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Excerpt on alcohol from 2002 WHO World Health Report
From: Miles D. Townes
Date: 11/4/2002
Time: 1:29:25 PM
Remote Name: 138.88.147.203
Comments
http://www.who.int/whr/2002/chapter4/en/index6.html
Excerpt from the WHO World Health Report 2002: “Reducing risks, promoting healthy life”
Alcohol use
Alcohol has been consumed in human populations for millennia, but the considerable and varied adverse health effects, as well as some benefits, have only been characterized recently (39 ,40 ). Alcohol consumption has health and social consequences via intoxication (drunkenness), dependence (habitual, compulsive, long-term heavy drinking) and other biochemical effects. Intoxication is a powerful mediator for acute outcomes, such as car crashes or domestic violence, and can also cause chronic health and social problems. Alcohol dependence is a disorder in itself. There is increasing evidence that patterns of drinking are relevant to health as well as volume of alcohol consumed, binge drinking being hazardous.
Global alcohol consumption has increased in recent decades, with most or all of this increase occurring in developing countries. Both average volume of alcohol consumption and patterns of drinking vary dramatically between subregions. Average volume of drinking is highest in Europe and North America, and lowest in the Eastern Mediterranean and SEAR-D. Patterns are most detrimental in EUR-C, AMR-B, AMR-D and AFR-E. Patterns are least detrimental in Western Europe (EUR-A) and the more economically established parts of the Western Pacific region (WPR-A).
Overall, there are causal relationships between average volume of alcohol consumption and more than 60 types of disease and injury. Most of these relationships are detrimental, but there are beneficial relationships with coronary heart disease, stroke and diabetes mellitus, provided low-to-moderate average volume of consumption is combined with non-binge patterns of drinking. For example, it is estimated that ischaemic stroke would be about 17% higher in AMR-A, EUR-A and WPR-A subregions if no-one consumed alcohol.
Worldwide, alcohol causes 3.2% of deaths (1.8 million) and 4.0% of DALYs (58.3 million). Of this global burden, 24%occurs in WPR-B, 16% in EUR-C, and 16% in AMR-B. This proportion is much higher in males (5.6% of deaths, 6.5% of DALYs) than females (0.6% of deaths, 1.3% of DALYs). Within subregions, the proportion of disease burden attributable to alcohol is greatest in the Americas and Europe, where it ranges from 8% to 18% of total burden for males and 2% to 4% for females. Besides the direct effects of intoxication and addiction resulting in alcohol use disorders, alcohol is estimated to cause about 20–30% of each of the following worldwide: oesophageal cancer, liver cancer, cirrhosis of the liver, homicide, epilepsy, and motor vehicle accidents. For males in EUR-C, 50–75% of drownings, oesophagus cancer, epilepsy, unintentional injuries, homicide, motor vehicle crashes and cirrhosis of the liver are attributed to alcohol.