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1.
Artículo en Inglés | MEDLINE | ID: mdl-34728469

RESUMEN

Alcoholic beverages are carcinogenic to humans. Globally, an estimated 4.1% of new cancer cases in 2020 were attributable to alcoholic beverages. However, the full cancer burden due to alcohol is uncertain because for many cancer (sub)types, associations remain inconclusive. Additionally, associations of consumption with therapeutic response, disease progression, and long-term cancer outcomes are not fully understood, public awareness of the alcohol-cancer link is low, and the interrelationships of alcohol control regulations and cancer risk are unclear. In December 2020, the U.S. NCI convened a workshop and public webinar that brought together a panel of scientific experts to review what is known about and identify knowledge gaps regarding alcohol and cancer. Examples of gaps identified include: (i) associations of alcohol consumption patterns across the life course with cancer risk; (ii) alcohol's systemic carcinogenic effects; (iii) alcohol's influence on treatment efficacy, patient-reported outcomes, and long-term prognosis; (iv) communication strategies to increase awareness of the alcohol-cancer link; and (v) the impact of alcohol control policies to reduce consumption on cancer incidence and mortality. Interdisciplinary research and implementation efforts are needed to increase relevant knowledge, and to develop effective interventions focused on improving awareness, and reducing harmful consumption to decrease the alcohol-related cancer burden.

3.
Nutrients ; 13(8)2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34444809

RESUMEN

Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents a narrative review of different dose-response relationships for alcohol use. Relative-risk (RR) functions were obtained from various comparative risk assessments. Two main dimensions of alcohol consumption are used to assess disease and injury risk: (1) volume of consumption, and (2) patterns of drinking, operationalized via frequency of heavy drinking occasions. Lifetime abstention was used as the reference group. Most dose-response relationships between alcohol and outcomes are monotonic, but for diabetes type 2 and ischemic diseases, there are indications of a curvilinear relationship, where light to moderate drinking is associated with lower risk compared with not drinking (i.e., RR < 1). In general, women experience a greater increase in RR per gram of alcohol consumed than men. The RR per gram of alcohol consumed was lower for people of older ages. RRs indicated that alcohol use may interact synergistically with other risk factors, in particular with socioeconomic status and other behavioural risk factors, such as smoking, obesity, or physical inactivity. The literature on the impact of genetic constitution on dose-response curves is underdeveloped, but certain genetic variants are linked to an increased RR per gram of alcohol consumed for some diseases. When developing alcohol policy measures, including low-risk drinking guidelines, dose-response relationships must be taken into consideration.


Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Enfermedad , Mortalidad , Factores de Edad , Causalidad , Relación Dosis-Respuesta a Droga , Humanos , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Fumar
4.
Alcohol Alcohol ; 2021 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-34387658

RESUMEN

AIM: To examine whether changes in alcohol consumption in Canada since the start of the novel coronavirus disease (COVID-19) pandemic are associated with feelings of anxiety, depression, loneliness and/or with changes in employment due to COVID-19. METHODS: Data collection occurred between 29 May 2020 and 23 March 2021 via a web panel, AskingCanadians, which sampled 5892 adults (≥18 years of age). Data were collected on changes in alcohol consumption compared to before the pandemic (ordinal variable ranging from 1='much less alcohol' to 5='much more alcohol'), anxiety (General Anxiety Disorder-7), self-perceived depression (Center for Epidemiologic Studies Depression Scale), self-perceived loneliness, changes in employment status due to COVID-19 and socio-demographic variables (age, gender, living situation, household income and urban vs rural residence). Multivariate associations were assessed using ordinal logistic regression. Effect modification by gender was tested using likelihood-ratio tests. RESULTS: Changes in alcohol consumption were positively associated with anxiety, feeling depressed and loneliness. In particular, people with mild to moderate (ordered Odds Ratio (OR):1.23, 95% Confidence Interval (CI):1.07, 1.62) or severe anxiety (ordered OR:1.49, 95% CI:1.15, 1.93) had a greater odds of increased drinking than did people with no to low levels of anxiety. Gender, age, household income, living situation and survey wave were also associated with changes in drinking. No effect modifications by gender were observed. CONCLUSION: Given the health harms caused by alcohol use, public health practitioners and primary care physicians should focus health messaging to identify and support individuals at risk of increased alcohol consumption, especially people experiencing depression, loneliness or anxiety.

