Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis
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SUMMARY: The aim of this study was to quantify the association between alcohol consumption and incidence of pneumonia and to examine possible pathways. This was done by a systematic review and meta-analyses on the dose–response relationship between alcohol consumption or alcohol-use disorders and the incidence of community-acquired pneumonia (CAP). The relative risk (RR) of CAP increased monotonically with increasing alcohol consumption. Individuals consuming 24, 60, and 120 g of pure alcohol daily demonstrated RRs for incident CAP of 1·12 (95% CI 1·02–1·23), 1·33 (95% CI 1·06–1·67) and 1·76 (95% CI 1·13–2·77), respectively, relative to non-drinkers. Clinically defined alcohol-use disorders were associated with an eightfold increased risk of CAP (RR 8·22, 95% CI 4·85–13·95). In conclusion, alcohol was found to be a risk factor for pneumonia with a clear statistical association, and a monotonic dose–response relationship.
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Heavy and prolonged alcohol use and alcohol use disorders have been linked specifically to a high risk of pneumonia, while evidence of the effects of lower levels of use is less clear.
“In line with what would be expected, based on the physiological effects, heavy and prolonged alcohol use and alcohol use disorders have been linked specifically to a high risk, while evidence of the effects of lower levels of use is less clear.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [142]
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Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · see citing works
Operating characteristics of a rank correlation test for publication bias
Begg, C. B., & Mazumdar, M. (1994) · Biometrics · doi:10.2307/2533446 · Cited by 16,955 · see citing works
The environment and disease: association or causation?
Hill, A. B. (2015) · Journal of the Royal Society of Medicine · doi:10.1177/0141076814562718 · Cited by 7,302 · see citing works
The Environment and Disease: Association or Causation?
Hill, A. B. (1965) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591576505800503 · Cited by 6,974 · see citing works
Mandell, L. A., Wunderink, R. G., Anzueto, A., Bartlett, J. G., Campbell, G. D., Dean, N. C., Dowell, S. F., File, T. M., Musher, D. M., Niederman, M. S., et al. (2007) · Clinical Infectious Diseases · doi:10.1086/511159 · Cited by 6,182 · see citing works
Methods for Trend Estimation from Summarized Dose-Response Data, with Applications to Meta-Analysis
Greenland, S., & Longnecker, M. P. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116237 · Cited by 2,353 · see citing works
Room, R., Babor, T., & Rehm, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)17870-2 · Cited by 1,625 · see citing works
Self-citationGeneralized Least Squares for Trend Estimation of Summarized Dose–response Data
Orsini, N., Bellocco, R., & Greenland, S. (2006) · The Stata Journal Promoting communications on statistics and Stata · doi:10.1177/1536867x0600600103 · Cited by 1,245 · see citing works
Royston, P. J., & Sauerbrei, W. (2008) · Wiley series in probability and statistics · doi:10.1002/9780470770771 · Cited by 992 · see citing works
Pathogenesis, treatment, and prevention of pneumococcal pneumonia
van der Poll, T., & Opal, S. M. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61114-4 · Cited by 713 · see citing works
Royston, P. J., & Sauerbrei, W. (2008) · Cited by 601 · see citing works
Room, R., Babor, T. F., & Rehm, J. T. (2005) · The Lancet · doi:10.1016/s0140-6736(05)70276-2 · Cited by 514 · see citing works
Self-citationA Recent Perspective on Alcohol, Immunity, and Host Defense
Szabo, G., & Mandrekar, P. (2009) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2008.00842.x · Cited by 387 · see citing works
Risk factors for pneumonia in the elderly
Koivula, I., Stén, M., & Mäkelä, P. H. (1994) · The American Journal of Medicine · doi:10.1016/0002-9343(94)90060-4 · Cited by 363 · see citing works
New evidence of risk factors for community-acquired pneumonia: a population-based study
Almirall, J., Bolíbar, I., Serra, M., Roig, J., Carandell, E., Agustí, M., Ayuso, P., Estela, A., Torres, A., & the Community-Acquired Pneumonia in Catalan Countries (PACAP) Study Group (2008) · European Respiratory Journal · doi:10.1183/09031936.00095807 · Cited by 354 · see citing works
Baik, I., Curhan, G. C., Rimm, E. B., Bendich, A., Willett, W. C., & Fawzi, W. W. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.20.3082 · Cited by 346 · see citing works
Risk factors for community-acquired pneumonia in adults: a population-based case-control study
Almirall, J., Bolíbar, I., Balanzó, X., & Gonzalez, C. (1999) · European Respiratory Journal · doi:10.1183/09031936.99.13234999 · Cited by 271 · see citing works
High alcohol intake as a risk and prognostic factor for community-acquired pneumonia.
Fernandez-Solà, J., Junqué, A., Estruch, R., Monforte, R., Torres, A., & Urbano-Márquez, Á. (1995) · Archives of Internal Medicine · doi:10.1001/archinte.1995.00430150137014 · Cited by 213 · see citing works
Szabó, G., Mandrekar, P., & Catalano, D. E. (1995) · Journal of Leukocyte Biology · doi:10.1002/jlb.58.3.342 · Cited by 126 · see citing works
Cytokines--central factors in alcoholic liver disease.
Neuman, M. G. (2003) · PubMed · Cited by 118 · see citing works
Alcohol Abuse, Immunosuppression, and Pulmonary Infection
Nelson, S., Zhang, P., Bagby, G., Happel, K., & Raasch, C. (2008) · Current Drug Abuse Reviewse · doi:10.2174/1874473710801010056 · Cited by 107 · see citing works
[Treatment and prevention of pneumococcal pneumonia].
