1 Risk of alcohol Peter Anderson MD, MPH, PhD, FRCP Professor, Alcohol and Health, Maastricht University Netherlands Zurich, 4 May 2011
2 Lifetime risk of an alcoholrelated death (1/100) Men daily Women daily Men weekly Women weekly Grams alcohol per day or per week Lifetime risk of dying from alcohol-related death by gram alcohol/day or /week for Australian men and women. Source: National Health and Medical Research Council, Australia, 2009
3 How can this be? Is it really the case that the risks for men and women are the same?
4 1. How are the estimates made 2. What about heart disease? 3. What do the risk curves mean?
5 1. How are the estimates made 2. What about heart disease? 3. What do the risk curves mean?
9 Let us first look at non-injury alcohol-related diseases
11 For each of the 10 consumption categories, need to work out life time risk of a death caused by alcohol
12 To do this, first, take the population (in this case Australian), and divide into men and women and 6 age groups, 15-29, 30-44, 45-59, 60-69, and 80+ years.
13 For each gender and age group, calculate, from death certificates, annual mortality rates for the specified diseases, multiplied by the number of years in the age group. For example, for women aged 30-44, their one year risk is multiplied by 15, as they are in this category for 15 years.
14 From this, then work out the proportion of deaths (and thus death rates) due to alcohol for each of the 10 drinking categories
15 Did this by getting the relative risks for the diseases under question for each of the consumption categories compared with no consumption from published meta-analyses. Here they are:
17 From this, can calculate alcohol attributable fractions (AAF), using the formula: Where: i: level of drinking (i.e. 10g pure alcohol per day. 100g pure alcohol per day) P: prevalence of alcohol consumption in the drinking category. RRi: relative risk for drinking level i Here are the AAFs:
19 Then, for each total mortality rate, multiply the total mortality rate by the AAF to give the alcohol mortality rate.
20 Then, add up the risks over diseases and age groups to give lifetime risk by consumption category. Here is the graph again.
22 The method of injury deaths is similar, but a little more complicated, as it needs to account for both the number of drinking occasions and the amount drunk per occasion, as well as the risk period (the time that alcohol remains in the body after a drinking occasion and thus increases risk of injury).
23 First, take Alcohol Attributable Fractions (AAF) by age group for injuries from an Australian study. Here they are:
25 Next, calculate the baseline rate for injury death without alcohol, being the total death rate minus (the total death rate times the AAF).
26 The Relative Risks for injury following a drinking occasion by alcohol consumption were obtained from a WHO 10 country study of emergency departments. Here they are:
28 For each amount per occasion, combine the baseline risk with the alcohol-based relative risk for one occasion to give the absolute risk of injury death per one drinking occasion related to consumption categories.
29 And, then multiply by the number of lifetime drinking occasions, ranging from 50 to 20,000, corresponding from a range of one drinking occasion per year to one drinking occasion per day.
30 Of course, need to adjust for the period of risk resulting form a drinking occasion. This period relates to the time that alcohol is in the blood, not the whole 24 hours of day.
31 For example, alcohol in blood 3 hours after an intake of 50g thus, the risk period is 3 hours, not 24 hours.
32 Probabilities of death are then computed for each age, gender, injury, and consumption group (e.g. the lifetime probability of an alcohol-attributable motor vehicle death for year old men who drank approximately 20g alcohol 4 times per week), and added up across injury categories and ages. Here are the graphs again:
35 1. How are the estimates made 2. What about heart disease? 3. What do the risk curves mean?
36 Whether or not alcohol reduces the risk of ischaemic heart disease (and ischaemic stroke) does not change the absolute risks of the deaths due to alcohol, which are due to adverse events.
37 In any case, most of the protective effect of alcohol on heart disease can be achieved at 5g alcohol/day, lower than any likely guidelines for lower risk drinking.
38 Any protective effect disappears when light drinkers report at least just one heavy drinking occasion per month.
39 And, a protective effect is based on a different conceptual framework from an adverse effect, since more protection can be achieved by engaging in other healthier behaviours (e.g., healthy diet, more physical activity), which incur no added risk.
40 1. How are the estimates made 2. What about heart disease? 3. What do the risk curves mean?
41 Lifetime risk of an alcoholrelated death (1/100) Men daily Women daily Men weekly Women weekly Grams alcohol per day or per week Lifetime risk of dying from alcohol-related death by gram alcohol/day or /week for Australian men and women. Source: National Health and Medical Research Council, Australia, 2009
42 The exact slope of the curves is country specific as it depends on the prevalence and distribution of both diseases and drinking patterns in the population -but, for most EU countries, at least, they will be similar to the Australian curves.
