HIGH ALCOHOL-RELATED PREMATURE MORTALITY IN FRANCE - CONCORDANT ESTIMATES FROM A PROSPECTIVE COHORT STUDY AND NATIONAL MORTALITY STATISTICS

This study examines the magnitude of alcohol-related premature death i n the French population, which still has the highest average alcohol i ntake in the world and a relatively low coronary heart disease mortali ty rate. Two data sources were used: the national mortality data in 19 90 and a prospective mortality experience in a cohort of 2,687 middle- aged working men examined in 1980-1985 and followed-up during an avera ge of 9.3 years. In the general population study, alcohol-related prem ature mortality (35-64 years) was calculated using alcohol-attributabl e fractions (AAFs) derived from studies of alcohol involvement in deat hs from various causes. In the cohort, it was estimated from AAFs and attributable risk using both alcohol exposure prevalence and relative risks of death according to alcohol intake categories. In 1990, estima tes of 19.1% and 13.0% of all premature deaths in French men and women were attributed to alcohol. Digestive diseases followed by malignant neoplasms in men and by unintentional injuries in women were major con tributors to the total number of alcohol-related premature deaths. In the cohort study, 90 deaths occurred during the follow-up period. The estimation of alcohol-related premature mortality using AAFs was 24.4% . The relative risk of total mortality (adjusted for age, smoking habi ts, and body mass index) for men who consumed >60 ml/day of alcohol, c ompared with those who consumed 0-25 ml/day was 1.9 (95% confidence in terval: 1.1-3.5), The consumption of 26-60 ml/day was not associated w ith reduced risk of mortality, and the adjusted relative risk for this group was 1.3 (95% confidence interval: 0.7-2.5). The estimated attri butable risk of premature mortality caused by consumption of >25 ml/da y of alcohol was 29.9%. This study reports the persisting high alcohol -related premature mortality in the French general population, as well as in middle-aged working men. The results suggest that efforts shoul d be paid to reduce further the consumption of alcohol in France.