Rehm Jürgen, Sulkowska Urszula, Mańczuk Marta, Boffetta Paolo, Powles John, Popova Svetlana, Zatoński Witold
Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention Division, Warsaw, Poland.
Int J Epidemiol. 2007 Apr;36(2):458-67. doi: 10.1093/ije/dyl294. Epub 2007 Jan 24.
There is a west-east mortality gradient in Europe, more pronounced in men. The objective of this article was to quantify the contribution of alcohol use to the gap in premature adult mortality between three old (France, Sweden and United Kingdom) and four new (Czech Republic, Hungary, Lithuania and Poland) European Union (EU) member states for the year 2002. Russia was added as an external comparator.
Exposure data were taken from surveys and per capita consumption records from the World Health Organization (WHO) Global Alcohol Database. Mortality data were taken from the WHO databank. The risk relationships were taken from published meta-analyses and from the WHO Comparative Risk Assessment project. Alcohol exposure and relative risk information was combined to derive alcohol-attributable fractions for relevant causes of premature mortality.
Alcohol consumption was responsible for 14.6% of all premature adult mortality in the eight countries, 17.3% in men and 8.0% in women. This proportion was clearly higher in the new EU member states and Russia compared with the comparison countries from the old EU. For men, Russia with 29.0 alcohol-attributable premature deaths per 10,000 population had a more than 10-fold higher rate compared with Sweden (2.7 deaths/10,000). For women, the ratio between Hungary (5.0 alcohol-attributable deaths/10,000) and Russia (4.7 deaths/10,000) compared with Sweden (0.5 deaths/10,000) was almost as high, but the rates were much lower. The Czech Republic and Poland showed proportionally less alcohol-attributable premature mortality than the other new EU member states or Russia for both genders, which, however, was still higher than in any of the old EU member states.
Alcohol is a strong contributor to the health gap between western and central and eastern Europe, with both average volume of consumption and patterns of drinking contributing to burden of disease and injury. Alcohol also contributes substantially to male-female differences in mortality and life expectancy. However, there are feasible and cost-effective measures to reduce alcohol-related burden that should be implemented in central and eastern Europe.
在欧洲存在着从西到东的死亡率梯度，在男性中更为明显。本文的目的是量化2002年酒精使用对三个老欧盟成员国（法国、瑞典和英国）与四个新欧盟成员国（捷克共和国、匈牙利、立陶宛和波兰）之间成年人过早死亡率差距的影响。俄罗斯被作为外部对照纳入研究。
暴露数据取自世界卫生组织（WHO）全球酒精数据库的调查和人均消费记录。死亡率数据取自WHO数据库。风险关系取自已发表的荟萃分析和WHO比较风险评估项目。将酒精暴露和相对风险信息相结合，得出过早死亡相关原因的酒精归因比例。
在这八个国家中，酒精消费导致了所有成年人过早死亡的14.6%，男性为17.3%，女性为8.0%。与老欧盟成员国相比，新欧盟成员国和俄罗斯的这一比例明显更高。对于男性，俄罗斯每10000人口中有29.0例酒精归因过早死亡，比瑞典（每10000人中有2.7例死亡）高出10倍以上。对于女性，匈牙利（每10000人中有5.0例酒精归因死亡）和俄罗斯（每10000人中有4.7例死亡）与瑞典（每10000人中有0.5例死亡）的比例几乎同样高，但比率要低得多。捷克共和国和波兰在两性中酒精归因过早死亡率的比例低于其他新欧盟成员国或俄罗斯，然而，仍高于任何一个老欧盟成员国。
酒精是导致西欧与中东欧健康差距的一个重要因素，饮酒量和饮酒模式均对疾病和伤害负担产生影响。酒精也在很大程度上导致了男女死亡率和预期寿命的差异。然而，在中东欧有可行且具有成本效益的措施来减轻与酒精相关的负担，应该予以实施。
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