Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
Alcohol use and burden for 195 countries and territories, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016
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 lifeyears (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 agestandardised 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. Funding Bill & Melinda Gates Foundation.
1015-1035
Griswold, Max G.
345c71a8-9beb-4acb-9363-0add0bc04fb7
Fullman, Nancy
5e849414-0fa4-43ff-ad39-9df9c6d80528
Hawley, Caitlin
cdfa58bd-fb7f-42e6-ab9c-a5cc795cd522
Arian, Nicholas
df0bc934-91df-4156-905d-81f7b2c57510
Zimsen, Stephanie R.M.
07bcd6fc-ac5d-40f6-8f4f-f1b6bf0497ba
Tymeson, Hayley D.
59bbb247-5f62-4005-9a38-2defc3c3b55e
Venkateswaran, Vidhya
43828d13-5375-4ba9-922d-fbbe6ada6eb4
Tapp, Austin Douglas
75d4f962-0177-4349-8f32-e177d88cfbac
Forouzanfar, Mohammad H.
a66998ef-7485-4e2e-81eb-b323e392bb2d
Salama, Joseph S.
1c52e826-f9d6-4646-a45f-7a525c1945dd
Abate, Kalkidan Hassen
935c9eac-ed9b-4b30-88a0-4d44a4a88f31
Abate, Degu
aad7e080-d248-4563-b181-4d029c10c8df
Abay, Solomon M.
36863758-3055-4818-b181-cd08c950a716
Abbafati, Cristiana
521168a7-4836-42f0-b082-7b21c8093724
Abdulkader, Rizwan Suliankatchi
3e6cc89b-c00c-45cb-a900-b6f10adc9006
Abebe, Zegeye
6a890421-5df9-40f3-bbaa-1416480fe451
Aboyans, Victor
49a8cbaa-c577-4047-90af-3cdae75aa1f5
Abrar, Mohammed Mehdi
02a51fb4-8f6f-4004-bde0-174faf940dc8
Acharya, Pawan
b23029c3-dc18-455d-b6db-22504eb59f7c
Adetokunboh, Olatunji O.
f80bd9b5-5b52-4f3e-9a3d-2cfb4ee24ab1
Adhikari, Tara Ballav
7a4aaa37-acd0-46b4-8394-f43e03cfc299
Adsuar, Jose C.
7a4653ce-9557-438e-8646-ff9d993a6ffe
Afarideh, Mohsen
203e5da5-06bc-4965-a781-9e827c7d9829
Agardh, Emilie Elisabet
1a38b30a-1179-46fc-81ae-c8955d2f3ad6
Agarwal, Gina
857b681f-eb3d-44a7-8f21-1ade6a01a9cc
Aghayan, Sargis Aghasi
f281eb1f-951d-4985-a3fc-09f950199492
Agrawal, Sutapa
188691a9-f0cb-4849-8c64-83e151b4d3b5
Ahmed, Muktar Beshir
e1af2a0d-079f-4e56-b325-714bc9b1e318
Akibu, Mohammed
250914b4-eafe-4afc-8895-2bc90acd2278
Akinyemiju, Tomi
c70b01a9-1434-4611-9dd5-be253673431e
Akseer, Nadia
6e709c6f-ae2a-48fd-851f-dd9d8a205080
Al Asfoor, Deena H.
8ade023a-a27a-4854-ad65-068be07c4dc5
Al-Aly, Ziyad
99c680ae-f71e-475f-90b8-736dc2333782
Alahdab, Fares
f446c0b7-f9d5-48f7-9053-40243513997a
Alam, Khurshid
3d76f8f9-aa4b-43e5-883a-a34d532a29f3
Albujeer, Ammar
e1daeb97-2eff-45f0-9384-05968458510a
Alene, Kefyalew Addis
78ffc0e2-0a0e-4bc6-94ee-989bf0d3a5b1
Ali, Raghib
6ba6761f-3786-4b42-9cca-a7a36e57175f
Ali, Syed Danish
5191f618-fd95-4660-a8eb-4875bce2d022
Alijanzadeh, Mehran
ae2c0e90-f257-46b4-b835-20e5c6146248
Aljunid, Syed Mohamed
d91ecd2f-7c4b-46e3-9219-998e95e341d3
Alkerwi, Ala'A
90c7fcfd-9014-438a-8357-1e00cc144d15
Allebeck, Peter
559e275b-a01b-4c1e-b038-1190c20f7064
Alvis-Guzman, Nelson
30ee5d80-26f2-4ff2-9029-79ffbea6b26f
Amare, Azmeraw T.
d284dd30-eff9-4664-a79d-184c9fc05aea
Aminde, Leopold N.
b4890f57-9b08-46f3-b1d5-e4b00a380c72
Aremu, Olatunde
0be4f104-f548-477e-929d-dbc3be016939
Salomon, Joshua A.
af51ebe8-275d-44a2-9bc6-2afc10a09d7c
Ullah, Irfan
15653bbb-6bcc-4f9e-b1af-54145ad92cdb
Wang, Yuan Pang
332ff320-0449-4df8-a3db-2ac6020cff7f
GBD 2016 Alcohol Collaborators
22 September 2018
Griswold, Max G.
