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

Griswold, Max; Fullman, Nancy; Hawley, Caitlin; Arian, Nicholas; Zimsen, Stephanie R M; Tymeson, Hayley D; Venkateswaran, Vidhya; Tapp, Austin Douglas; Forouzanfar, Mohammad H; Salama, Joseph S; Alene, Kefyalew; Calabria, Bianca

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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 life-years (DALYs) for 195 locations from...[Show more]

dc.contributor.authorGriswold, Max
dc.contributor.authorFullman, Nancy
dc.contributor.authorHawley, Caitlin
dc.contributor.authorArian, Nicholas
dc.contributor.authorZimsen, Stephanie R M
dc.contributor.authorTymeson, Hayley D
dc.contributor.authorVenkateswaran, Vidhya
dc.contributor.authorTapp, Austin Douglas
dc.contributor.authorForouzanfar, Mohammad H
dc.contributor.authorSalama, Joseph S
dc.contributor.authorAlene, Kefyalew
dc.contributor.authorCalabria, Bianca
dc.date.accessioned2019-04-12T07:49:29Z
dc.identifier.issn1474-547X
dc.identifier.urihttp://hdl.handle.net/1885/159527
dc.description.abstractBackground: 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 life-years (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 age-standardised 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.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherThe Lancet Publishing Group
dc.sourceThe Lancet
dc.titleAlcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume392
dc.date.issued2018
local.identifier.absfor111716 - Preventive Medicine
local.identifier.absfor111706 - Epidemiology
local.identifier.ariespublicationu1067127xPUB15
local.type.statusPublished Version
local.contributor.affiliationGriswold, Max, University of Washington
local.contributor.affiliationFullman, Nancy, University of Washington
local.contributor.affiliationHawley, Caitlin, University of Washington
local.contributor.affiliationArian, Nicholas, University of Washington
local.contributor.affiliationZimsen, Stephanie R M, University of Washington
local.contributor.affiliationTymeson, Hayley D, University of Washington
local.contributor.affiliationVenkateswaran, Vidhya, Harvard University
local.contributor.affiliationTapp, Austin Douglas, University of Washington
local.contributor.affiliationForouzanfar, Mohammad H, Seattle Genetics
local.contributor.affiliationSalama, Joseph S, University of Washington
local.contributor.affiliationAlene, Kefyalew, College of Health and Medicine, ANU
local.contributor.affiliationCalabria, Bianca, College of Health and Medicine, ANU
local.description.embargo2039-12-31
local.bibliographicCitation.issue10152
local.identifier.doi10.1016/S0140-6736(18)31310-2
local.identifier.absseo920414 - Substance Abuse
local.identifier.absseo920401 - Behaviour and Health
dc.date.updated2019-03-12T07:24:35Z
dc.provenanceJournal: Lancet (ISSN: 0140-6736, ESSN: 1474-547X) RoMEO: This is a RoMEO green journal Paid OA: A paid open access option is available for this journal. Author's Pre-print: green tick author can archive pre-print (ie pre-refereeing) Author's Post-print: green tick author can archive post-print (ie final draft post-refereeing) Publisher's Version/PDF: cross author cannot archive publisher's version/PDF
CollectionsANU Research Publications

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