5.
J Hepatol ; 75(3): 536-546, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33892007

RESUMEN

BACKGROUND & AIMS: Despite a marked reduction in new cases of cirrhosis caused by HCV infection, over 500,000 new cirrhosis cases in this category were estimated globally in 2019. This contribution quantifies the relationship between alcohol use and the progression of liver disease in people with HCV infections. METHODS: The causal impact of different levels of alcohol use on cirrhosis has previously been established. The quantification of this relationship was undertaken based on a systematic search of the literature and a meta-analysis. We limited our search to longitudinal and case-control studies with biologically verified outcomes. Different sensitivity analyses were conducted to check on key assumptions and on the generalizability of the relationship. RESULTS: Alcohol use has a dose-dependent relationship with incident cirrhosis, which is linear on the log-linear level, and thus exponential on the level of odds ratios or other risk indicators. Each standard drink of 12 grams of pure alcohol per day increases the risk by about 11%. The results were stable regardless of the statistical model used, level of adjustment, quality of the study, or outcome (i.e., cirrhosis, decompensated cirrhosis, liver-related death). CONCLUSIONS: Alcohol use has a marked impact on the progression of HCV infections to cirrhosis and more severe liver outcomes. LAY SUMMARY: Alcohol consumption has a significant impact on the progression of liver disease in people with HCV infections. Each alcoholic drink per day is associated with an increase in the risk of cirrhosis of 11%.

6.
Drug Alcohol Rev ; 40(7): 1377-1386, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33783063

RESUMEN

ISSUES: Alcohol use has been shown to impact on various forms of liver disease, not restricted to alcoholic liver disease. APPROACH: We developed a conceptual framework based on a narrative review of the literature to identify causal associations between alcohol use and various forms of liver disease including the complex interactions of alcohol with other major risk factors. Based on this framework, we estimate the identified relations for 2017 for the USA. KEY FINDINGS: The following pathways were identified and modelled for the USA for the year 2017. Alcohol use caused 35 200 (95% uncertainty interval 32 800-37 800) incident cases of alcoholic liver cirrhosis. There were 1700 (uncertainty interval 1100-2500) acute hepatitis B and C virus (HBV and HCV) infections attributable to heavy-drinking occasions, and 14 000 (uncertainty interval 5900-19 500) chronic HBV and 1700 (uncertainty interval 700-2400) chronic HCV infections due to heavy alcohol use interfering with spontaneous clearance. Alcohol use and its interactions with other risk factors (HBV, HCV, obesity) led to 54 500 (uncertainty interval 50 900-58 400) new cases of liver cirrhosis. In addition, alcohol use caused 6600 (uncertainty interval 4200-9300) liver cancer deaths and 40 700 (uncertainty interval 36 600-44 600) liver cirrhosis deaths. IMPLICATIONS: Alcohol use causes a substantial number of incident cases and deaths from chronic liver disease, often in interaction with other risk factors. CONCLUSION: This additional disease burden is not reflected in the current alcoholic liver disease categories. Clinical work and prevention policies need to take this into consideration.

7.
Addiction ; 116(9): 2326-2338, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33565663

RESUMEN

AIM: This study aimed to examine if there is an interaction between alcohol use and human development in terms of their associations with alcohol-attributable health harms. DESIGN: Statistical modelling of global country- and region-specific data from 2016. SETTING: Global. PARTICIPANTS/CASES: The units of the analyses were countries (n = 180) and regions (n = 4) based on their Human Development Index (HDI). MEASUREMENTS: Alcohol-attributable harms [deaths, years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALYs) lost] and risk relations were based on a recent study using World Health Organization (WHO) estimates for 2016. Human development was measured using the HDI, a summary score of life expectancy, education and gross national income from the United Nations Development Programme. Interactions between HDI and adult per-capita consumption (APC) affecting alcohol-attributable harms were assessed using likelihood ratio tests. Differences in alcohol-attributable harms per litre of APC between HDI groups were assessed using regression analyses and a reference group of low HDI. FINDINGS: APC is associated with alcohol-attributable deaths, YLL, YLDs and DALYs lost, while HDI is associated with alcohol-attributable deaths, YLL and DALYs lost. Statistical analyses indicated there is an interaction between HDI and APC in their associations with alcohol-attributable deaths, YLL and DALYs lost per 100 000 people. The alcohol-attributable burden was highest in low HDI countries, with 11.65 [95% confidence interval (CI) = 10.75, 12.40] deaths and 495.61 (95% CI = 461.83, 569.23) DALYs lost per 100 000 people per litre of APC, and lowest in very high HDI countries, with 4.15 (95% CI = 2.46, 5.71) deaths and 200.31 (95% CI = 122.78, 265.10) DALYs lost per 100 000 people per litre of APC. However, no statistical differences between low and very high HDI groupings for these burdens were observed. CONCLUSIONS: There appears to be an interaction between the Human Development Index and alcohol use in their associations with alcohol-attributable deaths, years of life lost and disability-adjusted life years lost but not with alcohol-attributable years lived with disability. Alcohol appears to have a stronger harmful impact per litre of alcohol consumed in lesser developed countries than in developed countries.


