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Original article

Vol. 144 No. 2122 (2014)

Alcohol-attributable mortality in Switzerland in 2011 – age-specific causes of death and impact of heavy versus non-heavy drinking

  • Simon Marmet
  • Jürgen Rehm
  • Gerrit Gmel
  • Hannah Frick
  • Gerhard Gmel
DOI
https://doi.org/10.4414/smw.2014.13947
Cite this as:
Swiss Med Wkly. 2014;144:w13947
Published
18.05.2014

Summary

BACKGROUND: Alcohol use causes high burden of disease and injury globally. Switzerland has a high consumption of alcohol, almost twice the global average. Alcohol-attributable deaths and years of life lost in Switzerland were estimated by age and sex for the year 2011. Additionally, the impact of heavy drinking (40+grams/day for women and 60+g/day for men) was estimated.

METHODS: Alcohol consumption estimates were based on the Addiction Monitoring in Switzerland study and were adjusted to per capita consumption based on sales data. Mortality data were taken from the Swiss mortality register. Methodology of the Comparative Risk Assessment for alcohol was used to estimate alcohol-attributable fractions.

RESULTS: Alcohol use caused 1,600 (95% CI: 1,472 – 1,728) net deaths (1,768 deaths caused, 168 deaths prevented) among 15 to 74 year olds, corresponding to 8.7% of all deaths (men: 1,181 deaths; women: 419 deaths). Overall, 42,627 years of life (9.7%, 95% CI: 40,245 – 45,008) were lost due to alcohol. Main causes of alcohol-attributable mortality were injuries at younger ages (15–34 years), with increasing age digestive diseases (mainly liver cirrhosis) and cancers (particularly breast cancers among women). The majority (62%) of all alcohol-attributable deaths was caused by chronic heavy drinking (men: 67%; women: 48 %).

CONCLUSION: Alcohol is a major cause of premature mortality in Switzerland. Its impact, among young people mainly via injuries, among men mainly through heavy drinking, calls for a mix of preventive actions targeting chronic heavy drinking, binge drinking and mean consumption.

