Mortality and potential years of life lost attributable to alcohol consumption in Canada in 2005

BMC Public Health

Jürgen Rehm¹  Jayadeep Patra²  Tara Kehoe³  Benjamin Taylor²  Kevin D Shield² 

[1] Institute for Clinical Psychology and Psychotherapy, TU Dresden, Germany;Dalla Lana School of Public Health (DLSPH), University of Toronto, Toronto, Canada;Department of Statistics, University of Toronto, Toronto, Canada

关键词: Canada;    Relative risk;    Potential years of life lost;    Mortality;    Alcohol consumption;   

Others  :  1163884
DOI  :  10.1186/1471-2458-12-91

 received in 2011-01-24, accepted in 2012-01-31,  发布年份 2012

【 摘 要 】

Background

Alcohol is a substantial risk factor for mortality according to the recent 2010 World Health Assembly strategy to reduce the harmful use of alcohol which outlined the need to characterize and monitor this burden. Accordingly, using new methodology we estimated 1) the number of deaths caused and prevented by alcohol consumption, and 2) the potential years of life lost (PYLLs) attributable to alcohol consumption in Canada in 2005.

Methods

Mortality attributable to alcohol consumption was estimated by calculating Alcohol-Attributable Fractions (AAFs) (defined as the proportion of mortality that would be eliminated if the exposure was eliminated) using data from various sources. Indicators for alcohol consumption were obtained from the Canadian Alcohol and Drug Use Monitoring Survey 2008 and corrected for adult per capita recorded and unrecorded alcohol consumption. Risk relations were taken from the Comparative Risk Assessment within the current Global Burden of Disease (GBD) study. Due to concerns about the reliability of information specifying causes of death for people aged 65 or older, our analysis was limited to individuals aged 0 to 64 years. Calculation of the 95% confidence intervals (CIs) for the AAFs was performed using Monte Carlo random sampling. Information on mortality was obtained from Statistics Canada. A sensitivity analysis was performed comparing the mortality results obtained using our study methods to results obtained using previous methodologies.

Results

In 2005, 3,970 (95% CI: 810 to 7,170) deaths (4,390 caused and 420 prevented) and 134,555 (95% CI: 36,690 to 236,376) PYLLs were attributable to alcohol consumption for individuals aged 0 to 64 years. These figures represent 7.7% (95% CI: 1.6% to 13.9%) of all deaths and 8.0% (95% CI: 2.2% to 14.1%) of all PYLLs for individuals aged 0 to 64 years. The sensitivity analysis showed that the number of deaths as measured by this new methodology is greater than that if mortality was estimated using previous methodologies.

Conclusions

The mortality burden attributable to alcohol consumption for Canada is large, unnecessary, and could be substantially reduced in a short period of time if effective public health policies were implemented. A monitoring system on alcohol consumption is imperative and would greatly assist in planning and evaluating future Canadian public health policies related to alcohol consumption.

