The primary aim of this epidemiological study was to investigate associations between chronic non-cancer pain with or without opioid treatment and the alcohol and smoking behavior. The secondary aims were to investigate self-reported quality of life, sleeping problems, oral health and the use of different health care providers. The Danish health survey of 2005 was based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents suffering from chronic pain were identified through the question 'Do you have chronic/long-lasting pain lasting 6 months or more?' The question concerning alcohol intake assessed the frequency of alcohol intake and binge drinking. Smoking behavior assessed the daily number of cigarettes. Individuals reporting chronic pain were stratified into two groups (opioid users and non-opioid users). In all, 7275 individuals completed a personal interview and 5552 individuals completed and returned the self-administrated questionnaire. Responders with a self-reported earlier or present cancer diagnosis were excluded from the study. Hence, the final study population consisted of 5292 individuals. We found, that individuals suffering from chronic pain were less likely to drink alcohol. In opioid users alcohol consumption was further reduced. Cigarette smoking was significantly increased in individuals suffering from chronic pain and in opioid users smoking was further increased. Poor oral health, quality of life and sleep were markedly associated with chronic pain and opioid use. The use of opioids was associated with significantly more contacts to healthcare care providers.
INTRODUCTION: The trend in alcohol consumption by middle-aged and elderly Danes has received little attention, but earlier studies indicated increased consumption. Social factors may influence the trend. Our objective was to investigate the trend in alcohol consumption by the middle-aged and elderly and inquire about significant trends among specific social subgroups. MATERIALS AND METHODS: In the Danish Health and Morbidity Survey carried out in 1987, 1994, 2000 and 2003, a total of 11,754 people aged 50 and older were asked about their alcohol consumption. The mean alcohol intake and the number of heavy drinkers were compared from year to year. RESULTS: The mean intake per day increased from 1.5 drinks in 1987 to 2.1 drinks in 2003 for men and from 0.5 drink in 1987 to 1.0 drink in 2003 for women. The percentage of elderly drinking above the sensible drinking limits increased from 15.2% to 20.4% for men and from 10.7% to 13.6% for women. The strongest increasing trend in the number of heavy drinkers was in the lowest socio-economic groups and among those married or cohabiting. CONCLUSION: The increased number of heavy drinkers among the middle-aged and elderly is of great importance to their general state of health. The increase has possibly been caused by a social and cultural development which has led to a generation of elderly who used to drink alcohol earlier in their lives and continue drinking in old age. More focus on alcohol consumption among the middle-aged and elderly in health policy initiatives is needed.
BACKGROUND: The aim of this study was to analyse the impact of alcohol intake and drinking pattern on the risk of breast cancer. METHODS: A total of 17 647 nurses were followed from 1993 until the end of 2001. At baseline participants completed a questionnaire on alcohol intake and other lifestyle-related factors. Data were analysed using Cox's proportional hazard model. RESULTS: During follow-up 457 women were diagnosed with breast cancer. The relative risk of breast cancer was 2.30 [Confidence interval (CI): 1.56-3.39] for alcohol intake of 22-27 drinks per week, compared to 1-3 drinks per week. Among alcohol consumers, weekly alcohol intake increased the risk of breast cancer with 2% for each additional drink consumed. Weekend consumption increased the risk with 4% for each additional drink consumed friday through sunday. Binge drinking of 4-5 drinks the latest weekday increased risk with 55%, compared with consumption of one drink. A possible threshold in risk estimates was found for consumption above 27 drinks per week. CONCLUSIONS: For alcohol consumption above the intake most frequently reported, the risk of breast cancer is increased. The risk is minor for moderate levels but increases for each additional drink consumed during the week. Weekend consumption and binge drinking imply an additional increase in breast cancer risk.
