The relationship between different dimensions of alcohol use and the burden of disease—an update

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Jürgen Rehm - , Department of Psychiatry and Psychotherapy, Institute of Clinical Psychology and Psychotherapy, Centre for Addiction and Mental Health (CAMH), University of Toronto, TUD Dresden University of Technology (Author)
  • Gerhard E. Gmel - , University of Toronto, University of Lausanne, Addiction Switzerland, University of the West of England (Author)
  • Gerrit Gmel - , University of Toronto (Author)
  • Omer S.M. Hasan - , University of Toronto (Author)
  • Sameer Imtiaz - , University of Toronto (Author)
  • Svetlana Popova - , University of Toronto (Author)
  • Charlotte Probst - , Chair of Clinical Psychology and Psychotherapy, Centre for Addiction and Mental Health (CAMH), University of Toronto, TUD Dresden University of Technology (Author)
  • Michael Roerecke - , University of Toronto (Author)
  • Robin Room - , La Trobe University, Stockholm University (Author)
  • Andriy V. Samokhvalov - , University of Toronto (Author)
  • Kevin D. Shield - , International Agency for Research on Cancer (Author)
  • Paul A. Shuper - , University of Toronto (Author)

Abstract

Background and aims: Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Methods: Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. Results: In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Conclusions: Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.

Details

Original languageEnglish
Pages (from-to)968-1001
Number of pages34
JournalAddiction
Volume112
Issue number6
Publication statusPublished - Jun 2017
Peer-reviewedYes

External IDs

PubMed 28220587

Keywords

Sustainable Development Goals

Keywords

  • Alcohol use, average volume, chronic disease, injury, patterns of drinking, risk-relations, systematic review, unrecorded consumption