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Correia D, Manthey J, Neufeld M, Ferreira-Borges C, Olsen A, Shield K, Rehm J. Classifying national drinking patterns in Europe between 2000 and 2019: A clustering approach using comparable exposure data. Addiction 2024; 119:1543-1553. [PMID: 38924624 DOI: 10.1111/add.16567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND AND AIMS Previously identified national drinking patterns in Europe lack comparability and might be no longer be valid due to changes in economic conditions and policy frameworks. We aimed to identify the most recent alcohol drinking patterns in Europe based on comparable alcohol exposure indicators using a data-driven approach, as well as identifying temporal changes and establishing empirical links between these patterns and indicators of alcohol-related harm. DESIGN Data from the World Health Organization's monitoring system on alcohol exposure indicators were used. Repeated cross-sectional hierarchical cluster analyses were applied. Differences in alcohol-attributable harm between clusters of countries were analyzed via linear regression. SETTING European Union countries, plus Iceland, Norway and Ukraine, for 2000, 2010, 2015 and 2019. PARTICIPANTS/CASES Observations consisted of annual country data, at four different time points for alcohol exposure. Harm indicators were only included for 2019. MEASUREMENTS Alcohol exposure indicators included alcohol per capita consumption (APC), beverage-specific consumption and prevalence of drinking status indicators (lifetime abstainers, current drinkers, former drinkers and heavy episodic drinking). Alcohol-attributable harm was measured using age-standardized alcohol-attributable Disability-Adjusted Life Years (DALYs) lost and deaths per 100 000 people. FINDINGS The same six clusters were identified in 2019, 2015 and 2010, mainly characterized by type of alcoholic beverage and prevalence drinking status indicators, with geographical interpretation. Two-thirds of the countries remained in the same cluster over time, with one additional cluster identified in 2000, characterized by low APC. The most recent drinking patterns were shown to be significantly associated with alcohol-attributable deaths and DALY rates. Compared with wine-drinking countries, the mortality rate per 100 000 people was significantly higher in Eastern Europe with high spirits and 'other' beverage consumption [ β ^ = 90, 95% confidence interval (CI) = 55-126], and in Eastern Europe with high lifetime abstainers and high spirits consumption ( β ^ = 42, 95% CI = 4-78). CONCLUSIONS European drinking patterns appear to be clustered by level of beverage-specific consumption, with heavy episodic drinkers, current drinkers and lifetime abstainers being distinguishing factors between clusters. Despite the overall stability of the clusters over time, some countries shifted between drinking patterns from 2000 to 2019. Overall, patterns of drinking in the European Union seem to be stable and partly determined by geographical proximity.
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Affiliation(s)
- Daniela Correia
- WHO Regional Office for Europe, Copenhagen, Denmark
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Jakob Manthey
- Centre of Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | | | | | | | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Centre of Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Program on Substance Abuse and WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Catalonia, Spain
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Rehm J, Badaras R, Ferreira-Borges C, Galkus L, Gostautaite Midttun N, Gobiņa I, Janik-Koncewicz K, Jasilionis D, Jiang H, Kim KV, Lange S, Liutkutė-Gumarov V, Manthey J, Miščikienė L, Neufeld M, Petkevičienė J, Radišauskas R, Reile R, Room R, Stoppel R, Tamutienė I, Tran A, Trišauskė J, Zatoński M, Zatoński WA, Zurlytė I, Štelemėkas M. Impact of the WHO "best buys" for alcohol policy on consumption and health in the Baltic countries and Poland 2000-2020. THE LANCET REGIONAL HEALTH. EUROPE 2023; 33:100704. [PMID: 37953993 PMCID: PMC10636269 DOI: 10.1016/j.lanepe.2023.100704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 11/12/2023]
Abstract
Alcohol use is a major risk factor for burden of disease. This narrative review aims to document the effects of major alcohol control policies, in particular taxation increases and availability restrictions in the three Baltic countries (Estonia, Latvia, and Lithuania) between 2000 and 2020. These measures have been successful in curbing alcohol sales, in general without increasing consumption of alcoholic beverages from unrecorded sources; although for more recent changes this may have been partly due to the COVID-19 pandemic. Moreover, findings from time-series analyses suggest improved health, measured as reductions in all-cause and alcohol-attributable mortality, as well as narrowing absolute mortality inequalities between lower and higher educated groups. For most outcomes, there were sex differences observed, with alcohol control policies more strongly affecting males. In contrast to this successful path, alcohol control policies were mostly dismantled in the neighbouring country of Poland, resulting in a rising death toll due to liver cirrhosis and other alcohol-attributable deaths. The natural experiment in this region of high-income European countries with high consumption levels highlights the importance of effective alcohol control policies for improving population health.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
| | - Robertas Badaras
- Faculty of Medicine, Clinic of Anaesthesiology and Intensive Care, Centre of Toxicology, Vilnius University, M. K. Čiurlionio g. 21, Vilnius LT-03101, Lithuania
