The relation between different dimensions of alcohol consumption and burden of disease: an overview.
paper
Cited
Public
- Authors
- Rehm, JΓΌrgen; 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; Taylor, Benjamin
- Year
- 2010
- Journal
- Addiction (Abingdon, England)
- PMID
- 20331573
- DOI
- 10.1111/j.1360-0443.2010.02899.x
- PMCID
- PMC3306013
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.
Causal model of alcohol consumption, intermediate mechanisms, and long-term consequences
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|---|---|---|
| 20 | METHODS β EXTRACTION OF INFORMATION FROM ANALYSES (STEP 6) | The following information was extracted from existing meta-analyses or calculated in newβ¦ |
| 21 | METHODS β EXTRACTION OF INFORMATION FROM ANALYSES (STEP 6) | In order to check for reliability in extracting data in our own meta-analyses, a sample of 15β¦ |
| 22 | RESULTS β HEALTH CONDITIONS WHOLLY ATTRIBUTABLE TO ALCOHOL | Table 1 lists all conditions 100% attributable to alcohol, or, in other words, disease conditionsβ¦ |
| 23 | RESULTS β HEALTH CONDITIONS WHOLLY ATTRIBUTABLE TO ALCOHOL | While these disease categories by definition involve some alcohol consumption, the specific impactβ¦ |
| 24 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE | Table 2 provides an overview of mainly chronic non-communicable and infectious disease conditionsβ¦ |
| 25 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE | In the following, we describe briefly the evidence of the relationship, including biologicalβ¦ |
| 26 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β TUBERCULOSIS (TB) | A technical meeting was hosted by the South African Medical Research Council and co-sponsored by theβ¦ |
| 27 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β TUBERCULOSIS (TB) | It has long been known that alcohol has been associated with TB [33]. The association between heavyβ¦ |
| 28 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β TUBERCULOSIS (TB) | Our analyses identified two plausible pathways between heavy alcohol consumption and TB. First,β¦ |
| 29 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β TUBERCULOSIS (TB) | Regarding the course of the disease, there is sufficient evidence indicating that heavy alcoholβ¦ |
| 30 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β HUMAN IMMUNODEFICIENCY VIRUS / ACQUIRED IMMUNE DEFICIENCY SYNDROME (HIV/AIDS) | At the Cape Town meeting mentioned above, it was similarly concluded that there is conclusiveβ¦ |
| 31 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β HUMAN IMMUNODEFICIENCY VIRUS / ACQUIRED IMMUNE DEFICIENCY SYNDROME (HIV/AIDS) | relationship between alcohol consumption and unprotected sex is examined within event-level contextsβ¦ |
| 32 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β HUMAN IMMUNODEFICIENCY VIRUS / ACQUIRED IMMUNE DEFICIENCY SYNDROME (HIV/AIDS) | However, there is enough evidence to conclude a causal impact of alcohol on the course of theβ¦ |
| 33 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β CANCER (IN GENERAL) | In February 2007, the Monograph Working Group of the International Agency for Research on Cancerβ¦ |
| 34 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β CANCER (IN GENERAL) | The molecular and biochemical mechanisms by which chronic alcohol consumption leads to theβ¦ |
| 35 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β CANCER (IN GENERAL) | Several of the cancers that were identified as alcohol-attributable in the latest review had alreadyβ¦ |
| 36 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β COLORECTAL CANCER | A causal relation between alcohol and colorectal cancer was established only recently by the IARCβ¦ |
| 37 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β COLORECTAL CANCER | A potential mechanism is that alcohol may act through folate metabolism or synergistically with lowβ¦ |
| 38 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β BREAST CANCER (FEMALE) | Many epidemiological studies have indicated a positive relation between alcohol consumption andβ¦ |
| 39 | RESULTS β CHRONIC AND INFECTIOUS DISEASE CONDITIONS WHERE ALCOHOL IS A COMPONENT CAUSE β BREAST CANCER (FEMALE) | The mechanism of association between alcohol and breast cancer may involve increased levels ofβ¦ |
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