Rationale for harmful alcohol consumption as a risk factor for chronic diseases Introduction The questions in this module measure: Frequency of alcohol consumption Quantity of alcohol consumption Research findings Some research findings related to alcohol consumption are as follows: In 2000, alcohol use caused 3.2% of deaths (1.8 million) worldwide, and 4% of the global disease burden.1 Alcohol consumption is the leading risk factor for disease burden in low mortality developing countries and the third largest risk factor in developed countries.2 The proportion of disease burden attributable to alcohol use in the developing world is between 2.6% to 9.8% of the total burden for males and 0.5% to 2.0% of the total burden for females.3 Besides the direct toxic effects of intoxication and addiction, alcohol use causes about 20% to 30% of each of esophageal cancer, liver disease, homicide, epileptic seizures, and motor vehicle accidents worldwide.2 Heavy alcohol use increases the risk of cardiovascular disease4,5, 6, 7, 8, 9 and stroke10, 11, 12, 13, 14. Alcohol consumption during pregnancy is related to various risks to the fetus, which include Fetal Alcohol Spectrum Disorders. Alcohol consumption during pregnancy can also lead to spontaneous abortion, low birth weight and prematurity, and intra-uterine growth retardation.15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 Higher volume of alcohol consumption is also associated with depression.2 Excessive alcohol consumption can severely impair an individual's functioning in social roles such as parent, spouse or partner.2 Reference 1. The World Health Report 2002 - Reducing Risks, Promoting Healthy Life. Geneva, World Health Organization, 2002. 2. Global Status Report on Alcohol 2004. Geneva, World Health Organization, 2004. 3. Rehm J et al. Alcohol. In: Ezzati M et al., eds. Comparative Quantification of Health Risks:Global and Regional Burden of Disease Due to Selected Major Risk Factors. Geneva, World Health Organization, 2004. 4. Friedman H S. Cardiovascular effects of alcohol. In: Galanter M ed. The Consequences of Alcoholism. New York, Plenum Press, 1998:135-166. 5. Klatsky A L. Cardiovascular effects of alcohol. Scientific American Science and Medicine, Vol 2(2), 1995:28-337. 6. Puddey I B et al. Influence of pattern of drinking on cardiovascular disease and cardiovascular risk factors - A review. Addiction, Vol 94(5), 1999:649-663. 7. Rosenqvist M. Alcohol and cardiac arrhythmias. Alcoholism, Clinical and Experimental Research, Vol 22(7suppl), 1998:318S-322S. 8. US Department of Health and Human Services. Ninth Special Report to the US Congress on Alcohol and Health from the Secretary of Health and Human Services, Vol 97-4017. Rockville, MD, US Department of Health and Human Services, Public Health Service, National Institute of Health, National Institute on Alcohol Abuse and Alcoholism, 1997. 9. Wood D et al. Alcohol consumption and the risk of fatal breast cancer in a prospective cohort of United States women. American Journal of Epidemiology, Vol 145(11), 1997:262-269. 10. Berger K et al. Light to moderate alcohol consumption and risk of stroke among US male physicians. New England Journal of Medicine, Vol 341(21), 1999:1557-1564. 11. Jackson R. Cardiovascular disease and alcohol consumption: evidence of benefits from epidemiologic studies. Contemporary Drug Problems, Vol 21(1), 1994:5-24. 12. Sacco R L et al. The protective effect of moderate alcohol consumption on ischemic stroke. Journal of the American Medical Association, Vol 281(1), 1999:53-60. 13. You R X et al. Risk Factors for stroke due to cerebral infarction in young adults. Stroke, Vol 28(10), 1997:1913-1918. 14. Ridolfo B and Stevenson C E. The quantification of Drug-Caused Mortality and Morbidity in Australia 1998. Canberra, Australian Institute of Health and Welfare, 2001. 15. Alvear J, Andreani S, Cortes F. Fetal alcohol syndrome and fetal alcohol effects:importance of early diagnosis and nutritional treatment. Revista Medica de Chile, Vol 126(4), 1998:407-412. 16. Church M W et al. Hearing, language speech, vestibular, and dentofacial disorders in fetal alcohol syndrome. Alcoholism, Clinical and Experimental Research, Vol 21(2):227-237. 17. Faden V B, Graubard B I, Dufour M. The relationship of drinking and birth outcome in a US national sample of expectant mothers. Paediatric and Perinatal Epidemiology, Vol 11(2), 1997:167-180. 18. Habbick B F et al. Mortality in foetal alcohol syndrome. Canadian Journal of Public Health, Vol 88(3), 1997:181-183. 19. Larkby C, Day N. The effects of prenatal alcohol exposure. Alcohol Health and Research World, Vol 21(3), 1997:192-198. 20. Larroque B, Kaminski M. Alcohol consumption during pregnancy and infant birth weight. Annals of Epidemiology, Vol 6(2), 1996:169-170. 21. Mattson S N et al. Heavy prenatal alcohol with or without physical features of fetal alcohol syndrome leads to IQ deficits. Journal of Pediatrics, Vol 131(5), 1997:718-721. 22. Passaro K T, Little R E. Childbearing and alcohol use. In: Wilsnack Rw & Wilsnack Sc, eds. Gender and Alcohol: Individual and Social Perspectives. New Brunswick, Rutgers Center of Alcohol Studies, 1997:90-113. 23. Passaro K T et al. The effect of maternal drinking before conception and in early pregnancy on infant birthweight. The ALSPAC Study Team (Avon Longitudinal Study of Pregnancy and Childhood). Epidemiology, Vol 7(4), 1996:377-383. 24. Polygenis D et al. Moderate alcohol consumption during pregnancy and the incidence of fetal malformations: a meta-analysis. Neurotoxicity and Teratology, Vol 20(1), 1998:61-67. 25. Roebuck T M, Mattson S N, Riley E P. A review of neuroanatomical findings in children with fetal alcohol syndrome or perinatal exposure to alcohol. Alcoholism, Clinical and Experimental Research, Vol 22(2), 1998:339-344. 26. Shu I et al. Alcohol use and mortality from coronary heart disease: the role of high density lipoprotein cholesterol. Annals of Internal Medicine, Vol 116(11), 1992:881-887. 27. Windham G C et al. The association of moderate maternal and paternal alcohol consumption with birthweight and gestational age. Epidemiology, Vol 6(6), 1995:591-597. 28. Abel E L. Maternal alcohol consumption and spontaneous abortion. Alcohol and Alcoholism, Vol 32(3), 1997:211-219. 29. Bradley K A et al. Medical risks for women who drink alcohol. Journal of General Internal Medicine, Vol 13(9), 1998:627-639. 30. Windham G C et al. Moderate maternal alcohol consumption and risk of spontaneous abortion. Epidemiology, Vol 8(5), 1997:509-514.