학술논문

Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016
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Author
Griswold, Max G.Fullman, NancyHawley, CaitlinArian, NicholasZimsen, Stephanie R. M.Tymeson, Hayley D.Venkateswaran, VidhyaTapp, Austin DouglasForouzanfar, Mohammad H.Salama, Joseph S.Abate, Kalkidan HassenAbate, DeguAbay, Solomon M.Abbafati, CristianaAbdulkader, Rizwan SuliankatchiAbebe, ZegeyeAboyans, VictorAbrar, Mohammed MehdiAcharya, PawanAdetokunboh, Olatunji O.Adhikari, Tara BallavAdsuar, Jose C.Afarideh, MohsenAgardh, Emilie ElisabetAgarwal, GinaAghayan, Sargis AghasiAgrawal, SutapaAhmed, Muktar BeshirAkibu, MohammedAkinyemiju, TomiAkseer, NadiaAl Asfoor, Deena H.Al-Aly, ZiyadAlahdab, FaresAlam, KhurshidAlbujeer, AmmarAlene, Kefyalew AddisAli, RaghibAli, Syed DanishAlijanzadeh, MehranAljunid, Syed MohamedAlkerwi, Ala'aAllebeck, PeterAlvis-Guzman, NelsonAmare, Azmeraw T.Aminde, Leopold N.Ammar, WalidAmoako, Yaw AmpemAmul, Gianna Gayle HerreraAndrei, Catalina LilianaAngus, ColinAnsha, Mustafa GeletoAntonio, Carl Abelardo T.Aremu, OlatundeArnlov, JohanArtaman, AlAryal, Krishna K.Assadi, RezaAusloos, MarcelAvila-Burgos, LeticiaAvokpaho, Euripide F. G. A.Awasthi, AshishAyele, Henok TadesseAyer, RakeshAyuk, Tambe B.Azzopardi, Peter S.Badali, HamidBadawi, AlaaBanach, MaciejBarker-Collo, Suzanne LynBarrero, Lope H.Basaleem, HudaBaye, EstifanosBazargan-Hejazi, ShahrzadBedi, NeerajBejot, YannickBelachew, Abate BekeleBelay, Saba AbrahamBennett, Derrick A.Bensenor, Isabela M.Bernabe, EduardoBernstein, Robert S.Beyene, Addisu ShunuBeyranvand, TinaBhaumik, SoumyadeeepBhutta, Zulfiqar A.Biadgo, BeleteBijani, AliBililign, NigusBirlik, Sait MentesBirungi, CharlesBizuneh, HailemichaelBjerregaard, PeterBjorge, ToneBorges, GuilhermeBosetti, CristinaBoufous, SoufianeBragazzi, Nicola LuigiBrenner, HermannButt, Zahid A.Cahuana-Hurtado, LuceroCalabria, BiancaCampos-Nonato, Ismael R.Campuzano Rincon, Julio CesarCarreras, GiuliaCarrero, Juan J.Carvalho, FelixCastaneda-Orjuela, Carlos A.Castillo Rivas, JacquelineCatala-Lopez, FerranChang, Jung-ChenCharlson, Fiona J.Chattopadhyay, AparajitaChaturvedi, PankajChowdhury, RajivChristopher, Devasahayam J.Chung, Sheng-ChiaCiobanu, Liliana G.Claro, Rafael M.Conti, SaraCousin, EwertonCriqui, Michael H.Dachew, Berihun AssefaDargan, Paul, IDaryani, AhmadDas Neves, JoseDavletov, KairatDe Castro, FilipaDe Courten, BarboraDe Neve, Jan-WalterDegenhardt, LouisaDemoz, Gebre TeklemariamDes Jarlais, Don C.Dey, SubhojitDhaliwal, Rupinder SinghDharmaratne, Samath DhammindaDhimal, MeghnathDoku, David TeyeDoyle, Kerrie E.Dubey, ManishaDubljanin, EleonoraDuncan, Bruce B.Ebrahimi, HedyehEdessa, DumessaZaki, Maysaa El SayedErmakov, Sergei PetrovichErskine, Holly E.Esteghamati, AlirezaFaramarzi, MahbobehFarioli, AndreaFaro, AndreFarvid, Maryam S.Farzadfar, FarshadFeigin, Valery L.Felisbino-Mendes, Mariana SantosFernandes, EduardaFerrari, Alize J.Ferri, Cleusa P.Fijabi, Daniel ObadareFilip, IrinaFinger, Jonas DavidFischer, FlorianFlaxman, Abraham D.Franklin, Richard CharlesFutran, Neal D.Gallus, SilvanoGanji, MorsalehGankpe, Fortune