43 At 20g/day, the lifetime risk that death is due to alcohol is less than 1:100 for both men and women.
44 At 60g/day, the lifetime risk that death is due to alcohol is just under 1:10 for both men and women.
45 How do the risks compare with other risks?
46 Well, they are high.
47 In terms of drinking water, WHO sets a general upper guideline at the concentration which would give rise to a risk of 1 additional cancer per 100,000 people on a lifetime basis. A study of regulation of risky substances in Canada and US sets thresholds at 1:22,00 and 1:10,000.
48 Asbestos exposure is estimated to pose a lifetime mortality risk of between 1:1,000 and 1:10,000. Eating pesticide grown fruit is estimated to pose a lifetime mortality risk of 1:22,000.
49 The data also suggests that we should talk in terms of risk, and not use terms like safe drinking, sensible drinking, alcohol misuse etc, because these terms do not mean anything. And, we need to get the risk message across -too many people still think that alcohol is good for you.
50 And, finally, this is at the individual level we will deal with the population level tomorrow morning.
Alcohol Units A brief guide 1 2 Alcohol Units A brief guide Units of alcohol explained As typical glass sizes have grown and popular drinks have increased in strength over the years, the old rule of thumb
W O R KING TO BUILD A HE A LTHY AUSTRALIA FREQUENTLY ASKED QUESTIONS www.nhmrc.gov.au National Health and Medical Research Council AUSTRALIAN GUIDELINES TO REDUCE HEALTH RISKS FROM DRINKING ALCOHOL Australian
Key trends nationally and locally in relation to alcohol consumption and alcohol-related harm November 2013 1 Executive Summary... 3 National trends in alcohol consumption and alcohol-related harm... 5
TAJIKISTAN SOCIOECONOMIC CONTEXT Total population 6,640,000 Annual population growth rate 1.3% Population 15+ years 61% Adult literacy rate 99.5% Population in urban areas 25% Income group (World bank)
AZERBAIJAN SOCIOECONOMIC CONTEXT Total population 8,406,000 Annual population growth rate 0.6% Population 15+ years 76% Adult literacy rate 98.8% Population in urban areas 52% Income group (World bank)
Alcohol Guidelines Review Report from the Guidelines development group to the UK Chief Medical Officers January 2016 2 Alcohol Guidelines Review Report from the Guidelines development group to the UK Chief
Statistical Snapshot of Underage Drinking Alcohol consumption and dangerous patterns of drinking are widespread among adolescents and lead to many adverse consequences for underage drinkers and others.
Suggested Grade Levels: 9 and up Likelihood of Cancer Possible Subject Area(s): Social Studies, Health, and Science Math Skills: reading and interpreting pie charts; calculating and understanding percentages
Underage Drinking Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance of abuse among America s youth, and drinking by young people poses
Alcohol s burden of disease in Australia Caroline Gao, Rowan Ogeil and Belinda Lloyd July 2014 This project was funded by the Foundation for Alcohol Research and Education (FARE) and Victorian Health Promotion
IAS Factsheet Young people and alcohol Updated May 2013 Young people and alcohol Factsheet Institute of Alcohol Studies Alliance House 12 Caxton Street London SW1H 0QS Tel: 020 7222 4001 Email: firstname.lastname@example.org
Health risk assessment: a standardized framework February 1, 2011 Thomas R. Frieden, MD, MPH Director, Centers for Disease Control and Prevention Leading causes of death in the U.S. The 5 leading causes
Facts About Alcohol Addiction Prevention & Treatment Services Table of Contents Facts about alcohol: What is harmful involvement with alcohol?... 2 What is alcohol dependence?... 3 What Is BAC?... 4 What
Alcohol Awareness: An Orientation Alcohol Facts The most commonly used addictive substance in the United States o 17.6 million people (1 in 12 adults) suffer from alcohol abuse or dependence o Millions
Alcohol treatment in England 2012-13 October 2013 About Public Health England Public Health England s mission is to protect and improve the nation s health and to address inequalities through working with
Alcohol Facts and Statistics Alcohol Use in the United States:» Prevalence of Drinking: In 2014, 87.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime;
Economic recession and alcoholrelated harm Peter Anderson Barcelona, 15 June 2010. On the one hand, as incomes reduce, you might expect alcohol consumption to go down But, on the one hand, as dislocation
Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions
Alcohol And Your Health Psychological Medicine Introduction Alcohol, when used in moderation and as part of a healthy lifestyle, can have beneficial effects for some people, particularly in the prevention
Alcohol Treatment Needs Assessment 2012-2013 1. Introduction Using the JSNA Support pack for alcohol prevention, treatment & recovery, which presents data from the Local Alcohol Profiles for England (LAPE),