Asunto(s)
Costo de Enfermedad , Personas con Discapacidad , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Salud Global , Humanos , Esperanza de Vida , Años de Vida Ajustados por Calidad de Vida
8.
Addiction ; 116(8): 2026-2038, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33449382

RESUMEN

AIMS: To compare systematically the alcohol-attributable mortality and burden of disease estimates for 2016 from a recent study by Shield and colleagues and the Global Burden of Disease study 2017 (GBD). METHOD: This study compared estimates of alcohol-attributable mortality and disability adjusted life years (DALYs) lost for 2016 with regards to absolute and relative differences, by region and by cause of disease or injury. Relative differences between the two studies are reported herein as percentage (%) differences. A difference of 10% or more was considered meaningful. RESULTS: The studies estimated similar global levels of overall alcohol-attributable mortality for 2016 (Shield and colleagues estimated 5.1% more alcohol-attributable mortality than the GBD study) but not alcohol-attributable DALYs lost (18.3% difference). There were marked differences by region and cause of disease or injury. Compared with the results from Shield and colleagues, the GBD study estimated a lower alcohol-attributable burden in Eastern Europe by 252 770 alcohol-attributable deaths (45.2% difference) and 6.1 million alcohol-attributable DALYs lost (32.9% difference) and in Western sub-Saharan Africa by 124 200 alcohol-attributable deaths (55.7% difference) and 7.0 million alcohol-attributable DALYs lost (63.4% difference), and estimated a higher alcohol-attributable burden in East Asia by 227 100 alcohol-attributable deaths (48.0% difference) and 2.2 million DALYs lost (11.0% difference). With regard to the cause of disease or injury, Shield and colleagues attributed an overall detrimental effect to alcohol on ischaemic heart disease mortality, whereas the GBD study attributed a net beneficial effect. The GBD study, as compared with Shield and colleagues' study, estimated a lower alcohol-attributable mortality because of liver cirrhosis and injuries by 262 500 (44.6% difference) and 398 800 (46.2% difference), respectively. CONCLUSIONS: Differences in estimates of the alcohol-attributable burden of disease in two recent studies indicate the need to improve the accuracy of underlying data and risk relations to obtain more consistent estimates and to formulate, advocate for, and implement alcohol policies more effectively.


Asunto(s)
Personas con Discapacidad , África del Sur del Sahara , Salud Global , Humanos , Años de Vida Ajustados por Calidad de Vida , Medición de Riesgo , Factores de Riesgo
9.
Eur Addict Res ; 27(3): 189-197, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33271557

RESUMEN

INTRODUCTION: Prevention of cancer has been identified as a major public health priority for Europe, and alcohol is a leading risk factor for various types of cancer. This contribution estimates the number of cancer cases that could have potentially been averted in 2018 in 4 European countries if an increase in alcohol excise taxation had been applied. METHODS: Current country and beverage-specific excise taxation of 4 member states of the WHO European Region (Germany, Italy, Kazakhstan, and Sweden) was used as a baseline, and the potential impacts of increases of 20, 50, and 100% to current excise duties were modelled. A sensitivity analysis was performed, replacing the current tax rates in the 4 countries by those levied in Finland. The resulting increase in tax was assumed to be fully incorporated into the consumer price, and beverage-specific price elasticities of demand were obtained from meta-analyses, assuming less elasticity for heavy drinkers. Model estimates were applied to cancer incidence rates for the year 2018. RESULTS: In the 4 countries, >35,000 cancer cases in 2018 were caused by alcohol consumption, with the highest rate of alcohol-attributable cancers recorded in Germany and the lowest in Sweden. An increase in excise duties on alcohol would have significantly reduced these numbers, with between 3 and 7% of all alcohol-attributable cancer cases being averted if taxation had been increased by 100%. If the 4 countries were to adopt an excise taxation level equivalent to the one currently imposed in Finland, an even higher proportion of alcohol-attributable cancers could be avoided, with Germany alone experiencing 1,600 fewer cancer cases in 1 year. DISCUSSION/CONCLUSION: Increasing excise duties can markedly reduce cancer incidence in European countries.