GbetohoGebregergs, Gebremedhin BerheGebrehiwot, Tsegaye TeweldeGeleijnse, Johanna M.Ghadimi, RezaGhandour, Lilian A.Ghimire, MamataGill, Paramjit SinghGinawi, Ibrahim AbdelmageedGiref, Ababi Zergaw Z.Gona, Philimon N.Gopalani, Sameer ValiGotay, Carolyn C.Goulart, Alessandra C.Greaves, FelixGrosso, GiuseppeGuo, YumingGupta, RahulGupta, RajeevGupta, VipinAlma Gutierrez, ReynaGvs, MurthyHafezi-Nejad, NimaHagos, Tekleberhan BeyeneHailu, Gessessew BugssaHamadeh, Randah R.Hamidi, SamerHankey, Graeme J.Harb, Hilda L.Harikrishnan, SivadasanpillaiMaria Haro, JosepHassen, Hamid YimamHavmoeller, RasmusHay, Simon, IHeibati, BehzadHenok, AndualemHeredia-Pi, IleanaFrancisco Hernandez-Llanes, NorbertoHerteliu, ClaudiuHibstu, Desalegn Ts TsegawHoogar, PraveenHorita, NobuyukiHosgood, H. DeanHosseini, MostafaHostiuc, MihaelaHu, GuoqingHuang, HsiangHusseini, AbdullatifIdrisov, BulatIleanu, Bogdan VasileIlesanmi, Olayinka StephenIrvani, Seyed Sina NaghibiIslam, Sheikh Mohammed SharifulJackson, Maria D.Jakovljevic, MihajloJayatilleke, Achala UpendraJha, Ravi PrakashJonas, Jost B.Jozwiak, Jacek JerzyKabir, ZubairKadel, RajendraKahsay, AmahaKapil, UmeshKasaeian, AmirKassa, Tesfaye D. DessaleKatikireddi, Srinivasa VittalKawakami, NoritoKebede, SeifuKefale, Adane TeshomeKeiyoro, Peter NjengaKengne, Andre PascalKhader, YousefKhafaie, Morteza AbdullatifKhalil, Ibrahim A.Khan, Md NuruzzamanKhang, Young-HoKhater, Mona M.Khubchandani, JagdishKim, Cho-IlKim, DanielKim, Yun JinKimokoti, Ruth W.Kisa, AdnanKivimaki, MikaKochhar, SonaliKosen, SoewartaKoul, Parvaiz A.Koyanagi, AiKrishan, KewalDefo, Barthelemy KuateBicer, Burcu KucukKulkarni, Veena S.Kumar, PushpendraLafranconi, AlessandraBalaji, Arjun LakshmanaLalloo, RatilalLallukka, TeaLam, HiltonLami, Faris HasanLan, QingLang, Justin J.Lansky, SoniaLarsson, Anders O.Latifi, ArmanLeasher, Janet L.Lee, Paul H.Leigh, JamesLeinsalu, Mall, 1958; Leung, JanniLevi, MiriamLi, YichongLim, Lee-LingLinn, ShaiLiu, ShiweiLobato-Cordero, AndreaLotufo, Paulo A.King Macarayan, Erlyn RachelleMachado, Isis EloahMadotto, FabianaAbd El Razek, Hassan MagdyAbd El Razek, Muhammed MagdyMajdan, MarekMajdzadeh, RezaMajeed, AzeemMalekzadeh, RezaMalta, Deborah CarvalhoMapoma, Chabila ChristopherMartinez-Raga, JoseMaulik, Pallab K.Mazidi, MohsenMckee, MartinMehta, VarshilMeier, ToniMekonen, TesfaMeles, Kidanu GebremariamMelese, AddisuMemiah, Peter T. N.Mendoza, WalterMengistu, Desalegn TadeseMensah, George A.Meretoja, Tuomo J.Mezgebe, Haftay BerhaneMiazgowski, TomaszMiller, Ted R.Mini, G. K.Mirica, AndreeaMirrakhimov, Erkin M.Moazen, BabakMohammad, Karzan AbdulmuhsinMohammadifard, NoushinMohammed, ShafiuMonasta, LorenzoMoraga, PaulaMorawska, LidiaJalu, Moti ToleraMousavi, Seyyed MeysamMukhopadhyay, SatinathMusa, Kamarul ImranNaheed, AliyaNaik, GurudattaNajafi, FaridNangia, VinayNansseu, Jobert RichieNayak, Mudavath Siva Durga PrasadNejjari, ChakibNeupane, SubasNeupane, Sudan PrasadNgunjiri, Josephine W.Nguyen, Cuong TatNguyen, Long HoangNguyen, Trang HuyenNingrum, Dina Nur AnggrainiNirayo, Yirga LegesseNoubiap, Jean JacquesOfori-Asenso, RichardOgbo, Felix AkpojeneOh, In-HwanOladimeji, OlanrewajuOlagunju, Andrew