Léophonte, P., & Mazières, J. (2003) · PubMed · Cited by 82 · see citing works
Alcohol Withdrawal Syndrome: Turning Minor Injuries Into a Major Problem
Bard, M. R., Goettler, C. E., Toschlog, E. A., Sagraves, S. G., Schenarts, P. J., Newell, M. A., Fugate, M. W., & Rotondo, M. F. (2006) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000245981.22931.43 · Cited by 68 · see citing works
Gacouin, A., Legay, F., Camus, C., Volatron, A.-C., Barbarot, N., Donnio, P.-Y., Thomas, R., & Tulzo, Y. L. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318174dd75 · Cited by 63 · see citing works
The effects of alcohol on immunity and bacterial infection in the lung
Gamble, L., Mason, C. M., & Nelson, S. (2006) · Médecine et Maladies Infectieuses · doi:10.1016/j.medmal.2005.08.010 · Cited by 60 · see citing works
[Community acquired pneumonia].
Marrie, T. J. (2001) · PubMed · Cited by 48 · see citing works
Hospital-acquired pneumonia guidelines in Europe: a review of their status and future development
Masterton, R. G., Craven, D. E., Rello, J., Struelens, M. J., Møller, J. K., Chastre, J. E., Örtqvist, Å., Cornaglia, G., Lode, H. M., Giamarellou, H., et al. (2007) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/dkm176 · Cited by 44 · see citing works
Booze and blood: the effects of acute and chronic alcohol abuse on the hematopoietic system.
Heermans, E. H. (1998) · PubMed · Cited by 39 · see citing works
Public Alcohol Policy: Current Directions and New Opportunities
Rehm, J. T., & Greenfield, T. K. (2008) · Clinical Pharmacology & Therapeutics · doi:10.1038/sj.clpt.6100502 · Cited by 28 · see citing works
Self-citationRisikofaktoren für die ambulant erworbene Pneumonie (Community Acquired Pneumonia)
Kohlhammer, Y., Schwartz, M., Raspe, H. H., et al. (2005) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/s-2005-863061 · Cited by 16 · see citing works
by the Institute for Clinical Systems Improvement, & Komadina, K. H. (2000) · Postgraduate Medicine · doi:10.3810/pgm.2000.02.905 · Cited by 14 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- Kohlhammer Y, et al. Risk factors for community ac- quired pneumonia (CAP). A systematic review. Deutsche Medizinische Wochenschrift 2005 ; 130 : 381-386.
- Rothman KJ, Greenland S, Lash TL. Modern Epidemi- ology, 3rd edn. Philadelphia, USA : Lippincott Williams & Wilkins, 2008.
Cited by
Sorted by citations
Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., AlMazroa, M. A., Amann, M., Anderson, H. R., Andrews, K. G., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61766-8 · Cited by 11,805 · see citing works
Self-citationGrant, B. F., Chou, S. P., Saha, T. D., Pickering, R. P., Kerridge, B. T., Ruan, W. J., Huang, B., Jung, J., Zhang, H., Fan, A., et al. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.2161 · Cited by 1,362 · see citing works
The relationship between different dimensions of alcohol use and the burden of disease—an update
Rehm, J., Gmel, G. E., Gmel, G., Hasan, O. S. M., Imtiaz, S., Popova, S., Probst, C., Roerecke, M., Room, R., Samokhvalov, A. V., et al. (2017) · Addiction · doi:10.1111/add.13757 · Cited by 1,204 · see citing works
Self-citationA narrative review of alcohol consumption as a risk factor for global burden of disease
Rehm, J., & Imtiaz, S. (2016) · Substance Abuse Treatment, Prevention, and Policy · doi:10.1186/s13011-016-0081-2 · Cited by 177 · see citing works
“This led to inclusion of these categories from 2010 onwards (underlying documentation: tuberculosis [51]; pneumonia [52]).”
BackgroundSelf-citationJorgenson, E., Thai, K. K., Hoffmann, T. J., Sakoda, L. C., Kvale, M. N., Banda, Y., Schaefer, C., Risch, N., Mertens, J., Weisner, C., et al. (2017) · Molecular Psychiatry · doi:10.1038/mp.2017.101 · Cited by 136 · see citing works
Schwarzinger, M., Thiébaut, S. P., Baillot, S., Mallet, V., & Rehm, J. (2018) · BMC Public Health · doi:10.1186/s12889-017-4587-y · Cited by 94 · see citing works
Self-citationAlcohol Intake Revisited: Risks and Benefits
Roerecke, M., & Rehm, J. (2012) · Current Atherosclerosis Reports · doi:10.1007/s11883-012-0277-5 · Cited by 58 · see citing works
Self-citation
- Authors
- SAMOKHVALOV, A. V., IRVING, H. M., & REHM, J.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- SAMOKHVALOV, A. V.
- Venue
- Epidemiology and Infection
- Publisher
- Cambridge University Press (CUP)
- Published
- 2010-04-12
- Volume
- 138
- Issue
- 12
- Pages
- 1789-1795
- ISSN
- 0950-2688 (ISSN-L)
- 1469-4409
- OpenAlex
- W2138755493
- Cited by
- 159
- References
- 33
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 14 · 2023: 10 · 2022: 13 · 2021: 16 · 2020: 4 · 2019: 7 · 2018: 15 · 2017: 9 · 2016: 15 · 2015: 12 · 2014: 9 · 2013: 13 · 2012: 6
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Infection (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Alcohol Abuse and Alcoholism (HHSN267200700041C)
- Topics
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol consumption, pneumonia, community-acquired pneumonia, alcoholism, dose-response relationship, risk factors, incidence
- MeSH terms
- Alcohol Drinking, Female, Humans, Male, Pneumonia, Risk Factors, Incidence, Community-Acquired Infections
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