Asunto(s)
Bebidas Alcohólicas , Neoplasias , Europa (Continente) , Femenino , Humanos , Masculino , Impuestos , Organización Mundial de la Salud
10.
Eur Addict Res ; 27(1): 1-8, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32417845

RESUMEN

BACKGROUND: Cancers constitute a major non-communicable disease category globally and in the European Union (EU). SUMMARY: Alcohol use has been established as a major cause of cancer in humans. Principal cancer agencies agree that the following cancer sites are causally impacted by alcohol: lip and oral cavity, pharynx (excluding nasopharynx), oesophagus, colon and rectum, liver, (female) breast, and larynx. For all of these cancer sites, there is a dose-response relationship with no apparent threshold: the higher the average level of consumption, the higher the risk of cancer incidence. In the EU in 2016, about 80,000 people died of alcohol-attributable cancer, and about 1.9 million years of life were lost due to premature mortality or due to disability. Key messages: Given the above-described impact of alcohol on cancer, public awareness about the alcohol-cancer link needs to be increased. In addition, effective alcohol policy measures should be implemented. As a large part of alcohol-attributable cancers are in low and moderate alcohol users, in particular for females, general population measures such as increases in taxation, restrictions on availability, and bans on marketing and advertisement are best suited to reduce the alcohol-attributable cancer burden.


Asunto(s)
Neoplasias , Consumo de Bebidas Alcohólicas , Personas con Discapacidad , Unión Europea , Humanos , Incidencia
11.
Drug Alcohol Rev ; 40(2): 161-165, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32830351

RESUMEN

Population survey research is limited by biases introduced through the exclusion of sub-populations from the sampling frame and by non-response bias. This is a particular problem for alcohol surveys, where populations such as the homeless and the institutionalised-who consume on average more alcohol than the general population-are usually excluded, and where people who respond to alcohol surveys tend to consume less alcohol than those who do not. These biases lead to the underestimation of alcohol consumption at the population level, which can be corrected for by triangulating alcohol consumption data with population data sources (i.e. taxation and production). Other methods which account for the biases inherent in surveys include triangulation with outcomes (e.g. traffic injuries), calculation of estimates for groups which are outside common sampling frames, and combining probabilistic sampling with new methodologies, such as computer-assisted web interviews. In particular, population surveys do not attract sufficient participation numbers for certain groups, such as the marginalised urban male youths. In this situation, it may be helpful to add estimates generated via respondent-driven sampling or non-probabilistic web panels restricted to a specific group to such population surveys. Additionally, computer-assisted web interviews perform better for sensitive questions, such as those about personal alcohol use. In sum, based on the objectives, the future of survey will need to include statistical modelling, adding data from external sources for validation and combining data from various types of surveys.

12.
Chem Biol Interact ; 331: 109280, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33010221

RESUMEN

In 2016, alcohol consumption was one of the leading risk factors for cancer development and cancer death globally, causing an estimated 376 200 cancer deaths, representing 4.2% of all cancer deaths, and 10.3 million cancer disability-adjusted life years lost, representing 4.2% of all cancer disability-adjusted life years lost. The impact of alcohol consumption on cancer in 2016 varied by age group; the proportion of cancer deaths attributable to alcohol consumption ranged from 13.9% of cancer deaths among people aged 30-34 years to 2.7% of cancer deaths among people aged 80-84 years. The burden of cancers caused by alcohol consumption might be decreased through (i) individual-level and societal-level interventions that reduce alcohol consumption, and (ii) measures that target those risk factors that interact with alcohol consumption to increase the risk of cancer or that directly affect the risk of alcohol-related cancers.


