BACKGROUND: The role of lifestyle factors is an important issue in the prevention and treatment of disease. Although certain lifestyle factors in relation to low-back pain have evoked much interest, interest has not focused on alcohol consumption. An appraisal of the epidemiologic literature seems warranted. OBJECTIVES: To establish if there is evidence in the literature for a causal link between alcohol consumption and low-back pain. Data Sources: Nine original research reports published between 1987 and 1995 were obtained through a MEDLINE search for the years 1992 to 1998, with various combinations of the terms "alcohol," "substance abuse," "life-style, " "risk factor," "epidemiology" and "low back pain." An additional manual search was made of relevant bibliographies without limitation for year of publication. Data Synthesis: A systematic review was made of the epidemiologic literature to uncover any evidence for a causal relation between alcohol consumption and low-back pain. RESULTS: None of the studies reported a positive link between alcohol consumption and low-back pain, and no positive gradient was found in studies that included an analysis of the dose-response. None of the studies was prospective in design. CONCLUSIONS: Alcohol consumption does not seem to be associated with low-back pain, but well-designed specific alcohol/low-back pain-centered studies are lacking.
Sweden has had a restrictive alcohol policy, but there are gender and geographical differences in alcohol consumption and injury rates within the country. Whether and how the Swedish alcohol environment influences gender differences in injuries in young people is still unclear. Thus, the aim of this study was to analyse the associations between the local alcohol environment and age- and gender-specific nonfatal injury rates in people up to 24 years in Sweden.
The local alcohol environment from 14 municipalities was studied using indicators of alcohol access, alcohol consumption and alcohol-related crimes. A comprehensive health care register of nonfatal injuries was used to estimate mean annual rates of nonfatal injuries by gender and age group (2000-2005). Pearson's correlation coefficients were used to analyse linear associations.
Associations were shown for both alcohol access and alcohol consumption with injury rates in boys aged 13-17 years; no other associations were observed between alcohol access or per capita alcohol consumption and nonfatal childhood injuries. The prevalence of crimes against alcohol laws was associated with injury rates in children of both genders aged 6-17?years.
This study found no strong area-level associations between alcohol and age and gender specific nonfatal injuries in young people. Further, the strength of the area-level associations varied by age, gender and type of indicator used to study the local alcohol environment.
Alcohol is a significant risk factor for injury, and is one of the leading causes of death, disability and premature mortality among young Canadians. This paper provides an overview of alcohol-related injury among adolescents and young adults presenting to Canadian emergency departments (EDs).
We reviewed records from the Canadian Hospitals Injury Reporting and Prevention Program database during the 4-year period between 2000 and 2003. We included individuals younger than 25 years who presented to EDs in 11 pediatric and general hospitals with injuries for which alcohol, either alone or in conjunction with drugs, was recorded as a contributing factor. We examined key socio-demographic and injury-related factors associated with alcohol and drug-related injuries, including intent and disposition.
Alcohol was identified as a factor in 2389 injuries during this 4-year period; 408 (17%) of these cases also involved drug use. Approximately 55% of these patients were male and the majority was between 15 and 19 years of age. Unintentional injuries were the most common presentation, self-harm injuries were more common among female patients and violence-related injuries were more common among male patients. Most patients received treatment for their injuries. However, as age increased, outcome differences were observed between sexes.
Alcohol-related injuries are increasing among Canadian youth. These findings highlight the importance of obtaining thorough drug and alcohol histories and measurement, when appropriate, for adolescents and young adults presenting to EDs with injuries.
To investigate the association between smoking and psoriatic arthritis (PsA) among patients with psoriasis and its interaction with the HLA-C*06 allele.
In this exploratory case-control study, smoking status was determined at the time of the diagnosis of arthritis for PsA patients and at their first study visit for psoriasis patients, when they were confirmed not to have PsA. The proportions of patients exposed to smoking were compared in patients with PsA to those with psoriasis alone. A logistic regression model was constructed to test the independent association of smoking and PsA after adjusting for potential confounders. The statistical interaction between HLA-C*06 and smoking was tested through a regression model.
The proportions of current and past smokers were higher in the psoriasis group compared with the PsA group (30.2% vs 23.4% and 26.7% vs 22.3%, p=0.001, respectively). On multivariate analysis being a current smoker versus a lifetime non-smoker remained inversely associated with PsA (OR 0.57, p=0.002), while past smoker versus lifetime non-smoker status was no longer significant. In a subgroup analysis, smoking remained inversely associated with PsA only among patients who were HLA-C*06 negative. Regression analysis revealed that the interaction between smoking status (ever smoked vs lifetime non-smoker) and HLA-C*06 was statistically significant (p=0.01).
Smoking may be inversely associated with PsA among psoriasis patients. This association is not present among HLA-C*06-positive individuals.
The high suicide rate in Russia and its profound fluctuation over the past decades have attracted considerable interest. There is growing evidence that beverage preference and binge-drinking patterns, i.e., excessive consumption of strong spirits, results in a quicker and deeper level of intoxication, which increases the propensity for the alcohol-related suicide. In line with this evidence, we assumed that higher levels of vodka consumption, in conjunction with binge-drinking patterns, would result in a close, aggregate-level association between vodka sales and suicide in Russia.
To test this hypothesis, trends in beverage-specific alcohol sales per capita and suicide rates from 1970 to 2005 in Russia were analyzed employing ARIMA time-series analysis.
The results of the time-series analysis suggested that a 1 liter increase in overall alcohol sales would result in a 4% increase in the male suicide rate and a 2.8% increase in the female suicide rate; a 1 liter increase in vodka sales would increase the suicide rate by 9.3% for men and by 6% for women.
