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Vol. 9, No. 4, 2003
Issue release date: October 2003
Eur Addict Res 2003;9:157–164

Alcohol as a Risk Factor for Global Burden of Disease

Rehm J. · Room R. · Monteiro M. · Gmel G. · Graham K. · Rehn N. · Sempos C.T. · Jernigan D.
aAddiction Research Institute, Zürich, Switzerland; bCentre for Addiction and Mental Health, Toronto, Ont., Canada; cUniversity of Toronto, Toronto, Ont., Canada; dCentre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden; eManagement of Substance Dependence, World Health Organization (WHO), Geneva, Switzerland; fSwiss Institute for the Prevention of Alcohol and Other Drug Problems, Lausanne, Switzerland; gUniversity of Western Ontario, London, Ont., Canada; hUniversity at Buffalo, Buffalo, N.Y., USA, and iHealth Policy Institute, Georgetown University, Washington, D.C., USA

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Aim: To make quantitative estimates of the burden of disease attributable to alcohol in the year 2000 on a global basis. Design: Secondary data analysis. Measurements: Two dimensions of alcohol exposure were included: average volume of alcohol consumption and patterns of drinking. There were also two main outcome measures: mortality, i.e. the number of deaths, and disability-adjusted life years (DALYs), i.e. the number of years of life lost to premature mortality or to disability. All estimates were prepared separately by sex, age group and WHO region. Findings: Alcohol causes a considerable disease burden: 3.2% of the global deaths and 4.0% of the global DALYs in the year 2000 could be attributed to this exposure. There were marked differences by sex and region for both outcomes. In addition, there were differences by disease category and type of outcome; in particular, unintentional injuries contributed most to alcohol-attributable mortality burden while neuropsychiatric diseases contributed most to alcohol-attributable disease burden. Discussion/Conclusions: The underlying assumptions are discussed and reasons are given as to why the estimates should still be considered conservative despite the considerable burden attributable to alcohol globally.

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