Alcohol Facts and Statistics Alcohol Use in the United States: Prevalence of Drinking: In 2012, 87.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime;
WINE FOR YOUR HEALTH: TRUTH AND MYTH Cutting through the Clutter about Heart Health Julia M. Dostal, PhD Executive Director, LEAF Council on Alcoholism & Addictions Board of Directors, National Council
Effectiveness of Brief Alcohol Intervention strategies Eileen Kaner Professor of Public Health and Primary Care Research email@example.com Introduction Scope of alcohol harm Preventive paradox
UK Chief Medical Officers Alcohol Guidelines Review Summary of the proposed new guidelines January 2016 2 UK Chief Medical Officers Alcohol Guidelines Review Summary of the proposed new guidelines 1. This
Major in Human Health, Nutrition and Environment, FS 2010 Public Health Concepts Determinants, Key Players and Possible Interventions David Fäh Aims Have an idea about which parameters can influence health
SIXTY-SIXTH WORLD HEALTH ASSEMBLY A66/8 Provisional agenda item 13.1 15 March 2013 Draft comprehensive global monitoring framework and targets for the prevention and control of noncommunicable diseases
How to keep health risks from drinking alcohol to a low level: public consultation on proposed new guidelines January 2016 2 How to keep health risks from drinking alcohol to a low level: public consultation
Alcohol Quick Facts ALCOHOL FACTS New Zealand s drinking patterns The proportion of New Zealanders aged 15 years or more who drank alcohol in the past year dropped from 84% in 2006/07 to 80% in 2011/12
Pilot study: Testing an online alcohol intervention in primary care Natasha Nair 1,2, Maree Teesson 1,2, Anthony Shakeshaft 1, Nicola Newton 1,2 & Paul Wallace 3 1 National Drug and Alcohol Research Centre,
Southern Grampians & Glenelg Shires COMMUNITY PROFILE Contents: 1. Health Status 2. Health Behaviours 3. Public Health Issues 4. References This information was last updated on 14 February 2007 1. Health
The Menace of Alcohol This report has been designed so that you consider the effects of excessive drinking. It has been compiled from a series of websites from around the world, all of which are reputable
Protecting and improving the nation s health Alcohol treatment in England 2013-14 October 2014 About Public Health England Public Health England exists to protect and improve the nation s health and wellbeing,
October 31, 2014 Why should we care? Deaths 0 500 1000 1500 2000 2500 2000 2002 2004 2006 2008 2010 2012 Year Accidents (unintentional injuries) Intentional self-harm (suicide) Other causes of death Assault
NHS Swindon and Swindon Borough Council Executive Summary: Adult Alcohol Needs Assessment Aim and scope The aim of this needs assessment is to identify, through analysis and the involvement of key stakeholders,
Alcohol Indicators Report A framework of alcohol indicators describing the consumption of use, patterns of use, and alcohol-related harms in Nova Scotia NOVEMBER 2005 Nova Scotia Health Promotion Addiction
http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive
Current Alcohol & Drug Trends Among Young Adults Current Alcohol trends among Americans Nearly 17.6 million adult Americans abuse alcohol or are alcoholic. 53 percent of men and women in the United States
9. pg 166-169: Self-reported alcohol consumption pg 170-171: Childhood experience of living with someone who used drugs pg 172-173: Hospitalizations related to alcohol and substance abuse pg 174-179: Accidental
HEALTH SCRUTINY PANEL 8 TH FEBRUARY 2011 Patterns of Alcohol Consumption Debating Paper The Health Scrutiny Panel agreed the following terms of reference for the review into patterns of alcohol consumption:
Statistics on Alcohol England, 2014 Published 29 May 2014 This product may be of interest to stakeholders, policy officials, commissioners and members of the public to gain a comprehensive picture of society
The Economic Benefits of Risk Factor Reduction in Canada Tobacco Smoking, Excess Weight, Physical Inactivity and Alcohol Use Public Health 2015 May 26, 2015 Risk Factors in High-Income North America Ranked
Alcohol Screening, Brief Intervention and Referral: A Clinical Tool Dr. Ryan Sommers Family Physician Medical Officer of Health, NSHA Dalhousie Family Medicine Refresher Nov 27 th 2015 Disclosures None
Alcohol use disorders, health and treatment interventions J. Rehm Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health, Toronto, Canada Dalla Lana School of Public
18 HEALTH STATUS HEALTH BEHAVIORS WOMEN S HEALTH USA 13 Adequate Physical Activity* Among Women Aged 18 and Older, by Educational Attainment and Activity Type, 09 11 Source II.1: Centers for Disease Control
Cancer is a group of more than 100 related diseases. Normally, cells grow and divide to produce more cells to keep the body healthy. Sometimes, this process goes wrong. New cells form when the body doesn
Alcohol Use in New Zealand Key Results of the 27/8 New Zealand Alcohol and Drug Use Survey Ministry of Health. 29. Alcohol Use in New Zealand: Key results of the 27/8 New Zealand Alcohol and Drug Use Survey.
