The relation between different dimensions of alcohol consumption and burden of disease: an overview

Article


Rehm, Jürgen, Baliunas, Dolly, Borges, Guilherme L. G., Graham, Kathryn, Irving, Hyacinth, Kehoe, Tara, Parry, Charles D., Patra, Jayadeep, Popova, Svetlana, Poznyak, Vladimir, Roerecke, Michael, Room, Robin, Samokhvalov, Andriy V. and Taylor, Benjamin. 2010. "The relation between different dimensions of alcohol consumption and burden of disease: an overview." Addiction. 105 (5), pp. 817-43. https://doi.org/10.1111/j.1360-0443.2010.02899.x
Article Title

The relation between different dimensions of alcohol consumption and burden of disease: an overview

ERA Journal ID13373
Article CategoryArticle
AuthorsRehm, Jürgen, Baliunas, Dolly, Borges, Guilherme L. G., Graham, Kathryn, Irving, Hyacinth, Kehoe, Tara, Parry, Charles D., Patra, Jayadeep, Popova, Svetlana, Poznyak, Vladimir, Roerecke, Michael, Room, Robin, Samokhvalov, Andriy V. and Taylor, Benjamin
Journal TitleAddiction
Journal Citation105 (5), pp. 817-43
Number of Pages27
Year2010
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0965-2140
1360-0443
Digital Object Identifier (DOI)https://doi.org/10.1111/j.1360-0443.2010.02899.x
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.02899.x
Abstract

Aims  As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease.

Methods  Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses.

Results  Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose–response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden.

Conclusions  Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol–disease relationships.

KeywordsAlcohol ; average volume; risk relation; patterns of drinking; mortality; morbidity; injury; burden of disease
ANZSRC Field of Research 2020420201. Behavioural epidemiology
Public NotesFiles associated with this item cannot be displayed due to copyright restrictions.
Byline AffiliationsCentre for Addiction and Mental Health, Canada
University of Toronto, Canada
Dresden University of Technology, Germany
University of Western Ontario, Canada
Curtin University of Technology
South African Medical Research Council, South Africa
Stellenbosch University, South Africa
World Health Organization, Switzerland
University of Melbourne
Turning Point Alcohol and Drug Centre, Australia
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