Increasing alcohol consumption correlated with hospital admission rates

Hospital admissions for somatic care among young men: the role of alcohol

The association between level of alcohol consumption and hospital admission for somatic care during a 15-year follow-up was studied in a cohort of 8226 Swedish conscripts. The relative risk for admission among high consumers of alcohol (more than 250 g alcohol per week) was 1.5 (95% confidence interval 1.2-1.8) compared with moderate consumers (1-100 g alcohol per week). After control for social background variables in a multivariate model the odds ratio was 1.2 (0.9-1.6). High consumers had a higher rate of recurring admissions; the number of admissions per capita increased from 1.8 among abstainers to 2.4 among high consumers. The association with alcohol was positive in all diagnostic categories studied. Earlier reports of a U-shaped curve for hospital admission was not confirmed; abstainers had the same rate of admission as moderate consumers.

The drinking habits of Sikh, Hindu, Muslim and white men in the West Midlands: a community survey

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol-related disorders. A community survey of random samples of 200 each of Sikh, Muslim and Hindu men and 200 white English-born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/Temple attenders drank regularly.

Relationship between male pancreatitis morbidity and alcohol consumption in Western Australia, 1971-84

Acute pancreatitis morbidity rates for Western Australian men aged 20 to 39 years, and over 40 years, were related to per adult (greater than or equal to 15 years) alcohol consumption, using the Mann-Whitney U test. A significant result was obtained for the young men. The male 20 years and over chronic pancreatitis morbidity rate was also significantly related to alcohol consumption. Various reasons for the results are discussed, and in particular from the view point that changes in the level of alcohol consumption appear to affect subsequent pancreatitis morbidity rates.

Alcohol and cancer

The cancers consistently associated with ingestion of alcohol, the head and neck cancers, are also associated with tobacco use and arise from epithelia that are in direct contact with both agents. Tobacco smoking-related cancers at sites not directly in contact with alcoholic beverages, that is, lung, bladder, and perhaps pancreas, do not consistently show a relationship to alcohol consumption, although lung and pancreatic tumors are associated in some studies. Liver cancer was thought to be strongly related to alcohol consumption on epidemiological grounds and because of its relationship to cirrhosis. As knowledge of the viral etiology of some cirrhoses has evolved and as methods to detect viruses have developed, the significant association between hepatitis B virus and hepatocellular carcinoma has become clear. Alcohol and hepatitis B virus may interact in the etiology of the disease and have important separate roles as well. There are epidemiologic and experimental data showing that malnutrition (resulting from poor food choice), economic deprivation, or alcoholism contributes to the risk for head, neck, and liver cancers. Colon cancers occur about equally in men and women, are found in well-nourished populations, and are not associated with tobacco smoking. Rectal cancers show a preponderance of cases in men but are frequently found in women as well and are not thought to be associated with smoking or malnutrition. The association between colorectal cancers and alcohol consumption, when it is found, apparently occurs at even relatively low alcohol intakes and is often stronger for consumption of beer than of other beverages. Nutritional and metabolic mechanisms proposed for the influence of alcohol on carcinogenesis are supported by studies in human subjects and laboratory animals. Animal models are needed in which effects of ethanol on carcinogenesis can be consistently demonstrated and which can then be used to examine mechanisms.