Premature mortality due to alcohol-related diseases of the liver in Poland according to voivodships (original) (raw)
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International Journal of Environmental Research and Public Health
This paper presents a comparative assessment of mortality in Poland and Ukraine, including due to alcohol consumption, by sex, place of residence, and age groups. Mortality from alcohol consumption is and remains one of the health problems of the state’s population. The aim of this study was to establish the difference in mortality, including due to alcohol consumption, in the two neighboring countries. The analysis was conducted in 2008 and 2018 according to statistical institutions in Poland and Ukraine. Data from the codes of the International Statistical Classification of Diseases of the 10th edition: F10, G31.2, G62.1, I42.6, K70, K86.0, and X45 were used to calculate mortality due to alcohol consumption. The share of mortality caused by alcohol consumption in Ukraine in 2008 was 3.52%, and 1.83% in 2018. At the same time, in Poland, there is an increase in this cause of death from 1.72% to 2.36%. Mortality caused by alcohol consumption is the main share of mortality in the sec...
Life expectancy and alcohol use health burden in Poland after 2002
Journal of Health Inequalities
Introduction: Between 1990 and 2002 Poland experienced one of the steepest gains in health in Europe. However, in 2002, unexpectedly, the health improvement in Poland halted. An increase in alcohol-related diseases after 2002 was most likely caused by an increase in alcohol consumption that followed a 30% reduction in excise tax on spirits and other weakening of alcohol control policies. This study examines the development of the health situation in Poland between 2002 and 2019, and describes potential causes of the health crisis, based on life expectancy statistics and epidemiological indicators of alcohol-related health burden. Material and methods: We examined life expectancy and 100% alcohol-attributable death cases (AAC). Standardised death rates were calculated using population statistics from the World Bank and the Segi standard. Changes in trends were analysed using Joinpoint Regression. The present analysis comprises the Polish adult population aged 20+. Results: The increase in life expectancy starting in 1991 in Poland first slowed down after 2002 and then stopped in 2014 in men and in 2016 in women. During the years 2002-2019, there was a manyfold linear growth of alcohol-attributable mortality in both sexes and all adult age groups. AAC standardised mortality rates increased from 7.5 (13.9 in men, 1.7 in women) in 2002 to 17.8 (29.3 in men, 7.1 in women) per 100,000 in 2019. The National Statistical Office recorded an increase of AAC deaths from 3685 (3256 in men and 429 in women) in 2002 to 10,396 (8251 in men, and 2145 in women) in 2019. During the years 2002-2019, the cumulative number of AAC deaths was 130,000 in men and women combined. Conclusions: The halt in the improvement of health in Poland, probably caused by the increase in alcohol consumption, constitutes a serious public health challenge. Strong alcohol control action is urgently needed.
Addiction, 2005
Background The burden of alcohol-related diseases differs widely among countries. Since the 1980s, a band of countries in Central and Eastern Europe have experienced a steep rise in deaths from chronic liver diseases and cirrhosis. A possible risk factor is the consumption of illegally produced home-made spirits in these countries containing varying amounts of aliphatic alcohols and which may be hepatotoxic. However, little is known about the composition of such beverages. Aims To compare the concentration of short-chain aliphatic alcohols in spirits from illegal and legal sources in Hungary. Design Samples taken from commercial retailers and illegal sources were collected and their aliphatic patterns and alcohol concentrations were determined by gas chromatographic/mass spectrometric (GC/MS) analysis. Findings The concentrations of methanol, isobutanol, 1-propanol, 1-butanol, 2-butanol and isoamyl alcohol were significantly higher in home-made spirits than those of from commercial sources. Conclusions The results suggest that the consumption of home-made spirits is an additional risk factor for the development of alcohol-induced cirrhosis and may have contributed to high level of liver cirrhosis mortality in Central and Eastern Europe. Restrictions on supply and sale of alcohol from illicit sources are needed urgently to reduce significantly the mortality from chronic liver disease. KEYWORDS alcohol consumption, cirrhosis, quality of spirits. 1990 Hungary** 1995 Ukraine** 1993 Rep. of Moldova**
Educational inequalities in mortality due to alcoholic liver disease in Poland
2020
Introduction: Poland has been experiencing an epidemic of alcohol-attributable deaths in the last decades. There is a growing body of scientific evidence that educational level is linked to health behaviours and health status. The aim of the study was to analyse the impact of educational inequalities on mortality due to alcoholic liver disease (ALD) in Poland in 2002 and 2011. Material and methods: The analysis included deaths due to alcoholic liver disease which occurred in 2002 and 2011 and information on education among Poles, aged 20 and over. Data originated from records of death certificates obtained from the database of the Central Statistical Office in Poland and the censuses. Attained educational level have been reclassified according to the International Standard Classification of Education. To assess the educational inequalities rate ratio of mortality in the group with lowest education to mortality in the group with highest education was used. Results: The lowest risk of death due to ALD was in the group with higher education, and the highest risk was in the group with the lowest education in both men and women (i.e. standardised death rate per 100,000 = 0.26 in 2002 and 0.68 in 2011 in higher educated vs 1.40 and 6.23, respectively, in lower educated women). In men, the highest risk of death from ALD was observed in the group with the lowest education aged 45-64 years (20.22/100,000 in 2002, and 44.08/100,000 in 2011). The rate ratio between 2002 and 2011 increased only in women. Conclusions: Significant differences in deaths from alcoholic liver cirrhosis due to education have been observed in Polish adults. There is an urgent need to implement national alcohol control programs in Poland which would especially deal with alcohol consumption in the groups of population with lower education levels.