T.Olivares, Pedro R.Olusanya, Bolajoko OlubukunolaOlusanya, Jacob OlusegunOommen, Anu MaryOren, EyalOrpana, Heather M.Ortega-Altamirano, Doris D., VOrtiz, Justin R.Ota, ErikaOwolabi, Mayowa OjoOyekale, Abayomi SamuelMahesh, P. A.Pana, AdrianPark, Eun-KeeParry, Charles D. H.Parsian, HadiPatle, AjayPatton, George C.Paudel, DeepakPetzold, MaxPhillips, Michael R.Pillay, Julian DavidPostma, Maarten J.Pourmalek, FarshadPrabhakaran, DorairajQorbani, MostafaRadfar, AmirRafay, AnwarRafiei, AlirezaRahim, FakherRahimi-Movaghar, AfarinRahman, MahfuzarRahman, Muhammad AzizRai, Rajesh KumarRajsic, SasaRaju, Sree BhushanRam, UshaRana, Saleem M.Ranabhat, Chhabi LalRawaf, David LaithRawaf, SalmanReiner, Robert C.Reis, CesarRenzaho, Andre M. N.Rezai, Mohammad SadeghRoever, LeonardoRonfani, LucaRoom, RobinRoshandel, GholamrezaRostami, AliRoth, Gregory A.Roy, AmbujSabde, Yogesh DamodarSaddik, BasemaSafiri, SaeidSahebkar, AmirhosseinSaleem, ZikriaSalomon, Joshua A.Salvi, Sundeep SantoshSanabria, JuanDolores Sanchez-Nino, MariaSantomauro, Damian FrancescoSantos, Itamar S.Milicevic, Milena M. M. SantricSarker, Abdur RazzaqueSarmiento-Suarez, RodrigoSarrafzadegan, NizalSartorius, BennSatpathy, MaheswarSawhney, MonikaSaxena, SoniaSaylan, MeteSchaub, Michael P.Schmidt, Maria InesSchneider, Ione J. C.Schoettker, BenSchutte, Aletta ElisabethSchwendicke, FalkSepanlou, Sadaf G.Shaikh, Masood A. AliSharif, MehdiShe, JunSheikh, AzizShen, JiabinShiferaw, Mekonnen SisayShigematsu, MikaShiri, RahmanShishani, KawkabShiue, IvyShukla, Sharvari RahulSigfusdottir, Inga DoraSantos Silva, Diego AugustoDa Silva, Natacha TorresAlves Silveira, Dayane GabrieleSinha, Dhirendra Narain NarainSitas, FreddySoares Filho, Adauto MartinsSoofi, MoslemSorensen, Reed J. D.Soriano, Joan B.Sreeramareddy, Chandrashekhar T.Steckling, NadineStein, Dan J.Sufiyan, Mu'awiyyah BabaleSur, Patrick J.Sykes, Bryan L.Tabares-Seisdedos, RafaelTabuchi, TakahiroTavakkoli, MohammadTehrani-Banihashemi, ArashTekle, Merhawi GebremedhinThapa, SubashThomas, NihalTopor-Madry, RomanTopouzis, FotisTran, Bach XuanTroeger, Christopher E.Truelsen, Thomas ClementTsilimparis, NikolaosTyrovolas, StefanosUkwaja, Kingsley NnannaUllah, IrfanUthman, Olalekan A.Valdez, Pascual R.Van Boven, Job F. M.Vasankari, Tommi JuhaniVenketasubramanian, NarayanaswamyViolante, Francesco S.Vladimirov, Sergey KonstantinovitchVlassov, VasilyVollset, Stein EmilVos, TheoWagnew, Fasil Wagnew ShiferawWaheed, YasirWang, Yuan-PangWeiderpass, ElisabeteWeldegebreal, FitsumWeldegwergs, Kidu GideyWerdecker, AndreaWesterman, RonnyWhiteford, Harvey A.Widecka, JustynaWijeratne, TissaWyper, Grant M. A.Xu, GelinYamada, TomohideYano, YuichiroYe, PengpengYimer, Ebrahim M.Yip, PaulYirsaw, Biruck DesalegnYisma, EngidaYonemoto, NaohiroYoon, Seok-JunYotebieng, MarcelYounis, Mustafa Z.Zachariah, GeevarZaidi, ZoubidaZamani, MohammadZhang, XueyingZodpey, SanjayMokdad, Ali H.Naghavi, MohsenMurray, Christopher J. L.Gakidou, Emmanuela
Source
The Lancet. 392(10152):1015-1035
Subject
Language
English
ISSN
0140-6736
1474-547X
Abstract
Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.