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plastic surgery, reconstructive surgical procedures, maxillofacial injuries, violence, Australia
Background: Lockout reforms were introduced in February 2014 by the New South Wales government in an attempt to curb alcohol-related violence in Sydney, following a number of fatalities. Changes include 1.30 a.m. venue lockouts and the 3 a.m. cessation of alcohol service. This study aims to assess the results of these reforms through analysis of departmental treatment data. All maxillofacial fractures that required operative management at St Vincent’s Hospital, Sydney, over a two-year period pre and post reforms were analysed.
Methods: Medical information, from multiple sources, of patients that required operative management for maxillofacial fractures over a 2-year period (2012-2014) were compared to those between (2014-2016). Data collected included age, gender, demographics, mechanism of injury, pattern of injury, treatment required, association with alcohol, time and place of injury, and long-term complications.
Results: 145 maxillofacial fractures were operatively treated prior to the reforms compared to only 58 (p<0.001) post. Reported incidents occurring in the city significantly fell from 54 to 15 (p<0.001), with no change in peripheral locations. The operated cases associated with alcohol dropped post reforms (102/145 (70%) vs 33/58 (57%). The number of assaults related to ‘king hits’ significantly reduced from 30 (33%) to just 5 (19.2%).
Conclusion: This study demonstrates a clear correlation with the reduction in maxillofacial trauma, alcohol and violence in a localised region of Sydney since the arrival of the lockout reforms. As such, it can provide guidance to other regions in Australia into the effects of such laws and its repercussions on patient care and service.
2. Menéndez P, Weatherburn D, Kypri K, Fitzgerald J. Lockouts and last drinks: the impact of the January 2014 liquor licence reforms on assaults in NSW, Australia. Crime and Justice Bulletin, 2015: 183. [Cited 30 September 2017.] Available from URL: http://www.bocsar.nsw.gov.au/Documents/CJB/CJB183.pdf
3. Briscoe S, Donnelly N. Temporal and regional aspects of alcohol-related violence and disorder. Alcohol Studies Bulletins, 2001. [Cited 30 September 2017.] Available from URL: http://www.bocsar.nsw.gov.au/Documents/BB/ab01.pdf
4. Doherty SJ, Roche AM. Alcohol and Licensed Premises: Best Practice in Policing. A Monograph for Police and Policy Makers. Commonwealth of Australia, 2003. [Cited 30 September 2017.] Available from URL: http://nceta.flinders.edu.au/files/7312/5548/1448/EN34.pdf
5. Poynton S, Donnelly N, Weatherburn D, Fulde G, Scott L. The role of alcohol in injuries presenting to St Vincent's Hospital emergency department and the associated short-term costs. Alcohol Studies Bulletins, 2005. [Cited 30 September 2017.] Available from URL: http://www.bocsar.nsw.gov.au/Documents/BB/ab06.pdf
6. Roth L. Liquor licencing restrictions to address alcohol-related violence in NSW: 2008 to 2014. NSW Parliamentary Service. 2014. [Cited 30 September 2017.] Available from URL:
7. Kypri K, McElduff P, Miller P. Restrictions in pub closing times and lockouts in Newcastle, Australia five years on. Drug Alcohol Rev. 2014; 33: 323-326. https://doi.org/10.1111/dar.12123 PMid:24589092
8. Australian Bureau of Statistics. 2011 Census Quick Stats. 2012. [Cited 30 September 2017.] Available from URL:
9. City of Sydney. Plan of Management for the Sydney CBD Entertainment Precinct. 2014. [Cited 30 September 2017.] Available from URL: http://www.justice.nsw.gov.au/Pages/media-news/media-releases/2014/plan-of-management-released.aspx
10. Telfer MR, Jones GM, Shepherd JP. Trends in the aetiology of maxillofacial fractures in the United Kingdom (1977-1987). Br J Oral Maxillofac Surg. 1991; 29: 256-258. https://doi.org/10.1016/0266-4356(91)90192-8
11. Lynham A, Tuckett J, Warnke P. Maxillofacial trauma. Aust Fam Physician 2012; 41: 172-180.
12. Moncrieff NJ, Qureshi C, Deva AK. A comparative cost analysis of maxillofacial trauma in Australia. J Craniofac Surg. 2004; 15: 686-691. https://doi.org/10.1097/00001665-200407000-00030 PMid:15213554
13. Warburton AL, Shepherd JP. Alcohol-related violence and the role of oral and maxillofacial surgeons in multi-agency prevention. Int J Oral Maxillofac Surg. 2002; 31: 657-663. https://doi.org/10.1054/ijom.2002.0245 PMid:12521325
14. Goulart DR, Durante L, de Moraes M, Asprino L. Characteristics of maxillofacial trauma among alcohol and drug users. J Craniofac Surg. 2015; 26(8): e783-786. https://doi.org/10.1097/SCS.0000000000002055
15. Fulde GW, Smith M, Forster SL. Presentations with alcohol-related serious injury to a major Sydney trauma hospital after 2014 changes to liquor laws. Med J Aust. 2015; 203(9): 366. https://doi.org/10.5694/mja15.00637 PMid:26510806
16. Donnelly N, Weatherburn D, Routledge K, Ramsey S, Mahoney N. Did the 'lockout law' reforms increase assaults at The Star casino, Pyrmont? Sydney: NSW Bureau of Crime Statistics and Research. 2016. [Cited 30 September 2017.] Available from URL: http://www.bocsar.nsw.gov.au/Pages/bocsar
17. De Goeij MCM, Veldhuizen EM, Buster MCA, Kunst AE. The impact of extended closing times of alcohol outlets on alcohol-related injuries in the nightlife areas of Amsterdam: a controlled before-and-after evaluation. Addiction. 2015; 110(6): 955-964. https://doi.org/10.1111/add.12886 PMid:25689068
18. Rossow I, Norström T. The impact of small changes in bar closing hours on violence. The Norwegian experience from 18 cities. Addiction. 2012; 107(3): 530-537. https://doi.org/10.1111/j.1360-0443.2011.03643.x PMid:21906198 PMCid:PMC3380552