The risk of being a victim of serious assault rises when alcohol sales are higher, and young urban males appear to be particularly vulnerable, a new study suggests.

The study, published online Monday by PLoS Medicine, looked at sales by the Liquor Control Board of Ontario, as well as health-care data for people involved in assaults who were admitted to hospital.

For each of the 3,212 patients age 13 and older, the researchers at St. Michael's Hospital and the Institute for Clinical Evaluative Sciences [ICES] used postal codes to find the liquor store closest to an individual's home.

"What we found principally in the main analysis was that for every 1,000 litres more that a given LCBO outlet sells — alcohol on a given day — there's an increase in the risk of being a victim of assault of about 13 per cent," said lead author Dr. Joel Ray, a clinician-scientist at St. Michael's Hospital and an adjunct scientist at ICES.

The study covered the period between April 1, 2002, and Dec. 1, 2004. During this 32-month period, the researchers found that 36 per cent of the assaults involved the use of a sharp or blunt object, while 48 per cent occurred during a fight or brawl without weapons.

Sexual assaults accounted for 1.7 per cent of victims and maltreatment by a spouse or partner for 2.1 per cent. Eighty-three per cent of those admitted to hospital due to assault were male, with 25 per cent of cases aged 13 to 20.

In all, 48 patients involved in the assaults died from their injuries.

Ontario was an ideal locale for the study because the province keeps detailed information about medical records and because all spirits are sold through the LCBO — as well as about 85 per cent of the wine and about 20 per cent of the beer sold in the province — and these sales can be tracked.

Ray acknowledged the study had limitations and didn't actually capture whether the victim or perpetrator had been drinking.

It's an "ecological" study, he said, and the relationship is found at a broad societal level.

Alcohol sold elsewhere

Dr. Michael Cusimano, another of the authors, noted that the study underestimates the total relationship because alcohol is sold in places besides the LCBO.

"There's alcohol being sold in bars, in clubs and people making their own alcohol, and in Ontario, the outlets called The Beer Stores and certain grocery stores," said Cusimano, a neurosurgeon and director of the injury prevention unit at St. Michael's Hospital.

Ray said one anomaly occurred around Christmas, as sales of alcohol increased but assaults dropped.

"Christmas is that one non-sporting event-type thing where people actually buy a lot of alcohol as presents and typically drink but don't have necessarily a non-loving type of interaction with people," he observed.

Dr. Richard Stanwick, chief medical officer of health for the Vancouver Island Health Authority, called it a "very interesting study" that would not have been possible in British Columbia, for instance, where liquor sales aren't tracked at a central location.

"I think it's a pretty compelling argument that the more liquor that flows, the more fights will ensue," he said.

"In a social setting, particularly when you mix males who are basically young, and alcohol, it can result in what would be perhaps a few innocent jibes resulting in fisticuffs," he said from Victoria.

Ray said that in recent decades, the mindset on drinking and driving has changed dramatically because of public education campaigns, and he suggested people might need to think differently about alcohol and violence.

"In relation to an individual who is in a bad mood or at risk of being in the wrong place at the wrong time, or at risk of an altercation, drinking is something that they individually have to consider is the wrong thing to do," he said.

"Drunkenness in that state is actually probably asking for trouble rather than necessarily just having a fun night out."

Cusimano concurred.

"We as a society have to start thinking the same way we did 20 years ago about drinking and driving — that alcohol can have other very serious effects, like violence. And this study clearly showed that."

He sees gunshot wounds, open wounds and blunt-trauma injuries in the hospital and on the operating table.

"We're in the inner city of Toronto so we see a lot of unfortunate situations, and alcohol is involved so often," he said.

"So I'm passionate to try to prevent some of this tragedy from happening."