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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 Publisher Pubmed



Griswold MG1 ; Fullman N1 ; Hawley C1 ; Arian N1 ; Zimsen SRM1 ; Tymeson HD1 ; Venkateswaran V5 ; Tapp AD1 ; Forouzanfar MH9 ; Salama JS1 ; Abate KH10 ; Abate D15 ; Abay SM16 ; Abbafati C20 Show All Authors
Authors
  1. Griswold MG1
  2. Fullman N1
  3. Hawley C1
  4. Arian N1
  5. Zimsen SRM1
  6. Tymeson HD1
  7. Venkateswaran V5
  8. Tapp AD1
  9. Forouzanfar MH9
  10. Salama JS1
  11. Abate KH10
  12. Abate D15
  13. Abay SM16
  14. Abbafati C20
  15. Abdulkader RS21
  16. Abebe Z23
  17. Aboyans V26, 27
  18. Abrar MM19
  19. Acharya P28
  20. Adetokunboh OO29, 31
  21. Adhikari TB34, 35
  22. Adsuar JC38
  23. Afarideh M39
  24. Agardh EE51
  25. Agarwal G54
  26. Aghayan SA55, 56
  27. Agrawal S58, 59
  28. Ahmed MB11
  29. Akibu M60
  30. Akinyemiju T62, 63
  31. Akseer N67
  32. Al Asfoor DH22, 66
  33. Alaly Z67, 68
  34. Alahdab F69, 70
  35. Alam K71
  36. Albujeer A73
  37. Alene KA24, 74
  38. Ali R66, 76
  39. Ali SD77
  40. Alijanzadeh M78
  41. Aljunid SM79, 80
  42. Alkerwi A81
  43. Allebeck P51, 82
  44. Alvisguzman N83, 84
  45. Amare AT85, 88
  46. Aminde LN89
  47. Ammar W94, 95
  48. Amoako YA97
  49. Amul GGH98
  50. Andrei CL101
  51. Angus C102
  52. Ansha MG61
  53. Antonio CAT103
  54. Aremu O105
  55. Arnlov J52, 106
  56. Artaman A107
  57. Aryal KK108
  58. Assadi R109
  59. Ausloos M111
  60. Avilaburgos L112
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  240. Khader Y338
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  242. Khalil IA1
  243. Khan MN161, 341
  244. Khang YH342, 343
  245. Khater MM344
  246. Khubchandani J345
  247. Kim CI346
  248. Kim D347
  249. Kim YJ348
  250. Kimokoti RW349
  251. Kisa A350, 352
  252. Kivimaki M181, 353
  253. Kochhar S2, 355, 356
  254. Kosen S358
  255. Koul PA359
  256. Koyanagi A293
  257. Krishan K360
  258. Defo BK361, 362
  259. Bicer BK363, 364
  260. Kulkarni VS365
  261. Kumar P213
  262. Lafranconi A275
  263. Balaji AL370
  264. Lalloo R90
  265. Lallukka T353, 371
  266. Lam H373
  267. Lami FH374
  268. Lan Q375
  269. Lang JJ132
  270. Lansky S376
  271. Larsson AO377, 378
  272. Latifi A380
  273. Leasher JL381
  274. Lee PH382
  275. Leigh J383
  276. Leinsalu M385, 386
  277. Leung J91
  278. Levi M387, 388
  279. Li Y389
  280. Lim LL390
  281. Linn S391, 392
  282. Liu S393
  283. Lobatocordero A394
  284. Lopez AD366
  285. Lotufo PA154
  286. Macarayan ERK7, 104
  287. Machado IE224
  288. Madotto F225
  289. Abd El Razek HM395
  290. Abd El Razek MM396
  291. Majdan M397
  292. Majdzadeh R45, 49
  293. Majeed A273
  294. Malekzadeh R46, 398
  295. Malta DC223
  296. Mapoma CC399
  297. Martinezraga J400, 401
  298. Maulik PK166, 192
  299. Mazidi M402
  300. Mckee M403
  301. Mehta V405
  302. Meier T406, 408
  303. Mekonen T87
  304. Meles KG152
  305. Melese A409
  306. Memiah PTN410
  307. Mendoza W411
  308. Mengistu DT148
  309. Mensah GA336, 412
  310. Meretoja TJ354, 413
  311. Mezgebe HB414
  312. Miazgowski T415
  313. Miller TR417, 418
  314. Mini G292, 419
  315. Mirica A302, 420
  316. Mirrakhimov EM421, 422
  317. Moazen B234, 423
  318. Mohammad KA424, 425
  319. Mohammadifard N426
  320. Mohammed S234, 428
  321. Monasta L430
  322. Moraga P431
  323. Morawska L432
  324. Mousavi SM47
  325. Mukhopadhyay S434
  326. Musa KI435
  327. Naheed A436
  328. Naik G437
  329. Najafi F438
  330. Nangia V440
  331. Nansseu JR290, 441
  332. Nayak MSDP369
  333. Nejjari C442, 443
  334. Neupane S243
  335. Neupane SP351, 444
  336. Ngunjiri JW445
  337. Nguyen CT445
  338. Nguyen LH446
  339. Nguyen TH446
  340. Ningrum DNA447, 448
  341. Nirayo YL150
  342. Noubiap JJ335
  343. Oforiasenso R232, 449
  344. Ogbo FA451
  345. Oh IH452
  346. Oladimeji O453, 454
  347. Olagunju AT221, 455
  348. Olivares PR456
  349. Olusanya BO457
  350. Olusanya JO458
  351. Oommen AM217
  352. Oren E4, 459
  353. Orpana HM133, 460
  354. Ortegaaltamirano DDV112
  355. Ortiz JR2, 461
  356. Ota E462
  357. Owolabi MO463
  358. Oyekale AS464
  359. Mahesh PA466
  360. Pana A302, 467
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  362. Parry CDH30, 334
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Source: The Lancet Published:2018


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.
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