345c71a8-9beb-4acb-9363-0add0bc04fb7
Fullman, Nancy
5e849414-0fa4-43ff-ad39-9df9c6d80528
Hawley, Caitlin
cdfa58bd-fb7f-42e6-ab9c-a5cc795cd522
Arian, Nicholas
df0bc934-91df-4156-905d-81f7b2c57510
Zimsen, Stephanie R.M.
07bcd6fc-ac5d-40f6-8f4f-f1b6bf0497ba
Tymeson, Hayley D.
59bbb247-5f62-4005-9a38-2defc3c3b55e
Venkateswaran, Vidhya
43828d13-5375-4ba9-922d-fbbe6ada6eb4
Tapp, Austin Douglas
75d4f962-0177-4349-8f32-e177d88cfbac
Forouzanfar, Mohammad H.
a66998ef-7485-4e2e-81eb-b323e392bb2d
Salama, Joseph S.
1c52e826-f9d6-4646-a45f-7a525c1945dd
Abate, Kalkidan Hassen
935c9eac-ed9b-4b30-88a0-4d44a4a88f31
Abate, Degu
aad7e080-d248-4563-b181-4d029c10c8df
Abay, Solomon M.
36863758-3055-4818-b181-cd08c950a716
Abbafati, Cristiana
521168a7-4836-42f0-b082-7b21c8093724
Abdulkader, Rizwan Suliankatchi
3e6cc89b-c00c-45cb-a900-b6f10adc9006
Abebe, Zegeye
6a890421-5df9-40f3-bbaa-1416480fe451
Aboyans, Victor
49a8cbaa-c577-4047-90af-3cdae75aa1f5
Abrar, Mohammed Mehdi
02a51fb4-8f6f-4004-bde0-174faf940dc8
Acharya, Pawan
b23029c3-dc18-455d-b6db-22504eb59f7c
Adetokunboh, Olatunji O.
f80bd9b5-5b52-4f3e-9a3d-2cfb4ee24ab1
Adhikari, Tara Ballav
7a4aaa37-acd0-46b4-8394-f43e03cfc299
Adsuar, Jose C.
7a4653ce-9557-438e-8646-ff9d993a6ffe
Afarideh, Mohsen
203e5da5-06bc-4965-a781-9e827c7d9829
Agardh, Emilie Elisabet
1a38b30a-1179-46fc-81ae-c8955d2f3ad6
Agarwal, Gina
857b681f-eb3d-44a7-8f21-1ade6a01a9cc
Aghayan, Sargis Aghasi
f281eb1f-951d-4985-a3fc-09f950199492
Agrawal, Sutapa
188691a9-f0cb-4849-8c64-83e151b4d3b5
Ahmed, Muktar Beshir
e1af2a0d-079f-4e56-b325-714bc9b1e318
Akibu, Mohammed
250914b4-eafe-4afc-8895-2bc90acd2278
Akinyemiju, Tomi
c70b01a9-1434-4611-9dd5-be253673431e
Akseer, Nadia
6e709c6f-ae2a-48fd-851f-dd9d8a205080
Al Asfoor, Deena H.
8ade023a-a27a-4854-ad65-068be07c4dc5
Al-Aly, Ziyad
99c680ae-f71e-475f-90b8-736dc2333782
Alahdab, Fares
f446c0b7-f9d5-48f7-9053-40243513997a
Alam, Khurshid
3d76f8f9-aa4b-43e5-883a-a34d532a29f3
Albujeer, Ammar
e1daeb97-2eff-45f0-9384-05968458510a
Alene, Kefyalew Addis
78ffc0e2-0a0e-4bc6-94ee-989bf0d3a5b1
Ali, Raghib
6ba6761f-3786-4b42-9cca-a7a36e57175f
Ali, Syed Danish
5191f618-fd95-4660-a8eb-4875bce2d022
Alijanzadeh, Mehran
ae2c0e90-f257-46b4-b835-20e5c6146248
Aljunid, Syed Mohamed
d91ecd2f-7c4b-46e3-9219-998e95e341d3
Alkerwi, Ala'A
90c7fcfd-9014-438a-8357-1e00cc144d15
Allebeck, Peter
559e275b-a01b-4c1e-b038-1190c20f7064
Alvis-Guzman, Nelson
30ee5d80-26f2-4ff2-9029-79ffbea6b26f
Amare, Azmeraw T.
d284dd30-eff9-4664-a79d-184c9fc05aea
Aminde, Leopold N.
b4890f57-9b08-46f3-b1d5-e4b00a380c72
Aremu, Olatunde
0be4f104-f548-477e-929d-dbc3be016939
Salomon, Joshua A.
af51ebe8-275d-44a2-9bc6-2afc10a09d7c
Ullah, Irfan
15653bbb-6bcc-4f9e-b1af-54145ad92cdb
Wang, Yuan Pang
332ff320-0449-4df8-a3db-2ac6020cff7f