Asunto(s)
Consumo de Bebidas Alcohólicas , Neoplasias/patología , Carga Global de Enfermedades , Humanos , Neoplasias/diagnóstico , Años de Vida Ajustados por Calidad de Vida , Factores de Riesgo
13.
Subst Abuse Treat Prev Policy ; 15(1): 66, 2020 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-32867799

RESUMEN

BACKGROUND: As several regulatory and environmental changes have occurred in North America, trends in overdose deaths were examined in the United States (US), Ontario and British Columbia (BC), including changes in consumption levels of prescription opioids (PO) and overdose deaths, changes in correlations between consumption levels of PO and overdose deaths and modeled differences between observed and predicted overdose deaths if no changes had occurred. METHODS: Consumption levels of PO included defined daily doses for statistical purposes per million inhabitants per day for the US and Canada (2001-2015). Overdose deaths included opioid overdose deaths for the US (2001-2017) and Ontario (2003-2017) and illicit drug overdose deaths for BC (2001-2017). The analytic techniques included structural break point analyses, Pearson product-moment correlations and multivariate Gaussian state space modeling. RESULTS: Consumption levels of PO changed in the US in 2010 and in Canada in 2012. Overdose deaths changed in the US in 2014 and in Ontario and BC in 2015. Prior to the observed changes in consumption levels of PO, there were positive correlations between consumption levels of PO and overdose deaths in the US (r = 0.99, p < 0.001) and Ontario (r = 0.92, p = 0.003). After the observed changes in consumption levels of PO, there was a negative correlation between consumption levels of PO and overdose deaths in the US (r = - 0.99, p = 0.002). Observed overdose deaths exceeded predicted overdose deaths by 5.7 (95% Confidence Interval [CI]: 4.8-6.6), 3.5 (95% CI: 3.2-3.8) and 21.8 (95% CI: 18.6-24.9) deaths per 100,000 people in the US, Ontario and BC, respectively in 2017. These excess deaths corresponded to 37.7% (95% CI: 31.9-43.6), 39.2% (95% CI: 36.3-42.1) and 72.2% (95% CI: 61.8-82.6) of observed overdose deaths in the US, Ontario and BC, respectively in 2017. CONCLUSIONS: The opioid crisis has evolved in North America, as a sizeable proportion of overdose deaths are now attributable to the several regulatory and environmental changes. These findings necessitate substance use policies to be conceptualized more broadly as well as the continued expansion of harm reduction services and types of pharmacotherapy interventions.


Asunto(s)
Analgésicos Opioides/envenenamiento , Drogas Ilícitas/envenenamiento , Sobredosis de Opiáceos/epidemiología , Prescripciones/estadística & datos numéricos , Colombia Británica/epidemiología , Humanos , Ontario/epidemiología , Estados Unidos/epidemiología
14.
Subst Abuse Treat Prev Policy ; 15(1): 45, 2020 06 30.
Artículo en Inglés | MEDLINE | ID: mdl-32605584

RESUMEN

Liver cirrhosis and other chronic liver diseases are usually compartmentalized into separate categories based on etiology (e.g., due to alcohol, virus infection, etc.), but it is important to study the intersection of, and possible interactions between, risk factors. The aim of this study is to summarize evidence on the association between alcohol use disorders (AUDs) and decompensated liver cirrhosis and other complications in patients with chronic Hepatitis C virus (HCV) infection. A systematic search of epidemiological studies was conducted using Ovid Medline databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Relative Risk estimates were combined using random-effects meta-analyses. The proportion of cases with liver disease progression that could be avoided if no person with a chronic HCV infection had an AUD was estimated using an attributable fraction methodology. A total of 11 studies fulfilled the inclusion criteria, providing data from 286,641 people with chronic HCV infections, of whom 63,931 (22.3%) qualified as having an AUD. Using decompensated liver cirrhosis as the outcome for the main meta-analysis (n = 7 unique studies), an AUD diagnosis was associated with a 3.3-fold risk for progression of liver disease among people with a chronic HCV infection (95% Confidence Interval (CI): 1.8-4.8). In terms of population-attributable fractions, slightly less than 4 out of 10 decompensated liver cirrhosis cases were attributable to an AUD: 35.2% (95% CI: 16.2-47.1%). For a secondary analyses, all outcomes related to liver disease progression were pooled (i.e., liver deaths or cirrhosis in addition to decompensated liver cirrhosis), which yielded a similar overall effect (n = 13 estimates; OR = 3.7; 95% CI: 2.2-5.3) and a similar attributable fraction (39.3%; 95% CI: 21.9-50.4%). In conclusion, AUDs were frequent in people with chronic HCV infections and contributed to worsening the course of liver disease. Alcohol use and AUDs should be assessed in patients who have liver disease of any etiology, and interventions should be implemented to achieve abstinence or to reduce consumption to the greatest possible extent.


