Journal of Community Health

, Volume 35, Issue 6, pp 660–666

Recent Incarceration Linked to Cutaneous Injection-Related Infections Among Active Injection Drug Users in a Canadian Setting

  • M.-J. Milloy
  • Evan Wood
  • Elisa Lloyd-Smith
  • Eric Grafstein
  • Mark Tyndall
  • Julio Montaner
  • Thomas Kerr
Original Paper


Cutaneous injection-related infections (CIRI), such as abscesses and cellulitis, are the cause of a substantial burden of morbidity and mortality among injection drug users (IDU). The possible contribution of exposure to correctional environments to CIRI risk has not been fully investigated. Thus, we sought to test the possible relationship between incarceration and CIRI using data from a community-based sample of IDU. Data for these analyses was from the Scientific Evaluation of Supervised Injecting (SEOSI) cohort, linked with administrative records of a local ED in Vancouver, Canada. Using longitudinal analysis we assessed the relationship between the number of ED visits for CIRI care and recent incarceration in a multivariate model including information on possible confounders. Between June 2004 and December 2006, 901 individuals were eligible for our analysis. Of these, 214 (9.6%) visited the ED for CIRI care at least once during the study period. The incidence of ED care for CIRI was 72.9 per 100 person years. In a multivariate model, recent incarceration was associated with a greater number of ED visits for CIRI care (adjusted relative rate = 1.56, 95% confidence interval: 1.31–1.85, P < 0.001). The need for ED treatment for CIRI was common among a sample of local IDU. Exposure to correctional environments was an independent risk factor for visiting the ED for CIRI care, suggesting improvements in infection control in local prisons is urgently needed.


Injection drug use Cutaneous injection-related infection Emergency department Incareration Epidemiology 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • M.-J. Milloy
    • 1
    • 2
  • Evan Wood
    • 1
    • 5
  • Elisa Lloyd-Smith
    • 3
  • Eric Grafstein
    • 4
    • 5
  • Mark Tyndall
    • 1
    • 5
  • Julio Montaner
    • 1
    • 5
  • Thomas Kerr
    • 1
    • 5
  1. 1.British Columbia Centre for Excellence in HIV/AIDSSt. Paul’s HospitalVancouverCanada
  2. 2.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  3. 3.Department of Infection Prevention and ControlProvidence Health CareVancouverCanada
  4. 4.Department of Emergency MedicineSt. Paul’s HospitalVancouverCanada
  5. 5.Faculty of MedicineUniversity of British ColumbiaVancouverCanada

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