【 授权许可】

   
2012 Shield et al; BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Global Health Risks. Mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: World Health Organization; 2009.
• [2]Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J: Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 2009, 373:2223-2233.
• [3]Rehm J, Baliunas D, Borges GLG, Graham K, Irving HM, Kehoe T, Parry CD, Patra J, Popova L, Poznyak V, Roerecke M, Room R, Samokhvalov AV, Taylor B: The relation between different dimensions of alcohol consumption and burden of disease - an overview. Addiction 2010, 105:817-843.
• [4]Rehm J, Room R, Graham K, Monteiro M, Gmel G, Sempos C: The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease - an overview. Addiction 2003, 98:1209-1228.
• [5]English DR, Holman CDJ, Milne E, Winter MJ, Hulse GK, Codde G, Bower CI, Cortu B, de Klerk N, Lewin GF, Knuiman M, Kurinczuk JJ, Ryan GA: The quantification of drug caused morbidity and mortality in Australia 1995. Canberra, Australia: Australian Government Publishing Service; 1995.
• [6]World Health Organization: World Health Organization: Global strategy to reduce the harmful use of alcohol. Geneva, Switzerland: World Health Organization; 2010.
• [7]Rehm J, Room R: Monitoring of alcohol use and attributable harm from an international perspective. Contemp Drug Probl 2009, 36:575-588.
• [8]Rehm J, Patra J, Popova S: Alcohol-attributable mortality and potential years of life lost in Canada 2001: implications for prevention and policy. Addiction 2006, 101:373-384.
• [9]Rehm J, Taylor B, Patra J: Volume of alcohol consumption, patterns of drinking and burden of disease in the European region 2002. Addiction 2006, 101:1086-1095.
• [10]Rehm J, Kehoe T, Gmel G, Stinson F, Grant B, Gmel G: Statistical modelling of volume of alcohol exposure for epidemiological studies of population health: the example of the US. Popul Health Metr 2010, 8:3. BioMed Central Full Text
• [11]Gmel G, Kuntsche E, Wicki M, Labhart F: Measuring Alcohol-Related Consequences in School Surveys: Alcohol-Attributable Consequences or Consequences with students' alcohol attribution. Am J Epidemiol 2010, 171:94-104.
• [12]Murray CJL, Lopez AD, Black R, Mathers CD, Shibuya K, Ezzati M, Salomon JA, Michaud CM, Walker N, Vos T: Global burden of disease 2005: call for collaborators. Lancet 2007, 370:109-110.
• [13]Single E, Robson L, Rehm J, Xie X: Morbidity and mortality attributable to alcohol, tobacco, and illicit drug use in Canada. Am J Public Health 1999, 89:385-390.
• [14]Health Canada: [http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/cadums-esccad-eng.php] webciteCanadian Alcohol and Drug Use Monitoring Survey.
• [15]Health Canada: [http:/ / prod.library.utoronto.ca/ datalib/ codebooks/ cstdli/ cadums/ 2008/ cadums-technical-guide-2008-final-e ng.pdf] webciteCanadian Alcohol and Drug Use Monitoring Survey 2008: Microdata User Guide.
• [16]Canadian Centre on Substance Abuse: Canadian Addiction Survey 2004: Microdata eGuide. Ottawa, Canada: Canadian Centre on Substance Abuse; 2004.
• [17]National Institute on Alcohol Abuse and Alcoholism: [http://pubs.niaaa.nih.gov/publications/AA70/AA70.htm] webciteNational Epidemiologic Survey on Alcohol and Related Conditions Alcohol. National Institute on Alcohol Abuse and Alcoholism; 2006.
• [18]Public Health Agency of Canada: Alcohol use and pregnancy: an important Canadian public health and social issue. Ottawa, Canada: Public Health Agency of Canada; 2007.
• [19]Gmel G, Rehm J: Measuring alcohol consumption Contemp Drug Probl. 2004, 31:467-540.
• [20]Macdonald S, Wells S, Giesbrecht N: Unrecorded alcohol consumption in Ontario, Canada: estimation procedures and research implications. Drug Alcohol Rev 1999, 18:21-29.
• [21]Statistics Canada: [http:/ / www.statcan.gc.ca/ cgi-bin/ imdb/ p2SV.pl?Function=getSurvey&SDDS = 3 233&lang=en&db=imdb&adm=8&dis=2] webciteVital Statistics-Death Database. 2011.
