Hazardous Alcohol Consumption Is a Major Factor in Male Premature Mortality in a Typical Russian City Prospective Cohort Study 2003–2009 英文参考文献.docVIP

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Hazardous Alcohol Consumption Is a Major Factor in Male Premature Mortality in a Typical Russian City Prospective Cohort Study 2003–2009 英文参考文献.doc

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Hazardous Alcohol Consumption Is a Major Factor in Male Premature Mortality in a Typical Russian City Prospective Cohort Study 2003–2009 英文参考文献

HazardousAlcoholConsumptionIsaMajorFactorin MalePrematureMortalityinaTypicalRussianCity: ProspectiveCohortStudy2003–2009 SusannahTomkins1,TimCollier1,AlexeyOralov2,LyudmilaSaburova3,MartinMcKee1 ,Vladimir Shkolnikov4,NikolayKiryanov5,DavidALeon1* 1LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,2IzhevskStateTechnicalUniversity,Izhevsk,Russia,3SocialTechnologiesInstitute,Izhevsk, Russia,4MaxPlanckInstituteforDemographicResearch,Rostock,GermanyandNewEconomicSchool,Moscow,Russia,5IzhevskMedicalAcademy,Izhevsk,Russia Abstract Introduction:Russiahasexperiencedmassivefluctuationsinmortalityatworkingagesoverthepastthreedecades.Routine data analyses suggest that these are largely driven by fluctuations in heavy alcohol drinking. However, individual-level evidencesupportingalcoholhavingamajorroleinRussianmortalitycomesfromonlytwocase-controlstudies,whichcould besubjecttoseriousbiasesduetotheirdesign. MethodsandFindings:A prospective study of mortality (2003–9) of 2000 men aged 25–54 years at recruitment was conducted in the city of Izhevsk, Russia. This cohort was free from key limitations inherent in the design of the two earlier case-control studies. Cox proportional hazards regression was used to estimate hazard ratios of all-cause mortality by alcohol drinking type as reported by a proxy informant. Hazardous drinkers were defined as those who either dranknon-beverage alcohols orwerereported toregularly havehangovers orother behaviours related toheavy drinking episodes. Over the follow-up period 113 men died. Compared to non-hazardous drinkers and abstainers, menwhodrank hazardously hadappreciably higher mortality (HR=3.4,95%CI2.2,5.1) adjusted forage,smoking and education. The population attributable risk percent (PAR%) for hazardous drinking was 26% (95% CI 14,37). However, largereffects wereseeninthefirsttwoyearsoffollow-up, withaHRof4.6(2.5,8.2)andacorresponding PAR%of37% (17, 51). Interpretation:Thisprospectivecohortstudystrengthensthee