Alcohol and Illness: The Epidemiological Viewpoint

Alcohol and Illness: The Epidemiological Viewpoint

Alcohol and Illness: The Epidemiological Viewpoint

Alcohol and Illness: The Epidemiological Viewpoint

Synopsis

"To what extent does drinking alcohol contribute to ill-health? How do the risks of illness relate to consumption levels? Are there any beneficial effects of alcohol on health? Are the observed relationships causal? Is there a consensus medical opinion on the issues? How satisfactory is the present state of knowledge and how much research remains to be done?" "Despite the widespread research interest in the association between alcohol and illness, questions such as these remain as relevant as ever. In this book, John Duffy brings together the latest findings of a broad range of epidemiologists and statisticians and provides a concise and unique presentation of current research and literature. The specially commissioned and technically sophisticated chapters include considerations of the extent to which alcohol may be responsible for cerebrovascular disease, liver and heart disease, reproductive damage, cancers and gastrointestinal conditions. Public health implications are considered and a description of statistical methods in epidemiology is included." Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Excerpt

This book brings together a collection of papers, specially written for this volume, on the major health risks known or suspected to be associated with drinking. The approach is mainly epidemiological, that is, based on studies of human populations, rather than, for example, laboratory studies of animals. Where appropriate, the authors evaluate the strength of the evidence to date relating alcohol to the medical conditions considered, in terms of quality of study design, control of other variables and consistency of findings across studies. For the most part, the papers are quite technically sophisticated, using currently available statistical methods to compare studies in more detail than previously. The source materials used comprise the major research studies in each field available at the time of editing (September 1991), and hence the book also serves as a useful reference source. What it does not do, however, is present opinions as definitive conclusions. Where controversy exists regarding the causal role of alcohol in the illnesses considered, the evidence is presented, and in some cases an opinion expressed, but without any claim of finally resolving the issues.

The papers relate to questions involving the level of understanding of the phenomena considered, the quality of research, and in particular cases the consensus medical opinion concerning the possible causal role of alcohol consumption. Where possible, risks associated with consumption at various levels are estimated and put into a public health context by examining the possible impact of alcohol on population mortality and morbidity by cause. For this purpose, most chapters use the population of England and Wales rather than Scotland, and there are two reasons for this. The first is that the former population is ten times larger than that of Scotland, which makes for increased stability in rates over time, especially for rare phenomena. Secondly, much more extensive and recent survey information concerning population alcohol consumption is available for England and Wales. The years chosen to illustrate population aspects are recent, but are not identical in all papers, reflecting the times at which the work was begun.

A brief description of epidemiological and statistical methods is given in the first chapter to aid interpretation of the rest of the book. Readers completely unfamiliar with the application of statistics may prefer to skip Chapter 1, but Section 1.8 will be helpful in understanding why it is that epidemiological studies rarely yield definitive results, and why scientific controversy in this area is so common.

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