Reducing the burden of alcoholic disease: expert calls for immediate global action

According to the World Health Organization (WHO), alcohol consumption is responsible for 3.2% of global mortality and about 4% of years of life lost prematurely.

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The situation is even worse when Europe is considered alone, with 4% of global mortality and 7.9% of years of life lost prematurely attributable to alcoholic diseases.

Speaking at the 18th United European Gastroenterology Week (UEGW) in Barcelona, today, Professor Helena Cortez-Pinto from the Hospital of Santa Maria in Lisbon called for the immediate implementation of more forceful measures to combat the increasing burden of alcohol misuse.

She said: “It is time we applied similar strategies to those used to control tobacco misuse. There should be regulation of all alcohol promotion, sponsorship should be banned, and there should be far stricter surveillance on drink-driving.”

Disability Adjusted Life Years (DALYs) is a measure used by the WHO to evaluate the burden of a disease. It is calculated as the sum of the years of life lost due to premature mortality in the population, plus the years lived with disability for incident cases of the disease.

Using this measure, it has been estimated that Europe has the highest alcohol-attributable DALYs, accounting for 11.6% of all DALYs.

“We have recently evaluated the burden and costs of alcohol-related harm in Portugal,” explained Prof. Cortez-Pinto.

“We found that liver disease represented the main source of burden attributable to alcohol, accounting for 31.5% of total DALYs. This was far higher than road traffic accidents and even several types of cancer.”

Alcohol and liver disease: the facts speak for themselves

The importance of alcohol as a cause of liver disease is confirmed by data from the European liver transplantation registry showing that alcohol is responsible for one third of cases of cirrhosis leading to liver transplantation, and it is the second most common cause of liver transplantation. There is a strong correlation between alcohol consumption and mortality from liver cirrhosis.

Nevertheless, it is difficult to define precisely how much alcohol you can drink.

There is a large variation in the noxious effects of alcohol among the population, probably related to genetic predisposition.

A suggested “safe” limit of alcohol intake has been 21 units per week in men and 14 units per week in women who have no other chronic liver disease (where a unit is defined as the equivalent of 8g of ethanol).

However, other data suggest that less alcohol than this may be toxic in women, implying a lower threshold of no more than 7 units per week may be more appropriate.