Gender-specific mortality associated with alcohol consumption in Poland in transition
Addiction, 2005
Aims To show the impact of rapid political and economic transitions on alcohol consumption and associated mortality in different socio-demographic segments of the Polish society, with particular focus on gender differences. Two causes of death associated with drinking (liver diseases and alcohol poisoning) are investigated. Design Mortality time series 1986-2002 are analysed against consumption estimates and population drinking survey data. Setting Poland 1986-2002. Participants General adult population. Measurement Age-standardized annual and 3-year death rates were calculated for age, gender and place of residence subgroups. For education, agestandardized relative frequency of deaths or proportional mortality in four basic educational levels was calculated. Findings Alcohol-related mortality shows great variability in response to substantial changes in alcohol consumption. Patterns of mortality and their magnitude of change correspond with average alcohol consumption and are therefore different for men and women, for different age and educational groups and in urban and rural areas. Level of education, however, may affect alcoholrelated mortality more strongly than overall alcohol intake, particularly with regard to acute consequences of drinking. Conclusion The Polish experience illustrates that the impact of rapid political and economic transitions on alcohol consumption and associated mortality is highly differentiated and specific to gender and social class.
Influence of unrecorded alcohol consumption on liver cirrhosis mortality
Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unrecorded alcohol regularly contains contaminants above toxicological thresholds. However, illegally produced spirits regularly contain higher percentages of alcohol (above 45% by volume), but for considerably less costs compared with licit beverages, potentially causing more problematic patterns of drinking. In this review, it is investigated whether patterns of drinking rather than product composition can explain the liver cirrhosis mortality rates. Statistical examination of World Health Organization country data shows that the originally detected correlation of the percentage of unrecorded alcohol consumption and liver cirrhosis mortality rates disappears when the data is adjusted for the prevalence of heavy episodic drinking. It may be concluded that there is currently a lack of data to demonstrate causality between the composition of illicit spirits (e.g., higher levels of certain contaminants in home-produced products) and liver toxicity on a population scale. Exceptions may be cases of poisoning with antiseptic liquids containing compounds such as polyhexamethyleneguanidine, which were reported to be consumed as surrogate alcohol in Russia, leading to an outbreak of acute cholestatic liver injury, histologically different from conventional alcoholic liver disease.
A comparison of the alcohol-attributable mortality in four European countries
European Journal of Epidemiology, 2000
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.
The Effects of Beverage Specific Alcohol Sale on Liver Cirrhosis Mortality in Russia
Background: Liver cirrhosis is a major cause of deaths in many developed countries. There is evidence that beverage preference may have modifying influence on liver cirrhosis risk independently of the amount of alcohol consumed. The aim of this study was to examine the relation between the consumption of different beverage types and liver cirrhosis mortality rates in Russia. Method: Time-series analytical modeling techniques were used to examine the relation between the sale of different alcoholic beverages (vodka, wine, beer) and age-standardized male and female liver cirrhosis mortality data for the period 1970-2005. Results: Total alcohol sale is a statistically significant associated with both male and female liver cirrhosis mortality rates, implying that a 1-litre increase in per capita alcohol sale is associated with an increase in male mortality of 17.2% and female mortality of 5.3%. The analysis also suggests that of the three beverages (vodka, beer and wine) vodka alone was associated with liver cirrhosis mortality in Russia. The estimated effects of vodka sales on the liver cirrhosis mortality rate are clearly statistically significant for both sexes: a 1 liter increase in vodka sale would result in a 37.6% increase in the male liver cirrhosis mortality rate and in 9.3% increase in female mortality rate. Conclusions: The findings from present study support the substantial literature which demonstrates a close link between alcohol consumption and liver cirrhosis mortality at aggregate level, and most important, suggests that this relationship is mediated by beverage preference.