| | - Carina Ferreira-Borges
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Lukas Galkus
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Nijole Gostautaite Midttun
- Lithuanian Tobacco and Alcohol Control Coalition, Stikliu 8, Vilnius 01131, Lithuania
- Mental Health Initiative, Teatro 3-10, Vilnius 03107, Lithuania
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
- Institute of Public Health, Riga Stradiņš University, Kronvalda Boulevard 9, Riga LV-1010, Latvia
| | - Kinga Janik-Koncewicz
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Laboratory of Demographic Data, Konrad-Zuse-Str. 1, Rostock 18057, Germany
- Vytautas Magnus University, Demographic Research Centre, Jonavos g. 66, Kaunas 44191, Lithuania
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada
| | - Vaida Liutkutė-Gumarov
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Jakob Manthey
- Faculty of Medicine, Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, Hamburg 20246, Germany
- Medical Faculty, Department of Psychiatry, University of Leipzig, Semmelweisstraße 10, Leipzig 04103, Germany
| | - Laura Miščikienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Maria Neufeld
- World Health Organization, Regional Office for Europe, UN City, Marmorvej 5, Copenhagen DK-2100, Denmark
| | - Janina Petkevičienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ričardas Radišauskas
- Faculty of Public Health, Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, Kaunas 50162, Lithuania
| | - Rainer Reile
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Hiiu 42, Tallinn 11619, Estonia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria 3086, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm 106 91, Sweden
| | - Relika Stoppel
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Ilona Tamutienė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Department of Public Administration, Faculty of Political Science and Diplomacy at Vytautas Magnus University, V.Putvinskio Str 23, Kaunas LT-44243, Lithuania
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St., Toronto, Ontario M5T 1R8, Canada
| | - Justina Trišauskė
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
| | - Mateusz Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
| | - Witold A. Zatoński
- Institute – European Observatory of Health Inequalities, Calisia University, Nowy Swiat 4, Kalisz 62-800, Poland
- Health Promotion Foundation, Mszczonowska 51, Nadarzyn 05-830, Poland
| | - Ingrida Zurlytė
- WHO Country Office Lithuania, A. Jakšto g. 12, LT-01105 Vilnius, Lithuania
| | - Mindaugas Štelemėkas
- Faculty of Public Health, Health Research Institute, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
- Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Tilzes Str. 18, Kaunas 47181, Lithuania
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Grigorasi GR, Nistor I, Corlade-Andrei M, Voroneanu L, Siriopol D, Apetrei M, Cimpoesu DC, Covic A. Outcomes of death and prolonged renal insufficiency in ethylene glycol poisoned patients. Int Urol Nephrol 2021; 54:149-155. [PMID: 33738645 DOI: 10.1007/s11255-021-02837-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 03/06/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite the severity of ethylene glycol intoxication, there is a paucity of studies that analyze prognostic factors. This study aims to determine prognostic factors with impact on core outcomes like death and prolonged kidney injury (KI) in ethylene glycol poisoned patients. METHODS We retrospectively assessed prevalence, clinical and biochemical features in one large data set from two regional hospitals from the North-East region of Romania, between January 2012 and October 2017. Secondly, we compared prognostic factors of cases treated with dialysis plus antidote (N = 28 patients) with cases who received antidote only and supportive therapy (N = 28 patients). RESULTS Of the 56 cases included, 16 deaths (28.57%) were recorded. The symptomatology at admission was more severe among patients requiring hemodialysis: a lower mean value for initial pH, lower initial alkaline reserve (AR) and higher mean values for initial serum creatinine (Cr1). The data analysis (survivors/deceased) showed a correlation between pH, Glasgow Coma Score (GCS), and increased mortality. In addition, we found a correlation between initial mean values for pH, AR (mmol/L), Cr1 (mg/dL), and peak Cr24 (mg/dL) with outcomes of RI or death. CONCLUSIONS Compared with survivors, patients who died or had prolonged kidney injury were more likely to exhibit clinical signs such as coma, seizures, and acidosis. Hemodialysis and antidote should be started early and continued until acidosis is corrected.
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Affiliation(s)
- Gabriela Raluca Grigorasi
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania.
- Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania.
| | - Ionut Nistor
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania
| | - Mihaela Corlade-Andrei
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania
| | - Luminita Voroneanu
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania
| | - Dimitrie Siriopol
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania
| | - Mugurel Apetrei
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania
| | - Diana Carmen Cimpoesu
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania.
- Emergency Department, Clinical Emergency County Hospital "St. Spiridon", Iasi, Romania.
| | - Adrian Covic
- University of Medicine and Pharmacy "Grigore T. Popa", Iasi, Romania
- Department of Nephrology, Dr CI Parhon" Hospital, Iasi, Romania
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