References

  1. Murray CJL, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197–223.
  2. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224–60.
  3. Rehm J, Borges G, Gmel G, Graham K, Grant B, Parry C, et al. The comparative risk assessment for alcohol as part of the Global Burden of Disease 2010 Study: What changed from the last study? Int J Alcohol Drug Res. 2013;2(1):1–5.
  4. Eidgenössische Alkoholverwaltung (EAV). Alkohol in Zahlen. Bern, Schweiz: Eigenössische Alkoholverwaltung (EAV), Bern. 2012. Available from: http://www.eav.admin.ch/dokumentation/00445/00582/. Accessed 09.10.2013
  5. Rehm J, Shield KD, Rehm MX, Gmel G, Frick U. Alcohol consumption, alcohol dependence and attributable burden of disease in Europe: Potential gains from effective interventions for alcohol dependence. Toronto, Canada: Centre for Addiction and Mental Health, 2012.
  6. World Health Organization (WHO). Global Information System on Alcohol and Health (GISAH). Geneva: WHO. 2013. Available from: http://apps.who.int/gho/data/node.main.GISAH. Accessed 09.10.2013
  7. Shield KD, Rylett M, Gmel G, Sen., Gmel G, Jr., Kehoe-Chan TAK, Rehm J. Global alcohol exposure estimates by country, territory and region for 2005 – a contribution to the Comparative Risk Assessment for the 2010 Global Burden of Disease Study. Addiction. 2013;108(5):912–22.
  8. World Health Organization (WHO). Lexicon of Alcohol and Drug Terms. Geneva, Switzerland: WHO Office of Publications. 1994. Available from: http://www.who.int/substance_abuse/terminology/who_lexicon. Accessed 09.10.2013
  9. Rehm J, Baliunas D, Borges GLG, Graham K, Irving H, Kehoe T, et al. The relation between different dimensions of alcohol consumption and burden of disease: An overview. Addiction. 2010;105(5):817–43.
  10. World Health Organization (WHO). Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva, Switzerland: WHO. 2009. Available from: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf. Accessed 09.10.2013
  11. Rose GL. Strategy of prevention: Lessons from cardiovascular disease. Br Med J. 1981;282(6279):1847–51.
  12. Kreitman N. Alcohol consumption and the preventive paradox. Br J Addict. 1986;81(3):353–63.
  13. World Health Organization (WHO). Global strategy to reduce the harmful use of alcohol. Geneva, Switzerland: World Health Organisation (WHO). 2010. Available from: http://www.who.int/substance_abuse/alcstratenglishfinal.pdf. Accessed 09.10.2013
  14. Gutjahr E, Gmel G. Association of alcohol consumption to mortality and person-years of life lost in Switzerland – measuring the impact of some methodological options. Eur J Epidemiol. 2005;20:37–47.
  15. Rehm J, Roerecke M, Patra J. Alcohol-attributable mortality and burden of disease in Switzerland – epidemiology and recommendations for alcohol policy. Zürich: Institut für Sucht- und Gesundheitsforschung (ISGF), 2006.
  16. Lönnroth K, Williams BG, Stadlin S, Jaramillo E, Dye C. Alcohol use as a risk factor for tuberculosis – A systematic review. BMC Pub Health. 2008;8:289.
  17. Klatsky AL, Udaltsova N. Alcohol drinking and total mortality risk. Ann Epidemiol. 2007;17(5):S63–S7.
  18. Walter SD. The estimation of interpretation of attributable risk in health research. Biometrics. 1976;32:829–49.
  19. Walter SD. Prevention of multifactorial disease. Am J Epidemiol. 1980;112:409–16.
  20. Benichou J. A review of adjusted estimators of attributable risk. Stat Methods Med Res. 2001;10(3):195–216.
  21. Gmel G, Jr., Shield KD, Frick H, Kehoe T, Gmel G, Sen., Rehm J. Estimating uncertainty of alcohol-attributable fractions for infectious and chronic diseases. BMC Med Res Methodol. 2011;11:48.
  22. Kroese DP, Taimre T, Zdravko IB. Handbook of Monte Carlo methods. New York: John Wiley and Sons; 2011.
  23. Roerecke M, Rehm J. The cardioprotective association of average alcohol consumption and ischaemic heart disease: A systematic review and meta-analysis. Addiction. 2012;107(7):1246–60.
  24. Roerecke M, Rehm J. Irregular heavy drinking occasions and risk of ischemic heart disease: A systematic review and meta-analysis. Am J Epidemiol. 2010;171(6):633–44.
  25. Gmel G, Jr., Shield KD, Rehm J. Developing a method to derive alcohol-attributable fractions for HIV/AIDS mortality based on alcohol's impact on adherence to antiretroviral medication. Popul Health Metrics. 2011;9(1):5.
  26. Shield KD, Gmel G, Patra J, Rehm J. Global burden of injuries attributable to alcohol consumption in 2004: A novel way of calculating the burden of injuries attributable to alcohol consumption. Popul Health Metrics. 2012;10(1):9.
  27. Gmel G, Givel J-C, Yersin B, Daeppen J-B. Injury and repeated injury – What is the link with acute consumption, binge drinking and chronic heavy alcohol use? SMW. 2007;137(45–46):642–8.
  28. Ramstedt M. Alcohol consumption and liver cirrhosis mortality with and without mention of alcohol--the case of Canada. Addiction. 2003;98(9):1267–76.
  29. Hanzlick R. Death certificates, natural death, and alcohol. The problem of underreporting. Am J Forensic Med Pathol. 1988;9(2):149–50.
  30. Gmel G, Kuendig H, Maffli E, Notari L, Wicki M, Georges A, et al. Suchtmonitoring Schweiz / Jahresbericht – Daten 2011. Bern: Bundesamt für Gesundheit (BAG), 2012.
  31. Rehm J, Kehoe T, Gmel G, Jr., Stinson FS, Grant BF, Gmel G. Statistical modelling of volume of alcohol exposure for epidemiological studies of population health: The US example. Popul Health Metrics. 2010;8:3.
  32. Kehoe T, Gmel G, Jr., Shield KD, Gmel G, Sen., Rehm J. Determining the best population-level alcohol consumption model and its impact on estimates of alcohol-attributable harms. Popul Health Metrics. 2012;10:6.
  33. Lachenmeier DW, Gmel G, Rehm J. Unrecorded alcohol consumption. In: Boyle P, Boffetta P, Lowenfels AB, Burns H, Brawley O, Zatonski W, et al., editors. Alcohol: Science, policy, and public health. Oxford: Oxford University Press; 2013. p. 132–40.
