The effects of capping the alcohol consumption distribution and relative risk functions on the estimated number of deaths attributable to alcohol consumption in the European Union in 2004

BMC Medical Research Methodology

Jürgen Rehm¹  Tara AK Kehoe-Chan³  Kevin D Shield⁴  Gerrit Gmel² 

[1] Institute for Clinical Psychology and Psychotherapy, TU Dresden, Germany;Faculty of Engineering, University of New South Wales, Sydney, Australia;Department of Statistics, University of Toronto, Toronto, Canada;Institute of Medical Science, University of Toronto, Toronto, Canada

关键词: Sensitivity analysis;    Mortality;    Capping;    Alcohol-Attributable Fraction;    Gamma distribution;    Modelling;    Alcohol consumption;   

Others  :  1126112
DOI  :  10.1186/1471-2288-13-24

 received in 2012-10-02, accepted in 2013-02-13,  发布年份 2013

【 摘 要 】

Background

When calculating the number of deaths attributable to alcohol consumption (i.e., the number of deaths that would not have occurred if everyone was a lifetime abstainer), alcohol consumption is most often modelled using a capped exposure distribution so that the maximum average daily consumption is 150 grams of pure alcohol. However, the effect of capping the exposure distribution on the estimated number of alcohol-attributable deaths has yet to be systematically evaluated. Thus, the aim of this article is to estimate the number of alcohol-attributable deaths by means of a capped and an uncapped gamma distribution and capped and uncapped relative risk functions using data from the European Union (EU) for 2004.

Methods

Sex- and disease-specific alcohol relative risks were obtained from the ongoing Global Burden of Disease, Comparative Risk Assessment Study. Adult per capita consumption estimates were obtained from the Global Information System on Alcohol and Health. Data on the prevalence of current drinkers, former drinkers, and lifetime abstainers by sex and age were obtained from various population surveys. Alcohol-attributable deaths were calculated using Alcohol-Attributable Fractions that were calculated using capped (at 150 grams of alcohol) and uncapped alcohol consumption distributions and capped and uncapped relative risk functions.

Results

Alcohol-attributable mortality in the EU may have been underestimated by 25.5% for men and 8.0% for women when using the capped alcohol consumption distribution and relative risk functions, amounting to the potential underestimation of over 23,000 and 1,100 deaths in 2004 in men and women respectively. Capping of the relative risk functions leads to an estimated 9,994 and 468 fewer deaths for men and for women respectively when using an uncapped gamma distribution to model alcohol consumption, accounting for slightly less than half of the potential underestimation.

Conclusions

Although the distribution of drinkers in the population and the exact shape of the relative risk functions at large average daily alcohol consumption levels are not known, the findings of our study stress the importance of conducting further research to focus on exposure and risk in very heavy drinkers.

【 授权许可】

   
2013 Gmel et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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