Public Health

Hazardous alcohol drinking linked to premature mortality in Russia

Last Updated: 2007-06-14 18:30:06 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Heavy drinking and consumption of manufactured ethanol-based liquids not meant to be ingested -- such as cologne or cleansers -- caused nearly half of all deaths among working-age men living in Izhevsk, Russia, between 2003 and 2005, investigators report in the June 16th issue of The Lancet.

Russia has a low life expectancy, averaging 59 years in men, lead author Dr. David A. Leon and his associates note, but there have been wide fluctuations in mortality rates over the last two decades.

They examined the contribution of hazardous alcohol consumption to increased male mortality in a population-based case-control study involving residents of Izhevsk, "a typical Russian city of its size" (population 632,000 in 2002), with demographics representative of Russia overall.

Cases were men who died at 25 to 54 years of age between October 2003 and October 2005. Control subjects were randomly selected living men from the same city. Proxies for cases and controls (1750 in each group) were interviewed to ascertain prevalence of problem drinking and non-beverage alcohol consumption.

After adjusting for smoking and education, 43% of mortality was attributable to hazardous drinking, report Dr. Leon, from the London School of Hygiene and Tropical Medicine, and his colleagues. The greatest difference between cases and controls was consumption of manufactured non-food products with high ethanol content (41% versus 8%).

The authors note that non-beverage alcohol products -- such as cologne, medicinal tinctures, and cleaning agents -- have very high concentrations of ethanol and are up to six times cheaper than vodka.

The investigators observed "a strong direct gradient with mortality ... for frequency of non-beverage alcohol drinking, independent of volume of beverage ethanol consumed." The odds ratio was 6.3 for any consumption at all during the year prior to their death.

Eighteen percent of deaths were due to alcohol abuse, and included cardiomyopathy, alcoholic liver disease, or acute alcohol poisoning. The consumption of manufactured non-food products with high ethanol content made a large contribution to those deaths.

The team concludes that the findings support the contention that "the sharp fluctuations seen in Russian mortality in the early 1990s could be related to hazardous drinking."

In an accompanying commentary, addiction specialists Dr. Jurgen Rehm, from Toronto, and Dr. Gerhard Gmel, from Lausanne, Switzerland, say it is "highly unlikely" that non-beverage alcohol consumption is the underlying mechanism.

Instead, they suggest that non-beverage alcohol consumption is more likely to be a marker for heavy drinking in general.

Lancet 2007;369:1975-1976,2001-2009.