  34. World Health Organization (WHO). Global Status Report on Alcohol and Health. Geneva: WHO. 2011. Available from: http://www.who.int/substance_abuse/publications/global_alcohol_report/en/index.html. Accessed 11.07.2013
  35. Rehm J, Klotsche J, Patra J. Comparative quantification of alcohol exposure as risk factor for global burden of disease. Int J Meth Psych Res. 2007;16(2):66–76.
  36. Midanik LT. Validity of self-reported alcohol use: A literature review and assessment. Br J Addict. 1988;83(9):1019–30.
  37. Gmel G, Rehm J. Measuring alcohol consumption. Contemp Drug Probl. 2004;31:467–540.
  38. Bundesamt für Statistik (BFS). Erhebungen, Quellen – Statistik der Todesursachen und Totgeburten (eCOD). Neuchâtel: BFS. 2013. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/infothek/erhebungen__quellen/blank/blank/cod/02.html. Accessed 09.10.2013
  39. Bundesamt für Statistik (BFS). Statistisches Jahrbuch der Schweiz 2013. Zürich: Verlag Neue Zürcher Zeitung; 2013.
  40. Bundesamt für Statistik (BFS). STAT-TAB: Die interaktive Statistikdatenbank. Neuchâtel: BFS. 2013. Available from: http://www.pxweb.bfs.admin.ch/Dialog/statfile.asp?lang=1. Accessed 09.10.2013
  41. Bundesamt für Statistik (BFS). Bevölkerungsbewegung – Indikatoren: Lebenserwartung. Neuchâtel: BFS. 2013. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/themen/01/06/blank/key/04/04.html. Accessed 09.10.2013
  42. Alperovitch A, Bertrand M, Jougla E, Vidal J-S, Ducimetiere P, Helmer C, et al. Do we really know the cause of death of the very old? Comparison between official mortality statistics and cohort study classification. Eur J Epidemiol. 2009;24(11):669–75.
  43. Lloyd-Jones DM, Martin DO, Larson MG, Levy D. Accuracy of death certificates for coding coronary heart disease as the cause of death. Ann Intern Med. 1998;129(12):1020–6.
  44. Tolstrup J, Gronbaek M. Alcohol and atherosclerosis: Recent insights. Current Atherosclerosis Reports. 2007;9(2):116–24.
  45. R Development Core Team. R: A language and environment for statistical computing. Vienna, Austria 2011. Available from: http://www.R-project.org/. Accessed 09.10.2013
  46. Rehm J, Taylor B, Room R. Global burden of disease from alcohol, illicit drugs and tobacco. Drug Alcohol Rev. 2006;25(6):503–13.
  47. Gore FM, Bloem PJN, Patton GC, Ferguson J, Joseph V, Coffey C, et al. Global burden of disease in young people aged 10–24 years: A systematic analysis. Lancet. 2011;377(9783):2093–102.
  48. Taylor B, Shield KD, Rehm J. Combining best evidence: A novel method to calculate the alcohol-attributable fraction and its variance for injury mortality. BMC Pub Health. 2011;11:265.
  49. Kuntsche E, Gmel G. Alcohol consumption in late adolescence and early adulthood – Where is the problem? SMW. 2013;143:w1386.
  50. Gmel G, Gaume J, Faouzi M, Kulling J-P, Daeppen J-B. Who drinks most of the total alcohol in young men – risky single occasion drinking as normative behaviour. Alcohol;43(6):692–7.
  51. Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Light alcohol drinking and cancer: A meta-analysis. Ann Oncol. 2013;24(2):301–8.
  52. Fuchs FD, Chambless LE. Is the cardioprotective effect of alcohol real? Alcohol. 2007;41(6):399–402.
  53. Alfsen GC, Maehlen J. The value of autopsies for determining the cause of death. Tidsskr Nor Laegeforen. 2012;132(2):147–51.
  54. Mant J, Wilson S, Parry J, Bridge P, Wilson R, Murdoch W, et al. Clinicians didn't reliably distinguish between different causes of cardiac death using case histories. J Clin Epidemiol. 2006;59(8):862–7.
  55. Rey G, Boniol M, Jougla E. Estimating the number of alcohol-attributable deaths: methodological issues and illustration with French data for 2006. Addiction. 2010;105(6):1018–29.
  56. Schneider M, Chersich M, Neuman M, Parry C. Alcohol consumption and HIV/AIDS: The neglected interface. Addiction. 2012;107(8):1369–71.
  57. Alati R, Lawlor DA, Najman JM, Williams GM, Bor W, O’Callaghan M. Is there really a 'J-shaped' curve in the association between alcohol consumption and symptoms of depression and anxiety? Findings from the Mater-University study of pregnancy and its outcomes. Addiction. 2005;100(5):643–51.
  58. World Health Organization (WHO). International guide for monitoring alcohol consumption and related harm. Geneva: WHO, Department of Mental Health and Substance Dependence, Noncommunicable Diseases and Mental Health Cluster. 2000. Available from: http://whqlibdoc.who.int/hq/2000/WHO_MSD_MSB_00.4.pdf. Accessed 09.10.2013
  59. Rehm J, Shield KD, Gmel G, Rehm MX, Frick U. Modeling the impact of alcohol dependence on mortality burden and the effect of available treatment interventions in the European Union. Eur Neuropsychopharmacol. 2013;23(2):89–97.
  60. Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009;373(9682):2234–46.
  61. Bundesamt für Gesundheit (BAG). Nationales Programm Alkohol. Bericht für die Jahre 2008 – 2012. Bern: BAG, 2013.
  62. Rehm J, Roerecke M. Reduction of drinking in problem drinkers and all-cause mortality. Alcohol. 2013;48(4):509–13.
  63. Kaner EF, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007(2):CD004148.
  64. Gaume J, Gmel G, Faouzi M, Bertholet N, Daeppen J-B. Is brief motivational intervention effective in reducing alcohol use among young men voluntarily receiving it? A randomized controlled trial. Alcohol Clin Exp Res. 2011;35(10):1822–30.
  65. Gmel G, Venzin V, Marmet K, Danko G, Labhart F. A quasi-randomized group trial of a brief alcohol intervention on risky single occasion drinking among secondary school students. Int J Publ Health. 2012;57(6):935–44.
  66. Neuner-Jehle S, Schmid M, Grüninger U. The “Health Coaching” programme: A new patient-centred and visually supported approach for health behaviour change in primary care. BMC family practice. 2013;14:100.

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