Alcohol consumption in Portugal represents heavy economic burden for that country's health system

• Portugal is currently ranked eighth in the world in alcohol consumption.
• A new study has examined the costs that alcohol consumption has on Portugal's health system.
• Findings show that roughly 3.8 percent of deaths are attributable to alcohol.

The World Health Organization has estimated that 3.2 percent of the "burden of disease" around the world is attributable to the consumption of alcohol. Portugal is currently ranked eighth in the world in alcohol consumption. A new study has found alcohol consumption in Portugal represents a heavy economic burden for that country's health system.

Results will be published in the August 2010 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"As a gastroenterologist, someone who takes cares of patients with liver diseases, I am very aware that alcohol-related liver cirrhosis is a disease with a very high morbidity and mortality," said Helena Cortez-Pinto, associate professor in the Institute of Molecular Medicine and corresponding author for the study.

"This is a brilliant study," said Helmut K. Seitz, professor of internal medicine, gastroenterology and alcohol research at the University of Heidelberg, and president of the European Society for Biomedical Research on Alcohol (ESBRA). "It shows very clearly on the basis of real data that alcohol consumption is not only a risk factor for various diseases, especially liver disease, but it also shows that these alcohol-related diseases cost enormous money. We have data from Canada and England and some other countries, but we need more accurate data to convince the public, the doctors and the politicians that we have to do something about it."

Cortez-Pinto and her colleagues analyzed 2005 demographic and health statistics using Disability-Adjusted Life Years (DALY). The DALY "sums" the effects that alcohol-related diseases (ARDs) can have on premature mortality, that is, how it might reduce years of life normally expected for an individual, with the effects it might have in reducing the quality of life during the years that an individual lives after being diagnosed with an ARD.

"We found that a significant percentage of deaths - 3.8 percent - in Portugal were somehow caused by alcohol consumption," said Cortez-Pinto, "resulting in a significant burden of disease, roughly 38,370 years of life lost for death or disability due to alcohol. The main source was liver disease at 31.5 percent, followed by traffic accidents at 28.2 percent, and several types of cancer and cardiovascular disease at 19.2 percent. In addition, this collectively represented a total cost of -191.0 million ($239 million USD) in direct costs, representing 0.13 percent of Gross Domestic Product and 1.25 percent of total national health expenditures."

She added they also found that heavy drinking was significantly higher in males, inversely correlated with amount of education, and strongly correlated with cigarette smoking.

"I think other countries could do similar studies to ours in order to get a clearer picture of the problem," said Cortez-Pinto. "It may help to increase consciousness of the severity of the problem and what it represents in economic costs, thus helping to put pressure on governments to take measures to reduce this heavy burden of disease, either by creating and enforcing laws to dissuade people from excessive drinking, mostly youngsters, and also to support funding investigation projects in the alcohol field."

Cortez-Pinto noted that countries in Eastern Europe currently have the highest alcohol consumption levels in Europe. Seitz added that countries like the United Kingdom and Germany have even greater problems, especially with binge drinking.

"The public has to understand that alcohol is a major health problem, that alcohol is the number one factor for liver disease in Europe, and that if we want to control this problem a variety of measures have to be taken, such as increasing the price of alcoholic beverages and decreasing their availability," said Seitz. "Clinicians have to be aware of alcoholic liver disease, and that there is a need for early detection and intervention. Furthermore, many clinicians as well as the public do not know that alcohol is a major risk factor for cancer of the mouth, larynx, pharynx, esophagus, liver, female breast, and the colorectum - cancers with a high prevalence in our societies."