Alcohol poisoning is a main determinant of recent mortality trends in Russia: evidence from a detailed analysis of mortality statistics and autopsies
Abstract
BACKGROUND: The changes in Russian mortality rates during the last two decades are unprecedented in a modern industrialized country. Although these fluctuations have attracted much interest, trends for major groups of causes of death have been analysed while trends in specific causes of death might shed light on the underlying determinants. METHODS: We analysed trends in total and cause-specific mortality in Russia for 1991-2006. The records of 24 836 forensic autopsies carried out during the period 1990-2004 in the city of Barnaul were analysed with respect to blood alcohol level. RESULTS: Diseases of the circulatory system (in the age group 35-69 years) and external causes (in the age group 15-34 years) were the main contributors to the fluctuations in Russian mortality rates observed in 1991-2006. The largest relative changes were for conditions directly related to alcohol intake. Among cardiovascular diseases, fluctuations were due to 'other forms' of acute and chronic ischaemia, and to atherosclerotic heart disease, while rates of myocardial infarction were low and relatively constant. In the autopsy series a very high proportion of decedents whose death was attributed to 'other' or 'not classified' cardiovascular diseases had lethal or potentially lethal concentrations of ethanol in blood. CONCLUSIONS: The increases in mortality in 1991-94 and in 1998-2003 coincided with economic and societal crisis, while decreases in 1994-98 and 2003-06 correlate with improvement in the economic situation. Excessive alcohol intake is a major cause of premature male Russian mortality, although many alcohol-related deaths are wrongly attributed to diseases of the circulatory system.
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The burden attributable to alcohol use increased substantially in eastern Europe since 1990, mainly because of a rise in the effects of heavy drinking on cardiovascular diseases.
“The burden attributable to alcohol use has increased substantially in eastern Europe since 1990, mainly because of a rise in the effects of heavy drinking on cardiovascular diseases.181”
The amount of misclassification can be substantial in some countries or regions.
“The amount of misclassification can be substantial in some countries or regions.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [48]
In a series of more than 22,000 autopsies in a Russian city, 16% of decedents had more than 4 g/l and 8% had more than 5 g/l blood alcohol concentrations.
“For example, Zaridze and colleagues 48 reported that in a series of more than 22 000 autopsies in a Russian city, 16% of decedents had more than 4 g/l and 8% had more than 5 g/l blood alcohol concentrations.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [48]
Some of the deaths reported by Zaridze and colleagues should have been coded as alcohol poisoning instead of the other codes given, often cardiovascular deaths.
“Some of the deaths reported by Zaridze and colleagues 48 should have been coded as alcohol poisoning instead of the other codes given, often cardiovascular deaths.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [48]
Alcohol poisonings are underestimated markedly for two main reasons.
“However, alcohol poisonings are underestimated markedly for two main reasons.”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [48]
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- Authors
- Zaridze, D., Maximovitch, D., Lazarev, A., Igitov, V., Boroda, A., Boreham, J., Boyle, P., Peto, R., & Boffetta, P.
- Affiliations
- Russian Cancer Research Center NN Blokhin (RU)
- University of Oxford (GB)
- Centre international de recherche sur le cancer (FR)
- Corresponding author
- Boffetta, P.
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-09-04
- Volume
- 38
- Issue
- 1
- Pages
- 143-153
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2148815007
- Cited by
- 156
- References
- 17
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 7 · 2018: 3 · 2017: 12 · 2016: 10 · 2015: 9 · 2014: 18 · 2013: 16 · 2012: 17
- FWCI
- 11.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- alcohol poisoning, alcohol-related mortality, mortality trends, Russia, forensic autopsy, blood alcohol concentration, cardiovascular disease, ischemic heart disease, myocardial infarction, external causes of death, economic crisis, Barnaul
- MeSH terms
- Adolescent, Adult, Aged, Ethanol, Autopsy, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Mortality, Neoplasms, Russia, Sex Factors, Alcohol-Related Disorders, Young Adult
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