Asunto(s)
Alcoholismo/epidemiología , Hepatitis C Crónica/epidemiología , Cirrosis Hepática/epidemiología , Cirrosis Hepática/patología , Progresión de la Enfermedad , Hepatitis C Crónica/mortalidad , Humanos , Cirrosis Hepática/mortalidad , Cirrosis Hepática/virología
15.
Drug Alcohol Rev ; 39(5): 539-545, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32515099

RESUMEN

INTRODUCTION AND AIMS: While injuries and alcohol contribute to a large proportion of the disease burden in Thailand, no well-designed underlying study has yet been published. This study aims to evaluate the relationship between acute alcohol consumption and injury risk in Thailand. DESIGN AND METHODS: Using the case-crossover design, this study examined 520 injured patients aged 18 years and older from two emergency departments in Meuang District, Chiang-Mai Province, Thailand, from June to August of 2016. The case period was defined as 6 h prior to injury, the two control periods as the same 6-h period at 1 day and 7 days prior to injury. Alcohol exposure and the amount consumed were measured for these periods. RESULTS: Twenty percent of injured patients consumed alcohol within the 6 h prior to injury, averaging 6.9 drinks during that time. The odds of injury for those individuals consuming alcoholic beverages was 5.0 (95% confidence interval 3.0, 8.2) times greater compared to non-exposure individuals; every additional drink consumed increased the odds of injury by 1.3 (95% confidence interval 1.2, 1.4). Alcohol use significantly increased the odds of sustaining an unintentional injury, intentional injury inflicted by someone else or experiencing a road traffic injury (among drivers). The dose-response analysis indicated alcohol use significantly increased the risks of unintentional injury and road traffic injuries (among drivers). DISCUSSION AND CONCLUSIONS: Exposure to alcohol increased the odds of injury in a dose-dependent fashion; hence, comprehensive, cost-effective strategies should be implemented in Thailand to reduce alcohol exposure, binge drinking and drunk driving.


Asunto(s)
Accidentes de Tránsito , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Servicio de Urgencia en Hospital , Conducta Autodestructiva/epidemiología , Heridas y Lesiones/epidemiología , Accidentes de Tránsito/prevención & control , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/terapia , Bebidas Alcohólicas/efectos adversos , Estudios de Casos y Controles , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Conducta Autodestructiva/etiología , Conducta Autodestructiva/terapia , Tailandia/epidemiología , Heridas y Lesiones/etiología , Heridas y Lesiones/terapia , Adulto Joven
16.
J Stud Alcohol Drugs ; 81(3): 339-351, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32527386

RESUMEN

OBJECTIVE: Data regarding alcohol-caused health harms are required by policymakers for setting health priorities. However, these estimations are currently resource intensive, and estimates vary substantially by method. Thus, many countries, states, and regions do not track these harms. We address this limitation through creation of the International Model of Alcohol Harms and Policies (InterMAHP), an open-access alcohol harms estimator. InterMAHP consists of methodologies and program software designed to assist alcohol research teams in estimating alcohol-attributable mortality and morbidity, by region. It is available at www.intermahp.cisur.ca. Application is illustrated through updated estimates of alcohol-attributable mortality in Canada. METHOD: Mortality counts and per capita alcohol sales were obtained from Statistics Canada. Drinking and bingeing prevalences were obtained from the Canadian Substance Use Exposure Database. InterMAHP automated the calculations of alcohol-attributable fractions (AAF) using the modern AAF formulation and a gamma distribution to specify the continuous prevalence distribution of consumption. RESULTS: Alcohol is a leading driver of mortality in Canada. In 2016, more than 14,800 (95% CI [12,435, 17,127]) deaths were alcohol attributable, representing 5.5% of all deaths. This burden is borne disproportionately by men (79%). Among condition categories, cancer is the leading cause of alcohol-attributable mortality in both men and women. CONCLUSIONS: InterMAHP has the potential to assist public health researchers globally in estimating alcohol harms. This open-access software was used to estimate alcohol-attributable mortality in Canada, which was shown to be substantial. Policies proven to reduce alcohol consumption and related harms should be considered to reduce this burden.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/mortalidad , Trastornos Relacionados con Alcohol/epidemiología , Modelos Estadísticos , Adolescente , Adulto , Anciano , Canadá/epidemiología , Comercio/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Morbilidad , Prevalencia , Política Pública , Programas Informáticos , Adulto Joven
17.
Int J Cancer ; 146(3): 646-656, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30882889

