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Life‐time risk of mortality due to different levels of alcohol consumption in seven European countries: implications for low‐risk drinking guidelines
Author(s) -
Shield Kevin D.,
Gmel Gerrit,
Gmel Gerhard,
Mäkelä Pia,
Probst Charlotte,
Room Robin,
Rehm Jürgen
Publication year - 2017
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13827
Subject(s) - environmental health , medicine , relative risk , demography , risk assessment , injury prevention , guideline , poison control , alcohol consumption , consumption (sociology) , occupational safety and health , years of potential life lost , confidence interval , alcohol , life expectancy , population , social science , biochemistry , chemistry , computer security , pathology , sociology , computer science
Background and Aims Low‐risk alcohol drinking guidelines require a scientific basis that extends beyond individual or group judgements of risk. Life‐time mortality risks, judged against established thresholds for acceptable risk, may provide such a basis for guidelines. Therefore, the aim of this study was to estimate alcohol mortality risks for seven European countries based on different average daily alcohol consumption amounts. Methods The maximum acceptable voluntary premature mortality risk was determined to be one in 1000, with sensitivity analyses of one in 100. Life‐time mortality risks for different alcohol consumption levels were estimated by combining disease‐specific relative risk and mortality data for seven European countries with different drinking patterns (Estonia, Finland, Germany, Hungary, Ireland, Italy and Poland). Alcohol consumption data were obtained from the Global Information System on Alcohol and Health, relative risk data from meta‐analyses and mortality information from the World Health Organization. Results The variation in the life‐time mortality risk at drinking levels relevant for setting guidelines was less than that observed at high drinking levels. In Europe, the percentage of adults consuming above a risk threshold of one in 1000 ranged from 20.6 to 32.9% for women and from 35.4 to 54.0% for men. Life‐time risk of premature mortality under current guideline maximums ranged from 2.5 to 44.8 deaths per 1000 women in Finland and Estonia, respectively, and from 2.9 to 35.8 deaths per 1000 men in Finland and Estonia, respectively. If based upon an acceptable risk of one in 1000, guideline maximums for Europe should be 8–10 g/day for women and 15–20 g/day for men. Conclusions If low‐risk alcohol guidelines were based on an acceptable risk of one in 1000 premature deaths, then maximums for Europe should be 8–10 g/day for women and 15–20 g/day for men, and some of the current European guidelines would require downward revision.

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