This study replicates previous findings from other settings, which suggest that suicide rates tend to be more responsive to changes in distilled spirits consumption per capita than to the total level of alcohol consumption. Assuming that drinking spirits is usually associated with intoxication episodes, these findings provide additional evidence that the drinking pattern is an important determinant in the relationship between alcohol and suicide. The outcomes of this study also provide support for the hypothesis that suicide and alcohol are closely connected in cultures where an intoxication-oriented drinking pattern prevails and adds to the growing body of evidence that alcohol plays a crucial role in the fluctuation in suicide mortality rates in Russia during recent decades.
BACKGROUND: Previous studies regarding the impact of cigarette smoking on the risk of hip fracture in postmenopausal women have been inconsistent, suggesting different effects in different groups. The effect of alcohol intake on fracture risk is puzzling: moderate alcohol intake appears to increase bone density, and its association with hip fracture is not clear. METHODS: To assess the associations of cigarette smoking and alcohol consumption with hip fracture risk among postmenopausal women, we conducted an analysis of a population-based case-control study from Sweden. Cases were postmenopausal women, aged 50 to 81 years, who sustained a hip fracture after minor trauma between October 1, 1993, and February 28, 1995; controls were randomly selected from a population-based register during the same period. A mailed questionnaire requesting information on lifestyle habits and medical history was used 3 months after the hip fracture for cases and simultaneously for controls. Age-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed by means of logistic regression. RESULTS: Of those eligible, 1328 cases (82.5%) and 3312 controls (81.6%) responded. Compared with never smokers, current smokers had an increased risk of hip fracture (age-adjusted OR, 1.66; 95% CI, 1.41-1.95). Duration of smoking-particularly postmenopausal smoking-was more important than the amount smoked. Former smokers had a small increase in risk (age-adjusted OR, 1.15; 95% CI, 0.97-1.37) that decreased with the duration of cessation. The age-adjusted OR for women consuming alcohol was 0.80 (95% CI, 0.69-0.93). CONCLUSIONS: Cigarette smoking is a risk factor for hip fracture among postmenopausal women; risk decreases after cessation. Alcohol consumption has a weak inverse association with risk.
Comment In: Arch Intern Med. 2002 Jan 14;162(1):101-211784234
BACKGROUND: Deaths due to alcohol consumption are an important component of all-cause mortality, particularly premature mortality. However, there are considerable regional variations, the reasons for which are unclear. METHODS: Estimates were made as reliably as possibly using vital statistics and best estimates of risk of the alcohol-attributable mortality, by age, sex and cause for four European countries (England and Wales, Germany, Denmark and Italy). Twenty-seven alcohol-related conditions were considered including the possible cardio-protective effects of alcohol. RESULTS: It was estimated that there are approximately 2% fewer deaths annually in England and Wales than would be expected in a non-drinking population and 0.3% fewer deaths among East German females. In West Germany, Denmark, Italy and among East German males there are more deaths caused by alcohol than are prevented (between 0.7 and 2.6% of all deaths). The highest age-specific proportion of alcohol-attributable deaths is found in East Germany where around 30% of deaths among males aged 25-44 years are due to drinking. Among young men in all four countries the largest contributor to alcohol-related deaths is road traffic accidents involving alcohol. CONCLUSIONS: Possible explanations for the variation in alcohol-attributable deaths between countries include different underlying heart disease rates, different patterns of alcohol consumption and beverage preferences, and different use of mortality classification. Differences in the reported alcohol consumption levels explain little of the variation in alcohol-attributable deaths. Estimating alcohol-attributable mortality by age and sex across countries may be a useful indicator for developing alcohol strategies and exploring ways of preventing premature mortality.
OBJECTIVES: To examine characteristics related to drinking during pregnancy among a population-based sample of women. METHOD: We analyzed data related to third-trimester drinking collected from the Alaska Pregnancy Risk Assessment Monitoring System (PRAMS). PRAMS used a population-based, stratified sampling design to survey 9733 of the approximately 44,000 live births to Alaska-resident women during 1991-1994. We defined regular drinking as one or more drinks per week on average during the third trimester. Analyses included bivariate and multivariate associations with any and regular drinking. RESULTS: Of women mailed a survey, 6973 responded and answered the questions related to alcohol consumption. Nine percent reported any drinking during the third trimester and 2.5% were regular third-trimester drinkers. The strongest risk factors for both any and regular third-trimester drinking were older age and marijuana or cocaine use. Other risk factors for any third-trimester drinking included prenatal cigarette smoking, greater education, non-Alaska Native race, the experience of significant life stressors, and residence in a community that did not restrict the sale of alcohol. Other risk factors for regular third-trimester drinking included prenatal cigarette smoking and the experience of domestic violence. Prenatal counseling regarding the effects of alcohol consumption during pregnancy and adequacy of prenatal care were not significantly associated with either outcome variable. CONCLUSIONS: Efforts to decrease prenatal alcohol consumption should be directed at older women and should address social determinants of health, such as education, domestic violence, drug use, and the availability of alcohol. In the absence of these efforts, prenatal alcohol education by health care providers may have little impact on pregnancy-related drinking.
Bathing in sauna is common in Finland, where there are approximately 2 million saunas among the population of 5.2 million. In this paper, deaths occurring while in a sauna in 1990-2002 in Finland were studied by analyzing police and forensic autopsy reports, death certificates, and toxicological results. The annual rate of death occurring while in a sauna was less than 2 per 100,000 inhabitants. Close to half (51%) of the cases were determined to be natural deaths and exposure to heat was the cause of death in 25%. Overall, 50% of all cases were under the influence of alcohol. The main conclusion is that death in the sauna is a rare event even in Finland where the frequency of sauna bathing is high. The role of alcohol as a risk factor has grown. The prevention of these deaths should focus on less drinking of alcohol and avoid leaving a drunken bather alone in the sauna.