• [22]Mathers C, Stein C, Ma Fat D, Rao C, Inoue M, Tomijima N, Bernard B, Lopez AD, Murray CJL: Global Burden of Disease 2000: version 2 methods and results. Geneva, Switzerland: World Health Organization; 2002.
• [23]Taylor B, Rehm J, Room R, Patra J, Bondy S: Determination of lifetime injury mortality risk in Canada in 2002 by drinking amount per occasion and number of occasions. Am J Epidemiol 2008, 168:1119-1125.
• [24]Rehm J, Gmel Gj, Shield K, Frick U, Kehoe T, Gmel Gs: Estimating uncertainty for alcohol-attributable fractions for infectious and chronic disease. Toronto, Canada: Centre for Addiction and Mental Health; 2010.
• [25]Laslett AM, Catalano P, Chikritzhs T, Dale C, Doran C, Ferris J, Jainullabudeen T, Livingston M, Matthews S, Mugavin S: Room, Schlotterleinand M, Wilkinson C: The range and magnitude of alcohol's harm to others. Fitzroy, Australia: Turning Point Alcohol & Drug Centre; 2010.
• [26]Roerecke M, Rehm J: Irregular heavy drinking occasions and risk of ischemic heart disease: a systematic review and meta-analysis. Am J Epidemiol 2010, 171:633-644.
• [27]Murray R, Connett J, Tyas S, Bond R, Ekuma O, Silversides C, Barnes G: Alcohol volume, drinking pattern, and cardiovascular disease morbidity and mortality: is there a U-shaped function? Am J Epidemiol 2002, 155:242-248.
• [28]Rehm J, Patra J, Popova L: Alcohol drinking cessation and its effect on oesophageal and head and neck cancers: a pooled analysis. Int J Cancer 2007, 121:1132-1137.
• [29]Zatonski W, Sulkowska U, Manczuk M, Rehm J, Lowenfels AB, La Vecchia C: Liver cirrhosis mortality in Europe, with special attention to central and eastern Europe. Eur Addict Res 2010, 16:193-201.
• [30]Kehoe T, Gmel G, Shield K, Gmel G, Rehm J: Determining the best population-level alcohol consumption model and its impact on estimates of alcohol-attributable harms. Popul Health Metr, in press.
• [31]Rehm J, Klotsche J, Patra J: Comparative quantification of alcohol exposure as risk factor for global burden of disease. Int J Methods Psychiatr Res 2007, 16:66-76.
• [32]Shield K, Rehm J: Difficulties with telephone-based surveys on alcohol in high-income countries: the Canadian example. Int J Methods Psychiatr Res, in press.
• [33]Rehm J, Baliunas D, Borges GLG, Graham K, Irving HM, Kehoe T, Parry CD, Patra J, Popova L, Poznyak V, Roerecke M, Room R, Samokhvalov AV, Taylor B: The relation between different dimensions of alcohol consumption and burden of disease - An overview. Addiction 2010, 105:817-843.
• [34]Flegal KM, Williamson DF, Graubard BI: Using adjusted relative risks to calculate attributable fractions. Am J Public Health 2006, 96:398.
• [35]Korn EL, Graubard BI: Analysis of Health Surveys. New York, United States: John Wiley & Sons Inc; 1999.
• [36]Rockhill B, Newman B: Use and misuse of population attributable fractions. Am J Public Health 1998, 88:15-19.
• [37]Baliunas D: A comparison of two methods of adjusted attributable fraction estimation as applied to the four major smoking related causes of death in Canada, in 2005. In PhD Thesis. University of Toronto, Dalla Lana School of Public Health; 2011.
• [38]World Health Organization: The world health report 2002: Reducing risks, promoting healthy life. Geneva, Switzerland: World Health Organization; 2002.
• [39]Chisholm D, Rehm J, van Ommeren M, Monteiro M: Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J Stud Alcohol 2004, 65:782-793.
• [40]Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Grube J, Gruenewald P, Hill L, Holder H, Livingston M, Österberg E, Rehm J, Room R, Rossow I: Alcohol: No ordinary commodity. Research and public policy. 2nd edition. Oxford and London, United Kingdom of Great Britain and Northern Ireland: Oxford University Press; 2010.
• [41]Room R, Babor T, Rehm J: Alcohol and public health: a review. Lancet 2005, 365:519-530.