RESUMEN

Cancer is a major contributing cause of morbidity and mortality in the Eastern Mediterranean region. The aim of the current study was to estimate the cancer burden attributable to major lifestyle and environmental risk factors. We used age-, sex- and site-specific incidence estimates for 2012 from IARC's GLOBOCAN, and assessed the following risk factors: smoking, alcohol, high body mass index, insufficient physical activity, diet, suboptimal breastfeeding, infections and air pollution. The prevalence of exposure to these risk factors came from different sources including peer-reviewed international literature, the World Health Organization, noncommunicable disease Risk Factor Collaboration, and the Food and Agriculture Organization. Sex-specific population-attributable fraction was estimated in the 22 countries of the Eastern Mediterranean region based on the prevalence of the selected risk factors and the relative risks obtained from meta-analyses. We estimated that approximately 33% (or 165,000 cases) of all new cancer cases in adults aged 30 years and older in 2012 were attributable to all selected risk factors combined. Infections and smoking accounted for more than half of the total attributable cases among men, while insufficient physical activity and exposure to infections accounted for more than two-thirds of the total attributable cases among women. A reduction in exposure to major lifestyle and environmental risk factors could prevent a substantial number of cancer cases in the Eastern Mediterranean. Population-based programs preventing infections and smoking (particularly among men) and promoting physical activity (particularly among women) in the population are needed to effectively decrease the regional cancer burden.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Infecciones/epidemiología , Neoplasias/epidemiología , Conducta Sedentaria , Fumar Tabaco/epidemiología , Adulto , Factores de Edad , Contaminación del Aire/efectos adversos , Consumo de Bebidas Alcohólicas/efectos adversos , Índice de Masa Corporal , Ejercicio Físico/fisiología , Conducta Alimentaria/fisiología , Femenino , Humanos , Incidencia , Infecciones/complicaciones , Masculino , Región Mediterránea/epidemiología , Neoplasias/etiología , Neoplasias/prevención & control , Prevalencia , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Fumar Tabaco/efectos adversos
18.
Drug Alcohol Rev ; 39(6): 634-636, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33463836

RESUMEN

INTRODUCTION AND AIMS: We discuss the rejoinder of Sherwin to our review which came to the result that adult alcohol per capita consumption is the best indicator for the harmful use of alcohol for the sustainable development goals. DESIGN AND METHODS: Scientific discourse. RESULTS: Sherwin suggested two additional indicators, 'age-standardised prevalence of heavy episodic drinking among adolescents and adults' and 'alcohol-related morbidity and mortality among adolescents and adults'. Given that these indicators should be part of the comprehensive sustainable development goals, we do not believe that three indicators for one target make sense. In addition, both suggested indicators are can only be derived using adult alcohol per capita consumption as basis. DISCUSSION AND CONCLUSIONS: Adult per capita consumption should remain the indicator for the sustainable development goals.


Asunto(s)
Consumo de Bebidas Alcohólicas , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Humanos , Prevalencia
19.
Biomedicines ; 7(4)2019 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-31847084

RESUMEN

Alcohol use is a major risk factor for burden of mortality and morbidity. Alcoholic liver disease (ALD) and alcohol use disorders (AUDs) are important disease outcomes caused by alcohol use. We will describe the global mortality and burden of disease in disability-adjusted life years for ALD and AUDs, based on data from the comparative risk assessment of the World Health Organization for 2016. AUDs have a limited impact on mortality in this assessment, since alcohol poisonings are almost the only disease category directly attributable to AUDs; most other alcohol-related deaths are indirect, and the cause which directly led to the death, such as liver cirrhosis, is the one recorded on the death certificate. Burden of disease for AUDs is thus mainly due to disability resulting from alcohol use. In contrast to AUDs, ALD is one of the major lethal outcomes of alcohol use, and burden of disease is mainly due to (premature) years of life lost. Many of the negative outcomes attributable to both AUDs and ALD are due to their interactions with other factors, most notably economic wealth. To avoid alcohol-attributable morbidity and mortality, measures should be taken to reduce the AUDs and ALD burden globally, especially among the poor.

20.
Lancet ; 393(10189): 2390, 2019 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-31204673
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