Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Griswold, M. G. and Fullman, N. and Hawley, C. and Arian, N. and Zimsen, S. R. M. and Tymeson, H. D. and Venkateswaran, V. and Tapp, A. D. and Forouzanfar, M. H. and Salama, J. S. and Abate, K. H. and Abate, D. and Abay, S. M. and Abbafati, C. and Abdulkader, R. S. and Abebe, Z. and Aboyans, V. and Abrar, M. M. and Acharya, P. and Adetokunboh, O. O. and Adhikari, T. B. and Adsuar, J. C. and Afarideh, M. and Agardh, E. E. and Agarwal, G. and Aghayan, S. A. and Agrawal, S. and Ahmed, M. B. and Akibu, M. and Akinyemiju, T. and Akseer, N. and Al Asfoor, D. H. and Al-Aly, Z. and Alahdab, F. and Alam, K. and Albujeer, A. and Alene, K. A. and Ali, R. and Ali, S. D. and Alijanzadeh, M. and Aljunid, S. M. and Alkerwi, A. and Allebeck, P. and Alvis-Guzman, N. and Amare, A. T. and Aminde, L. N. and Ammar, W. and Amoako, Y. A. and Amul, G. G. H. and Andrei, C. L. and Angus, C. and Ansha, M. G. and Antonio, C. A. T. and Aremu, O. and Ärnlöv, J. and Artaman, A. and Aryal, K. K. and Assadi, R. and Ausloos, M. and Avila-Burgos, L. and Avokpaho, E. F. G. A. and Awasthi, A. and Ayele, H. T. and Ayer, R. and Ayuk, T. B. and Azzopardi, P. S. and Badali, H. and Badawi, A. and Banach, M. and Barker-Collo, S. L. and Barrero, L. H. and Basaleem, H. and Baye, E. and Bazargan-Hejazi, S. and Bedi, N. and Béjot, Y. and Belachew, A. B. and Belay, S. A. and Bennett, D. A. and Bensenor, I. M. and Bernabe, E. and Bernstein, R. S. and Beyene, A. S. and Beyranvand, T. and Bhaumik, S. and Bhutta, Z. A. and Biadgo, B. and Bijani, A. and Bililign, N. and Birlik, S. M. and Birungi, C. and Bizuneh, H. and Bjerregaard, P. and Bjørge, T. and Borges, G. and Bosetti, C. and Boufous, S. and Bragazzi, N. L. and Brenner, H. and Butt, Z. A. (2018) Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. The Lancet, 392 (10152). pp. 1015-1035.

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Abstract

Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted lifeyears (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2 (95 uncertainty interval UI 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of agestandardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% 95% UI 1·0-1·7 of total deaths), road injuries (1·2% 0·7-1·9), and self-harm (1·1% 0·6-1·5). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week. Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. Funding Bill & Melinda Gates Foundation. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Item Type: Article
Additional Information: Cited By :294 Export Date: 16 February 2020 CODEN: LANCA Correspondence Address: Gakidou, E.; Institute for Health Metrics and Evaluation, University of WashingtonUnited States; email: gakidou@uw.edu
Uncontrolled Keywords: age distribution alcohol consumption Article automutilation cause of death death disability-adjusted life year geographic distribution global disease burden health hazard human malignant neoplasm priority journal risk assessment risk factor sex difference systematic review traffic accident tuberculosis adolescent adult aged commercial phenomena drinking behavior epidemiology female global health health survey male meta analysis middle aged mortality observational study prevalence prospective study quality adjusted life year retrospective study sex ratio statistics and numerical data very elderly young adult Aged, 80 and over Alcohol Drinking Commerce Global Burden of Disease Humans Observational Studies as Topic Population Surveillance Prospective Studies Quality-Adjusted Life Years Retrospective Studies Risk Factors Sex Distribution
Subjects: WB Practice of Medicine
WM Psychiatry
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 18 May 2020 08:06
Last Modified: 18 May 2020 08:06
URI: http://eprints.mums.ac.ir/id/eprint/17305

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