Shield Kevin D, Rehm Jürgen
Social and Epidemiological Research department, Centre for Addiction and Mental Health (CAMH), CAMH 33 Russell Street, Room T528, Toronto, ON, M5S 2S1, Canada.
WHO/PAHO Collaborating Centre in Addiction and Mental Health, CAMH, Toronto, Canada.
BMC Public Health. 2015 May 10;15:482. doi: 10.1186/s12889-015-1818-y.
Alcohol consumption is a major risk factor for the burden of disease globally. This burden is estimated using Relative Risk (RR) functions for alcohol from meta-analyses that use data from all countries; however, for Russia and surrounding countries, country-specific risk data may need to be used. The objective of this paper is to compare the estimated burden of alcohol consumption calculated using Russia-specific alcohol RRs with the estimated burden of alcohol consumption calculated using alcohol RRs from meta-analyses.
Data for 2012 on drinking indicators were calculated based on the Global Information System on Alcohol and Health. Data for 2012 on mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years (DALYs) lost by cause were obtained by country from the World Health Organization. Alcohol Population-Attributable Fractions (PAFs) were calculated based on a risk modelling methodology from Russia. These PAFs were compared to PAFs calculated using methods applied for all other countries. The 95% Uncertainty Intervals (UIs) for the alcohol PAFs were calculated using a Monte Carlo-like method.
Using Russia-specific alcohol RR functions, in Russia in 2012 alcohol caused an estimated 231,900 deaths (95% UI: 185,600 to 278,200) (70,800 deaths among women and 161,100 deaths among men) and 13,295,000 DALYs lost (95% UI: 11,242,000 to 15,348,000) (3,670,000 DALYs lost among women and 9,625,000 DALYs lost among men) among people 0 to 64 years of age. This compares to an estimated 165,600 deaths (95% UI: 97,200 to 228,100) (29,700 deaths among women and 135,900 deaths among men) and 10,623,000 DALYs lost (95% UI: 7,265,000 to 13,754,000) (1,783,000 DALYs lost among women and 8,840,000 DALYs lost among men) among people 0 to 64 years of age caused by alcohol when non-Russia-specific alcohol RRs were used.
Results indicate that if the Russia-specific RRs are used when estimating the health burden attributable to alcohol consumption in Russia, then the total estimated burden will be more than if RRs from meta-analyses are used. Furthermore, additional research is needed to understand which aspects of the Russian style of drinking cause the most harm.
饮酒是全球疾病负担的主要风险因素。该负担是使用来自荟萃分析的酒精相对风险（RR）函数来估计的，这些荟萃分析使用了来自所有国家的数据；然而，对于俄罗斯及周边国家，可能需要使用特定国家的风险数据。本文的目的是比较使用俄罗斯特定酒精RR计算得出的饮酒估计负担与使用荟萃分析中的酒精RR计算得出的饮酒估计负担。
基于全球酒精与健康信息系统计算了2012年饮酒指标数据。2012年按病因划分的死亡率、寿命损失年数、带病生存年数和伤残调整生命年（DALY）数据由各国从世界卫生组织获取。基于俄罗斯的风险建模方法计算了酒精人群归因分数（PAF）。将这些PAF与使用适用于所有其他国家的方法计算得出的PAF进行比较。使用类似蒙特卡洛的方法计算酒精PAF的95%不确定性区间（UI）。
使用俄罗斯特定酒精RR函数，2012年在俄罗斯，酒精导致0至64岁人群中估计有231,900人死亡（95% UI：185,600至278,200）（女性70,800人死亡，男性161,100人死亡），以及13,295,000个DALY损失（95% UI：11,242,000至15,348,000）（女性3,670,000个DALY损失，男性9,625,000个DALY损失）。相比之下，使用非俄罗斯特定酒精RR时，0至64岁人群中酒精导致估计165,600人死亡（95% UI：97,200至228,100）（女性29,700人死亡，男性135,900人死亡），以及10,623,000个DALY损失（95% UI：7,265,000至13,754,000）（女性1,783,000个DALY损失，男性8,840,000个DALY损失）。
结果表明，如果在估计俄罗斯饮酒所致健康负担时使用俄罗斯特定RR，那么估计的总负担将比使用荟萃分析中的RR时更高。此外，需要进一步研究以了解俄罗斯饮酒方式的哪些方面造成的危害最大。