Review of Eliminating occupational cancer in Europe and globally by J. Takala There primary concerns of this manuscript are outlined below. More detail discussion of these points is presented on the following
Consumption of alcoholic beverages; evaluation of cancer hazards Robert A Baan PhD The IARC MONOGRAPHS International Agency for Research on Cancer Lyon, France The IARC Monographs The IARC Monographs are
H E A LT H SURVEY Alcohol Consumption 7 Alcohol Consumption N AT I O N A L Introduction Excessive alcohol consumption is associated with inflammation of the pancreas and damage to the an increased risk
Substance Abuse 108 Background The deliberate use and overuse of harmful substances has a serious impact on the quality of life of Maine people. As a result of substance abuse, the lives of Maine residents
1 Key words Fill the gaps in the sentences using these key words from the text. dementia condition binge drinking epidemic diagnosis brain damage liver priority cope with reduce 7. If you give something,
ALCOHOL AND TYPE 1 DIABETES 1300 136 588 ndss.com.au The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. Contents Topic Page Introduction
www.cymru.gov.uk GUIDANCE ON THE CONSUMPTION OF ALCOHOL BY CHILDREN AND YOUNG PEOPLE From Dr Tony Jewell Chief Medical Officer for Wales GUIDANCE ON THE CONSUMPTION OF ALCOHOL BY CHILDREN AND YOUNG PEOPLE
Drinking patterns 6 Linda Ng Fat and Elizabeth Fuller Summary This chapter presents data on frequency of drinking alcohol, the amount consumed on the heaviest drinking day in the previous week, and regular
Your Results Name: Date: For more information visit: www.sutton.gov.uk/healthchecks In partnership with Introduction Everyone is at risk of developing diabetes, heart disease, kidney disease, stroke and
Macomb County Office of Substance Abuse MCOSA Executive Summary This report marks the second data profile of alcohol and illicit drugs burden in Macomb County. The first report produced in 2007 detailed
MARKET RESEARCH PROJECT BRIEF: MEN S HELP SEEKING BEHAVIOUR beyondblue: the national depression and anxiety initiative 1. Purpose beyondblue is seeking proposals from market research agencies to undertake
Page 1 of 5 Alcohol and Sensible Drinking See your doctor or practice nurse if you are drinking above the safe limits and are finding it difficult to cut down. What are the recommended safe limits of alcohol
Alcohol consumption 6 Elizabeth Fuller Summary This chapter presents adults alcohol consumption in several ways: frequency; the maximum amount drunk on any day in the last week; and usual weekly consumption.
Alcohol Concern Alcohol Concern is the national agency on alcohol misuse campaigning for effective alcohol policy and improved services for people whose lives are affected by alcoholrelated problems. This
The cost of physical inactivity October 2008 The cost of physical inactivity to the Australian economy is estimated to be $13.8 billion. It is estimated that 16,178 Australians die prematurely each year
Statistical Bulletin Drinking Habits Amongst Adults, 2012 Coverage: GB Date: 17 December 2013 Geographical Area: Region Theme: Health and Social Care Correction A minor error was found in table 11 of the
The Prevention Status Reports (PSRs) highlight for all 50 states and the District of Columbia the status of public health policies and practices designed to prevent or reduce important health problems.
