Titre : | Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths (2009) |
Auteurs : | D. ZARIDZE ; P. BRENNAN ; J. BOREHAM ; BORODA A. ; KARPOV R. ; LAZAREV A. ; KONOBEEVSKAYA I. ; IGITOV V. ; TERECHOVA T. ; P. BOFFETTA ; R. PETO |
Type de document : | Article : Périodique |
Dans : | Lancet (The) (Vol.373, n°9682, Jun 27, 2009) |
Article en page(s) : | 2201-2214 |
Note générale : |
Lancet (The), 2009, 373, (9682), 2201-2214 Editorial: 'Alcohol and harm reduction in Russia', p.2171. Comments: 'Alcohol: a global health priority', Beaglehole R. & Bonita R., p.2173-4 ; 'Action needed to tackle a global drink problem', Gilmore I., p.2174-6 ; 'A case study in how harmful alcohol consumption can be', Rehm J. & Room R., p.2176-7. |
Langues: | Anglais |
Discipline : | EPI (Epidémiologie / Epidemiology) |
Mots-clés : |
Thésaurus mots-clés ALCOOL ; CAUSE DE DECES ; MORTALITE ; ETUDE RETROSPECTIVE ; AGE ; SEXE ; PATHOLOGIE ; INTOXICATION ; ACCIDENT ; EVOLUTIONThésaurus géographique RUSSIE |
Résumé : |
ENGLISH : BACKGROUND: Alcohol is an important determinant of the high and fluctuating adult mortality rates in Russia, but cause-specific detail is lacking. Our case-control study investigated the effects of alcohol consumption on male and female cause-specific mortality. METHODS: In three Russian industrial cities with typical 1990s mortality patterns (Tomsk, Barnaul, Biysk), the addresses of 60,416 residents who had died at ages 15-74 years in 1990-2001 were visited in 2001-05. Family members were present for 50,066 decedents; for 48,557 (97%), the family gave proxy information on the decedents' past alcohol use and on potentially confounding factors. Cases (n=43,082) were those certified as dying from causes we judged beforehand might be substantially affected by alcohol or tobacco; controls were the other 5475 decedents. Case versus control relative risks (RRs; calculated as odds ratios by confounder-adjusted logistic regression) were calculated in ever-drinkers, defining the reference category by two criteria: usual weekly consumption always less than 0.5 half-litre bottles of vodka (or equivalent in total alcohol content) and maximum consumption of spirits in 1 day always less than 0.5 half-litre bottles. [] FINDINGS: In men, the three causes accounting for the most alcohol-associated deaths were accidents and violence (RR 5.94, 95% CI 5.35-6.59, in the highest consumption category), alcohol poisoning (21.68, 17.94-26.20), and acute ischaemic heart disease other than myocardial infarction (3.04, 2.73-3.39), which includes some misclassified alcohol poisoning. There were significant excesses of upper aerodigestive tract cancer (3.48, 2.84-4.27) and liver cancer (2.11, 1.64-2.70). Another five disease groups had RRs of more than 3.00 in the highest alcohol category: tuberculosis (4.14, 3.44-4.98), pneumonia (3.29, 2.83-3.83), liver disease (6.21, 5.16-7.47), pancreatic disease (6.69, 4.98-9.00), and ill-specified conditions (7.74, 6.48-9.25). Although drinking was less common in women, the RRs associated with it were generally more extreme. After correction for reporting errors, alcohol-associated excesses accounted for 52% of all study deaths at ages 15-54 years (men 8182 [59%] of 13968, women 1565 [33%] of 4751) and 18% of those at 55-74 years (men 3944 [22%] of 17,536, women 1493 [12%] of 12 302). Allowance for under-representation of extreme drinkers would further increase alcohol-associated proportions. Large fluctuations in mortality from these ten strongly alcohol-associated causes were the main determinants of recent fluctuations in overall mortality in the study region and in Russia as a whole. INTERPRETATION: Alcohol-attributable mortality varies by year; in several recent years, alcohol was a cause of more than half of all Russian deaths at ages 15-54 years. Alcohol accounts for most of the large fluctuations in Russian mortality, and alcohol and tobacco account for the large difference in adult mortality between Russia and western Europe. (Author' s abstract) |
Domaine : | Alcool / Alcohol |
Refs biblio. : | 34 |
Affiliation : |
Department of Epidemiology and Prevention, N N Blokhin Russian Cancer Research Centre, Moscow. Email : dgzaridze@crc.umos.ru Russie. Russia. |
Centre Emetteur : | 13 OFDT |
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