BACKGROUND: Cross-sectional studies have reported a lower prevalence of abdominal obese persons among frequent drinkers than among nonfrequent drinkers. OBJECTIVE: We tested the hypothesis that drinking frequency is associated with subsequent changes in waist circumference. DESIGN: Data come from a prospective cohort study conducted in 1993-1997 (baseline) and 1999-2002 (follow-up) and included 43 543 men and women. Baseline information on alcohol drinking frequency was related to 1) change in waist circumference by linear regression and 2) major gain and major loss in waist circumference (defined as waist change in the lowest or highest quintile of waist changes) by polytomous logistic regression, also taking into account amount of alcohol intake. RESULTS: Drinking frequency was inversely associated with changes in waist circumference in women and was unassociated with changes in waist circumference in men. Drinking frequency was unassociated with major waist loss but was inversely associated with major waist gain: odds ratios among men were 0.97 (95% CI: 0.73, 1.28), 0.95 (95% CI: 0.81, 1.12), 0.88 (95% CI: 0.77, 0.99), 0.82 (95% CI: 0.71, -0.95), and 0.79 (95% CI: 0.69, 0.9) for never drinking, drinking on 1, 2-4, 5-6, and 7 d/wk, respectively, compared with men who drank alcohol on
Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, and Department of Health Psychology, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark. firstname.lastname@example.org
Knowledge of the epidemiology of suicide is a necessary prerequisite for developing prevention programs. The aim of this study was to analyze the risk of completed suicide among individuals with alcohol use disorders (AUD), and to assess the role of other psychiatric disorders in this association. A prospective cohort study was used, containing three updated sets of lifestyle covariates and 26 years follow-up of 18,146 individuals between 20 and 93 years of age from the Copenhagen City Heart Study in Denmark. The study population was linked to four different registers in order to detect: Completed suicide, AUD, Psychotic disorders, Anxiety disorders, Mood disorders, Personality disorders, Drug abuse, and Other psychiatric disorders. Individuals registered with AUD were at significantly increased risk of committing suicide, with a crude hazard ratio (HR) of 7.98 [Confidence interval (CI): 5.27-12.07] compared to individuals without AUD. Adjusting for all psychiatric disorders the risk fell to 3.23 (CI: 1.96-5.33). In the stratified sub-sample of individuals without psychiatric disorders, the risk of completed suicide was 9.69 (CI: 4.88-19.25) among individuals with AUD. The results indicate that individuals registered with AUD are at highly increased risk of completed suicide, and that registered co-morbid psychiatric disorders are neither sufficient nor necessary causes in this association.
AIMS: It is generally accepted, but not yet documented that the risk of future alcoholism increases with the amount of alcohol consumed. The objective of this study was to investigate this association using the Copenhagen City Heart Study. METHODS: Quantity and frequency of alcohol intake was measured in 19 698 men and women randomly drawn from the Copenhagen Population Register in 1976-78. The study population was linked to three different registers in order to detect alcoholism, and average follow-up time was 25 years. RESULTS: After adjustment for all putative confounders, the risk of alcoholism for women increased significantly at 1-7 drinks per week with a hazard ratio (HR) of 2.02 (95% confidence interval (CI): 1.16, 3.53) compared to never/almost never drinking; the HR for drinking monthly was 1.75 (95% CI: 1.08, 2.85). The risk for men did not increase significantly before 22-41 drinks per week (HR = 3.81, 95 % CI: 2.18, 6.68) or if they had a daily alcohol intake (HR = 3.55, 95 % CI: 2.11, 5.99). Smoking was independently associated with the risk of alcoholism for both men and women. CONCLUSION: The risk of developing alcoholism increased significantly by very low intakes of alcohol in women, while the risk is only increased significantly in men consuming more than 21 drinks per week.
OBJECTIVE: The purpose of this study was to examine whether preferred type of alcoholic beverage influences the later risk of alcohol-use disorders (AUD). METHOD: A prospective cohort study was used, comprising three updated measures of alcohol intake and covariates, and 26 years of follow-up data on 18,146 individuals from the Copenhagen City Heart Study, Denmark. The study population was linked to three different registers to detect AUD registrations. RESULTS: For both genders, wine drinking was associated with lower risk of AUD irrespective of the weekly amount of alcohol consumed. Women drinking 15-21 drinks per week of only beer and distilled spirits had a risk of 15.8 (95% confidence interval [CI]: 7.8-33.3) for AUD, whereas those whose total alcohol intake comprised more than 35% wine had a risk of 2.0 (CI: 0.7-5.2). Men drinking 15-21 drinks per week of only beer and distilled spirits had a risk of 3.1 (CI: 1.8-5.4), whereas those whose total alcohol intake comprised more than 35% wine had a risk of 0.8 (CI: 0.3-2.1). Consuming more than 35% beer increased the risk of AUD for women, whereas the percentage of distilled spirits intake did not influence the risk of AUD for either women or men. CONCLUSIONS: Individuals who include wine when they drink alcohol have lower risks of AUD, independent of the total amount of alcohol consumed. The most likely explanation of these results is that lifestyle factors and personal characteristics are associated with beverage preference.
