Figure 1 provides an overview of the conceptual model used for the current analysis of alcohol within the Global Burden of Disease and Injury (GBD) 2005 study. The GBD 2005 study is a comprehensive effort to estimate and analyse mortality and disability on a global level, including measuring the impact of major risk factors in a comparative fashion [2] In our conceptual model for the impact of alcohol consumption on disease morbidity and mortality, two separate but related dimensions of individual level drinking are hypothesized as exerting the main causal impact on burden of disease: overall volume of alcohol consumption and pattern of drinking. Volume, usually operationalized as the total absolute alcohol consumed over a time period, such as one year, has been the traditional measure of exposure in alcohol epidemiology [3], and has been causally linked to many International Classification of Diseases (ICD) codes following the seminal work of English and colleagues [4]. Specifically, more than 30 ICD-10 (version 10) three or four-digit codes include alcohol in their name or definition [5], indicating that alcohol consumption is a necessary