When we think of health we often think of health conditions like diabetes or cancer, visits to the doctor s office, or wait times for medical services. But evidence shows that, long before illness, health
Risk factors and public health in Denmark Summary report Knud Juel Jan Sørensen Henrik Brønnum-Hansen Prepared for Risk factors and public health in Denmark Summary report Knud Juel Jan Sørensen Henrik
The facts about... Alcohol and the Liver Five key things you need to know This is a part of your body that regularly works overtime. The liver is our largest organ and it has 500 different roles. One of
Health in Camden Camden s shadow health and wellbeing board: joint health and wellbeing strategy 2012 to 2013 2 Contents 1. Introduction - Reducing health inequalities - Building on strong partnerships
Mortality statistics and road traffic accidents in the UK An RAC Foundation Briefing Note for the UN Decade of Action for Road Safety In 2009 2,605 people died in road traffic accidents in the UK. While
Presentation to Imperial College London Wednesday 10 th December 2014 Screening and brief intervention for alcohol use in general practice and the potential role of digital technologies in optimising delivery
A project by: Focus on... Alcohol October 2012 Alcohol plays an important role in many aspects of society. The majority of people who drink, do so in a way that is unlikely to cause harm. However, a significant
Policy Brief Tackling Harmful Alcohol Use Economics and Public Health Policy May 2015 Directorate for Employment, Labour and Social Affairs OECD s new flagship report examines the economic and public health
Alcohol consumption and harms in the Australian Capital Territory Alcohol consumption The 2010 National Drug Strategy Household Survey found that 86.5 per cent of Australian Capital Territory (ACT) residents
Take Care New York 2016: An Agenda for Healthier New York City Presentation to the Health Committee of Community Board 6 Camellia Mortezazadeh, MPH, Executive Director, Take Care New York and Ewel Napier,
Alcohol s harm to others in Ireland A Health Service Executive Report Alcohol s harm to others in Ireland Health Service Executive, March 2014 Report prepared by Dr Ann Hope, Department of Public Health
ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR Alcoholism By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/alcoholism/ds00340 Definition Alcoholism is a chronic and often progressive
Alcohol Marketing, the Alcohol Industry and Their Impact on Binge Drinking by Adolescents Thomas F. Babor, PhD, MPH The University of Connecticut School of Medicine Department of Community Medicine and
ALCO H O L AN D H EALTH THE EFFECTS OF MODERATE, REGULAR ALCOHOL CONSUMPTION ISBN 2-9807330-6-7 Legal deposit 2005 A l c o h o l a n d H e a l t h THE HEALTH BENEFITS OF MODERATE AND REGULAR ALCOHOL CONSUMPTION
22 SAFER JOURNEYS DISCUSSION DOCUMENT Have your say on our next road safety strategy AUGUST 29 11 Reducing the impact of alcohol/drug impaired driving What is the problem? Alcohol/drug impaired driving
A L C OHOL What You Don t Know Can Harm You National Institute on Alcohol Abuse and Alcoholism National Institutes of Health U.S. Department of Health and Human Services If you are like many Americans,
Page 1 of 5 This Factsheet summarises a selection of health indicators (health behaviours & risk factors, hospitalisations and deaths) for the of the Southern NSW Local Health District (LHD). Health services
ΠΡΟΓΡΑΜΜΑ ΜΕΤΑΠΤΥΧΙΑΚΩΝ ΣΠΟΥΔΩΝ «Η ΔΙΑΤΡΟΦΗ ΣΤΗΝ ΥΓΕΙΑ ΚΑΙ ΣΤΗ ΝΟΣΟ» Η δίαιτα στην πρόληψη του αγγειακού εγκεφαλικού επεισοδίου Γεώργιος Ντάιος Παθολογική Κλινική Πανεπιστημίου Θεσσαλίας Stroke Statistics
Important facts to remember If you re pregnant or trying to get pregnant, or if you know someone who is, there are several important points to remember: See a healthcare professional regularly. Get plenty
Alcohol Use and healthy aging: the need for monitoring and prevention to add life to years Emanuele Scafato, Istituto Superiore di Sanità, Rome, ITALY Director Population Health Unit CNESPS Osservatorio
The Corrosive Effects of Alcohol and Drug Misuse on NH s Workforce and Economy SUMMARY REPORT Prepared by: November 2014 The Corrosive Effects of Alcohol and Drug Misuse on NH s Workforce and Economy New
Annex 7 Statistics Calculating rates Rates are the most common way of measuring disease frequency in a population and are calculated as: number of new cases of disease in population at risk number of persons
Stroke Helpline: 0303 3033 100 Website: stroke.org.uk Alcohol and stroke Regularly drinking large amounts of alcohol greatly increases your risk of stroke. This factsheet explains how alcohol can increase
How Data are Obtained The distinction between observational study and experiment is important in statistics. Observational Study Experiment Observes individuals and measures variables of interest but does