Fourth, ARDI does not include estimates of AAD for several causes (eg, tuberculosis, pneumonia, hepatitis C) for which alcohol is believed to be an important risk factor, but for which suitable pooled risk estimates were not available. Fifth, ARDI exclusively uses the underlying cause of death from vital statistics data to identify alcohol-related causes and does not consider contributing causes of death that might be alcohol-related. Finally, age-specific estimates of AAF were only available for motor-vehicle traffic deaths, even though alcohol involvement varies by age, particularly for acute causes of death. While our results do show the substantial burden of alcohol-related consequences, many of the limitations cited could result in a substantial underestimate of the true contribution of excessive alcohol consumption to total deaths and YPLL in the United States.
