Steps towards constructing a global comparative risk analysis for alcohol consumption: Determining indicators and empirical weights for patterns of drinking, deciding about theoretical minimum, and dealing with different consequences

In order to conduct a comparative risk analysis for alcohol within the Glob al Burden of Disease Study (GBD 2000), several questions had to be answered . (1) What are the appropriate dimensions for alcohol consumption and how c an they be categorized? The average volume of alcohol and patterns of drink ing were selected as dimensions. Both dimensions could be looked upon as co ntinuous but were categorized for practical purposes. The average volume of drinking was categorized into the following categories: abstention; drinki ng 1 (>0-19.99 g pure alcohol daily for females, >0-39.99 g for males); dri nking 2 (20-39.99 g for females, 40-59.99 g for males), and drinking 3 ( gr eater than or equal to 40 g for females, greater than or equal to 60 g for males). Patterns of drinking were categorized into four levels of detriment al impact based on an optimal scaling analysis of key informant ratings. (2 ) What is the theoretical minimum for both dimensions? A pattern of regular light drinking (at most 1 drink every day) was selected as theoretical min imum for established market economies for all people above age 45. For all other regions and age groups, the theoretical minimum was set to zero. Pote ntial problems and uncertainties with this selection are discussed. (3) Wha t are the health outcomes for alcohol and how do they relate to the dimensi ons? Overall, more than 60 disease conditions were identified as being rela ted to alcohol consumption. Most chronic conditions seem to be related to v olume only (exceptions are coronary heart disease and ischemic stroke), and most acute conditions seem to be related to volume and patterns. In additi on, using methodology based on aggregate data, patterns were relevant for a ttributing harms for men but not women. Copyright (C) 2001 S. Karger AG, Ba sel.