Chunk #63 — RESULTS — CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE — LOWER RESPIRATORY INFECTIONS: COMMUNITY ACQUIRED PNEUMONIA
Community acquired pneumonia (CAP), distinguished from hospital-acquired pneumonia because of its different aetiology, has been recognized as caused by heavy alcohol consumption since the seminal work of Rush in the late 18th century [33]. An association between CAP and alcohol intake has been found [161], and plausible biological pathways have been identified. As already indicated above (see section on TB), heavy alcohol consumption can cause alterations of the immune system, thereby increasing host susceptibility to CAP. Also, because of the sedative properties of alcohol which lead to diminished oropharyngeal tone, an increased risk of aspiration and diminished cough reflex and mucociliary clearance [38;162], alcohol intake can facilitate the development of CAP. A preliminary meta-analysis by our group indicated that the risk curve is relatively flat for lower consumption, and reaches a RR of 1.3 only at a consumption level of about 5 drinks per day (equivalent to 60 g pure alcohol per day). On the other hand, older studies showed that patients defined as “alcoholics” according to clinical symptoms showed an 8-fold increased risk for CAP [163;164]. Also, in a
