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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, MG, Fullman, N, Hawley, C, Arian, N, Zimsen, SRM, Tymeson, HD, Venkateswaran, V, Tapp, AD, Forouzanfar, MH, Salama, JS, Abate, KH, Abate, D, Abay, SM, Abbafati, C, Abdulkader, RS, Abebe, Z, Aboyans, V, Abrar, MM, Acharya, P, Adetokunboh, OO, Islam, Shariful and et al 2018, Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016, Lancet, vol. 392, no. 10152, pp. 1015-1035, doi: 10.1016/S0140-6736(18)31310-2.

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Title Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
Author(s) Griswold, MG
Fullman, N
Hawley, C
Arian, N
Zimsen, SRM
Tymeson, HD
Venkateswaran, V
Tapp, AD
Forouzanfar, MH
Salama, JS
Abate, KH
Abate, D
Abay, SM
Abbafati, C
Abdulkader, RS
Abebe, Z
Aboyans, V
Abrar, MM
Acharya, P
Adetokunboh, OO
Islam, SharifulORCID iD for Islam, Shariful orcid.org/0000-0001-7926-9368
et al
Journal name Lancet
Volume number 392
Issue number 10152
Start page 1015
End page 1035
Total pages 21
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2018-09-22
ISSN 0140-6736
1474-547X
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
ALL-CAUSE MORTALITY
REDUCED MORTALITY
RISK-FACTORS
DRINKING
METAANALYSIS
CONSUMPTION
DEPENDENCE
Summary 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 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.
Language eng
DOI 10.1016/S0140-6736(18)31310-2
Field of Research 11 Medical And Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30114170

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.