in the journal Medicine. The study was conducted in Peel Region near Toronto, but Dr. Ray said the results are relevant to other jurisdictions.

Dr. Ray also found that EMS calls for assaults near a bar or restaurant peaked dramatically at 2 a.m., when the sale of alcohol must stop in the province of Ontario. Such calls nearly tripled at the end of the month when monthly paycheques are often deposited.

The study determined the risk of EMS calls in association with the density of bars and restaurants service alcohol in Peel, where all on-premise and off-premise alcohol establishments are licensed by the provincial government and the legal drinking age is 19.

The study found the relationship between the density of licensed alcohol establishments and EMS calls for trauma ranged from 45.3 per 1,000 calls in areas with no on-premise licensed alcohol establishments to 381 per 1,000 in areas with the highest density of such establishments.

Dr. Ray’s paper makes several policy recommendations, including limiting the opening of licensed alcohol establishments in areas that already have a large number of them, or areas that have an excessive number of EMS calls for assault or public intoxication.

He said the findings on the timing of the month and EMS calls for assault or intoxication reinforce the observation that alcohol consumption is related not just to the price of alcohol but also the availability of funds to buy it.

“We reiterate that public policies that raise prices of alcohol are an effective means to reduce drinking,” he said. “Given the province of Ontario’s actions to liberally increasing access to alcohol, such as through grocery stores, it is imperative that pricing remains high.”

Finally, the paper notes that since 2.3 per cent of EMS calls in the study were related to intoxication, EMS personnel should consider using a checklist to determine whether people without serious injuries should be taken directly to a detoxification centre.

“Alcohol is a widely available substance that alters perception, and leads to behaviors that individuals might not otherwise engage in,” Dr. Ray said. “Our study provides novel and comprehensive information about alcohol’s availability within on-premise alcohol establishments, within a heavily regulated setting that few others can reproduce. It is time to take a more active stance about a substance that is legal, widely available – yet, harmful.”


This paper is an example of how St. Michael's Hospital is making Ontario Healthier, Wealthier, Smarter.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

Media contacts

For more information or to arrange an interview with Dr. Ray, please contact:

Leslie Shepherd
Manager, Media Strategy, St. Michael's Hospital
416-864-6094
shepherdl@smh.ca