Britton A, Nolte E, White I R, Grønbaek M, Powles J, Cavallo F, McPherson K
Department of Epidemiology and Public Health, University College London, UK.
Eur J Epidemiol. 2003;18(7):643-51. doi: 10.1023/a:1024834608689.
Deaths due to alcohol consumption are an important component of all-cause mortality, particularly premature mortality. However, there are considerable regional variations, the reasons for which are unclear.
Estimates were made as reliably as possibly using vital statistics and best estimates of risk of the alcohol-attributable mortality, by age, sex and cause for four European countries (England and Wales, Germany, Denmark and Italy). Twenty-seven alcohol-related conditions were considered including the possible cardio-protective effects of alcohol.
It was estimated that there are approximately 2% fewer deaths annually in England and Wales than would be expected in a non-drinking population and 0.3% fewer deaths among East German females. In West Germany, Denmark, Italy and among East German males there are more deaths caused by alcohol than are prevented (between 0.7 and 2.6% of all deaths). The highest age-specific proportion of alcohol-attributable deaths is found in East Germany where around 30% of deaths among males aged 25-44 years are due to drinking. Among young men in all four countries the largest contributor to alcohol-related deaths is road traffic accidents involving alcohol.
Possible explanations for the variation in alcohol-attributable deaths between countries include different underlying heart disease rates, different patterns of alcohol consumption and beverage preferences, and different use of mortality classification. Differences in the reported alcohol consumption levels explain little of the variation in alcohol-attributable deaths. Estimating alcohol-attributable mortality by age and sex across countries may be a useful indicator for developing alcohol strategies and exploring ways of preventing premature mortality.
酒精消费导致的死亡是全因死亡率的重要组成部分，尤其是过早死亡。然而，存在相当大的地区差异，其原因尚不清楚。
尽可能可靠地利用生命统计数据以及对酒精所致死亡率风险的最佳估计，按年龄、性别和死因对四个欧洲国家（英格兰和威尔士、德国、丹麦和意大利）进行了估算。考虑了27种与酒精相关的情况，包括酒精可能的心脏保护作用。
据估计，英格兰和威尔士每年的死亡人数比不饮酒人群预期的少约2%，东德女性的死亡人数少0.3%。在西德、丹麦、意大利以及东德男性中，酒精导致的死亡人数超过了预防的死亡人数（占所有死亡人数的0.7%至2.6%）。酒精所致死亡的年龄特异性比例最高的是东德，25至44岁男性中约30%的死亡是饮酒所致。在所有四个国家的年轻男性中，与酒精相关死亡的最大原因是涉及酒精的道路交通事故。
各国酒精所致死亡差异的可能解释包括潜在心脏病发病率不同、酒精消费模式和饮料偏好不同以及死亡率分类的使用不同。报告的酒精消费水平差异对酒精所致死亡差异的解释作用不大。按年龄和性别估算各国酒精所致死亡率可能是制定酒精战略和探索预防过早死亡方法的有用指标。
