Alcohol consumption and mortality and hospital admissions in men from the Midspan collaborative cohort study.
OBJECTIVE
To investigate the relationships between alcohol consumption and mortality and morbidity risk by specific causes.


METHODS
Prospective cohort study.


METHODS
Twenty-seven work-places in West and Central Scotland.


METHODS
A total of 6000 men aged 21-64 years at screening in 1970-1973, median follow-up 29 years.


METHODS
Relative rates, using Cox's proportional hazard models, by weekly reported units of alcohol consumption for all cause, coronary heart disease (CHD), stroke, respiratory, digestive, liver disease and alcohol-related causes of mortality and for specific causes of acute hospital admissions.


RESULTS
Mortality risk was increased for men drinking 15-21 or more units per week for all causes, stroke, liver disease and alcohol-related causes. For respiratory mortality, drinkers of 35 or more units had double the risk compared to non-drinkers. CHD mortality showed increasing trends with consumption when adjusted for age and after full adjustment showed no clear patterns, although the 8-14 units group had a lower risk than non-drinkers [relative rate 0.81 (0.68-0.97)]. Hospital admissions had similar patterns to mortality for stroke and liver disease. Increased risk began at 8-14 units for alcohol-related admissions, and at 15-21 units for respiratory admissions. Non-drinkers had higher risks of having a CHD admission than drinkers and there were decreasing trends with increasing consumption (P = 0.019).


CONCLUSIONS
Consumption of 15-21 units per week and over was associated with increased mortality from most causes and increased risk of hospital admissions from stroke, liver disease and respiratory diseases. Alcohol-related admissions were raised from 8 to 14 units. Alcohol use may have been under-reported in our study, but it was similar to other studies of the time. The apparent protective effect of alcohol with CHD admissions could be due partly to detrimental effects of heavy drinking causing sudden deaths. The associations, including that with respiratory disease, may arise from inadequate adjustment for confounding by other factors such as smoking.
Hart
Carole L
CL
Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, Glasgow, UK. c.l.hart@udcf.gla.ac.uk
Smith
George Davey
GD
D000328:Adult; D000428:Alcohol Drinking / Q000401:mortality*; D019973:Alcohol-Related Disorders / Q000401:mortality; D002318:Cardiovascular Diseases / Q000401:mortality; D015331:Cohort Studies; D004066:Digestive System Diseases / Q000401:mortality; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000401:mortality; D012606:Scotland / Q000453:epidemiology; D055815:Young Adult