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Perspectives in Disease Prevention and Health Promotion Alcohol-Related Deaths -- United States, 1968-1978

According to mortality data from the National Center for Health Statistics, from 1968 through 1978, 11,806,737 people died in the United States. Of these deaths, 22,958 were attributed to acute alcoholism,* acute ethylism,** or unspecified alcoholism (ICD*** 8-rubric 303.9); and 3,415 were attributed to poisoning by alcohol (ICD 8-rubric E860). When the risk of death was determined (using data from the Bureau of the Census), the risk remained constant. However, during this 11-year period, the proportion of deaths from these causes increased somewhat, especially for males.

To identify risk factors for reducing the number of deaths from these causes, acute alcoholism/ethylism deaths and alcohol poisoning deaths were further analyzed by urban or rural residence, sex, and month and week of occurrence. The proportion of deaths from both acute alcoholism/ethylism and alcohol poisoning was greatest for rural males (Table 1). Regardless of area of residence, the proportion of deaths attributed to both causes was more than twice as great for males as for females. The median age at death from acute alcoholism was 50.4 years, with the median age for women nearly equal to that (50.1). Nine of the deaths occurred among persons under the age of 10 years and 235 among persons 80 years or older. The median age at death for victims of alcohol poisoning was 48.2 years, with the median age for women slightly above that for men (50.5, compared with 47.3). Eighteen of these deaths occurred among persons under 10 years of age, and 10, among persons 80 years or older.

Seasonal data for deaths from acute alcoholism/ethylism and poisoning as a proportion of all deaths indicate that the proportion is greatest during December (Figure 1), especially among males. When deaths during the period from December 1 through January 4 were further analyzed by week, the pattern for males differed from that for females (Figure 2). For both causes of death, the greatest percentage of deaths among males within this period occurred during the week including December 25, with a decline during the week including January 1. For females, the rate rose during Christmas week and increased even more during the week following, which includes New Year's Eve and New Year's Day. Reported by Div of Surveillance and Epidemiologic Studies, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: The potential for rapid intake of large amounts of alcohol to cause death has been previously documented (1,2). Many of these are classified as deaths from acute alcohol intoxication, acute alcoholism, or acute ethylism. Death from alcohol poisoning has also been described (1,3). At least one study indicated the vast majority of alcohol poisoning deaths was caused by ethanol alone, and the remainder, by a combination of ethanol with other forms of alcohol (3). Even poisonings caused by alcohol other than ethanol are usually due to substitution of these substances for ethanol (4) and sometimes result from adulterated beverages given to unsuspecting drinkers (1). The similarity in distribution and trends for deaths from acute alcoholism and ethylism and deaths from alcohol poisoning indicates that these deaths are part of the same health problem.

Nearly all deaths from acute alcohol poisoning are accidental, and many persons are not aware that alcohol in excess is poisonous and possibly fatal (3). Death from acute alcohol intoxication is often associated with exposure to cold (1). Conversely, ethanol has been identified as a risk factor for death from hypothermia (5). From the data presented here, several additional risk factors for acute alcohol-consumption deaths can be identified. It appears that not only the cold-weather months, but especially the weeks surrounding Christmas, are high-risk periods. During these times, males in general and rural males in particular are important target populations for prevention efforts.

References

  1. Lees F. Alcohol and the nervous system. Br J Psychiat 1975; Spec. No. 9:263-71.

  2. Estes NJ, Heinemann ME. Alcoholism: development, consequences, and interventions. St. Louis: The C. V. Mosby Company, 1982.

  3. Fatteh A, Hayes B. Poisons that killed: an analysis of 300 cases. North Carolina Med J 1974; 35:227-9.

  4. Friedman PA. Common poisons. In: Isselbacher KJ, Adams RD, Braunwald E, Petersdorf RG, Wilson JD, eds. Harrison's principles of internal medicine (ninth edition). New York: McGraw-Hill Book Co., 1980.

  5. CDC. Exposure-related hypothermia deaths--District of Columbia, 1972-1982. MMWR 1982;31:669-71.



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