• [42]Rehm J, Gnam W, Popova S, Patra J, Sarnocinska-Hart A: Avoidable cost of alcohol abuse in Canada 2002. Toronto, Canada: Centre for Addiction and Mental Health; 2008.
• [43]Rehm J, Patra J, Gnam W, Sarnocinska-Hart A, Popova S: Avoidable cost of alcohol abuse in Canada. Eur Addict Res 2011, 17:72-79.
• [44]Leon D, Chenet L, Shkolnikov V, Zakharov S, Shapiro J, Rakhmanova G, Vassin S, McKee M: Huge variation in Russian mortality rates 1984-1994: Artefact, alcohol, or what? Lancet 1997, 350:383-388.
• [45]Wagenaar AC, Maldonado-Molina MM, Wagenaar BA: Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004. Am J Public Health 2009, 99:1464-1470.
• [46]Lönnroth K, Williams B, Stadlin S, Jaramillo E, Dye C: Alcohol use as a risk factor for tuberculosis - a systematic review. BMC Public Health 2008, 8:289. BioMed Central Full Text
• [47]Rehm J, Samokhvalov AV, Neuman MG, Room R, Parry CD, Lönnroth K, Patra J, Poznyak V, Popova S: The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review BMC Public Health 2009, 9:450.
• [48]Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Alteri A, Cogliano V, on behalf of the WHO international agency for research on cancer monograph working group: Carcinogenicity of alcoholic beverages. Lancet Oncol 2007, 8:292-293.
• [49]Corrao G, Bagnardi V, Zambon A, La Vecchia C: A meta-analysis of alcohol consumption and the risk of 15 diseases. Prev Med 2004, 38:613-619.
• [50]Baliunas D, Taylor B, Irving H, Roerecke M, Patra J, Mohapatra S, Rehm J: Alcohol as a risk factor for type 2 diabetes - a systematic review and meta-analysis. Diabetes Care 2009, 32:2123-2132.
• [51]Samokhvalov AV, Irving H, Mohapatra S, Rehm J: Alcohol consumption, unprovoked seizures and epilepsy: a systematic review and meta-analysis. Epilepsia 2010, 51:1177-1184.
• [52]Taylor B, Irving HM, Baliunas D, Roerecke M, Patra J, Mohapatra S, Rehm J: Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. Addiction 2009, 104:1981-1990.
• [53]Roerecke M, Rehm J: Alcohol consumption and the risk for morbidity and mortality of ischemic heart disease - A systemic review and meta-analysis. Toronto, Canada: Centre for Addiction and Mental Health; 2010.
• [54]Samokhvalov AV, Irving HM, Rehm J: Alcohol as a risk factor for atrial fibrillation: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2010, 17:706-712.
• [55]Patra J, Taylor B, Irving H, Roerecke M, Baliunas D, Mohapatra S, Rehm J: Alcohol consumption and the risk of morbidity and mortality for different stroke types - a systematic review and meta-analysis. BMC Public Health 2010, 10:258. BioMed Central Full Text
• [56]Rehm J, Taylor B, Mohapatra S, Irving H, Baliunas D, Patra J, Roerecke M: Alcohol as a risk factor for liver cirrhosis - a systematic review and meta-analysis. Drug Alcohol Rev 2010, 29:437-445.
• [57]Irving HM, Samokhvalov A, Rehm J: Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis JOP 2009, 10:387-392.
• [58]Samokhvalov AV, Irving HM, Rehm J: Alcohol consumption as a risk factor for pneumonia: systematic review and meta-analysis. Epidemiol Infect 2010, 138:1789-1795.
• [59]Patra J, Bakker R, Irving H, Jaddoe VWV, Rehm J: Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG 2011, 188:1411-1421.
• [60]Taylor B, Irving HM, Kanteres F, Room R, Borges G, Cherpitel C, Greenfield T, Rehm J: The more you drink, the harder you fall: a systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend 2010, 110:108-116.
• [61]Rehm J, Room R, Taylor B: Method for moderation: measuring lifetime risk of alcohol-attributable mortality as a basis for drinking guidelines. Int J Methods Psychiatr Res 2008, 17:141-151.
• [62]Taylor B, Rehm J, Room R, Patra J, Bondy S: Determination of lifetime injury mortality risk in Canada in 2002 by drinking amount per occasion and number of occasions. Am J Epidemiol 2008, 168:1119-1125.