Seizures are often found in children with fetal alcohol syndrome, but it is not known whether binge drinking during pregnancy by nonalcoholic women is associated with an increased risk of seizure disorders in children. The authors conducted a population-based cohort study of 80,526 liveborn singletons in the Danish National Birth Cohort (1996-2002). Information on maternal binge drinking (intake of > or = 5 drinks on a single occasion) was collected in 2 computer-assisted telephone interviews during pregnancy. Children were followed for up to 8 years. Information on neonatal seizures, epilepsy, and febrile seizures was retrieved from the Danish National Hospital Register. Results showed that exposure to binge drinking episodes during pregnancy was not associated with an increased risk of seizure disorders in children, except for those exposed at 11-16 gestational weeks. These children had a 3.15-fold increased risk of neonatal seizures (95% confidence interval: 1.37, 7.25) and a 1.81-fold increased risk of epilepsy (95% confidence interval: 1.13, 2.90). These findings suggest that maternal binge drinking during a specific time period of pregnancy may be associated with an increased risk of specific seizure disorders in the offspring. The results are exploratory, however, and need to be replicated.
OBJECTIVE: To examine whether the frequency and timing of binge drinking episodes (intake of five or more drinks on one occasion) during the first 16 weeks of pregnancy increase the risk of fetal death. METHODS: The study is based upon data from 89,201 women who were enrolled in the Danish National Birth Cohort from 1996 to 2002 and participated in an interview that took place in midpregnancy (n=86,752) or after a fetal loss (n=2,449). In total, 3,714 pregnancies resulted in fetal death. Data were analyzed by means of Cox regression models. RESULTS: Neither the frequency nor the timing of binge episodes was related to the risk of early (at or before 12 completed weeks) or late (13-21 completed weeks) spontaneous abortion. However, three or more binge episodes showed an adjusted hazard ratio of 1.56 (95% confidence interval 1.01-2.40) for stillbirth (22 or more completed weeks) relative to nonbinge drinkers. Women with an average intake of three or more drinks per week and two or more binge drinking episodes had a hazard ratio of 2.20 (95% confidence interval 1.73-2.80) compared with women with no average intake and no binge drinking. CONCLUSION: Binge drinking three or more times during pregnancy is associated with an increased risk of stillbirth, but neither frequency nor timing of binge drinking was associated with an increased risk of spontaneous abortion in clinically recognized pregnancies.
BACKGROUND: Consumption of high doses of alcohol on a single occasion (binge drinking) may harm the developing foetus and pregnant women are advised to avoid binge drinking while pregnant. We present characteristics of Danish women who binge drank in the pre-and post recognised part of their pregnancy. METHODS: During the years 1996-2002 approximately 100,000 pregnant women were enrolled into the Danish National Birth Cohort. Women with information on binge drinking, time of recognition of pregnancy, age, reproductive history, marital status, smoking, occupational status, pre-pregnancy BMI, alcohol consumption before pregnancy, and mental disorders (n = 85,334) were included in the analyses. RESULTS: Approximately one quarter of the women reported binge drinking at least once during pregnancy; most of these in the pre-recognised part of pregnancy. Weekly alcohol consumption before pregnancy, single status and smoking were predictors for binge drinking in both the unrecognised and recognised part of pregnancy. Moreover, binge drinking in the pre-recognised part of pregnancy was more common among women aged 25-29 years, who were nulliparous, well educated in good jobs or skilled workers. Binge drinking after recognition of pregnancy was more common among women who were unintended pregnant, multiparous unskilled workers, had been unemployed for more than one year, or had mental/neurotic disorder. CONCLUSIONS: In order to prevent binge drinking during pregnancy, health care providers should target their efforts towards pregnant women as well as pregnancy-planners. It is important to be aware that women who binge drink before versus after the pregnancy is recognised have different social characteristics.