Alcohol Consumption and Burden of Disease: Germany and Switzerland

  • M. Roerecke
  • J. Rehm
  • J. Patra
Reference work entry


We estimated the burden of disease attributable to alcohol in Germany and Switzerland for the year 2002. We calculated disease-specific attributable fractions for diseases and conditions based on relative risk estimates from meta-analyzes, prevalence of exposure from the Global Alcohol Database and large, representative surveys, and obtained  mortality and burden of disease data from the World Health Organization. Comparatively high alcohol consumption in Switzerland caused substantial burden, in particular among Swiss women. Although alcohol consumption was high among women in Germany and Europe as well, the burden among women was much less compared to Switzerland. For men in both countries comparable burden of disease was estimated. Both detrimental and beneficial effects of alcohol consumption were considered in this analysis. Because effective and cost-effective interventions are available, the burden of disease due to alcohol should be a focus of public health policy development. Specific measures are discussed.


Alcohol Consumption Cardioprotective Effect High Density Lipoprotein Relative Risk Estimate Attributable Fraction 

List of Abbreviations:


disability-adjusted life years, a health gap measure combining years of life lost and years lived with a disability, therefore taking into account mortality and morbidity


years of life lost, a health gap measure taking into account the time of deaths relative to the normative life expectancy


number of deaths

CRA 2000

comparative risk analysis study for the year 2000, conducted as part of the global burden of disease study by the World Health Organization


attributable fraction, the fraction of disease outcome, for example, that is caused by a specific risk factor, in this case alcohol


World Health Organization;  GBD, global burden of disease study conducted by the World Health Organization describing the effect of 26 risk factors on burden of disease around the world


global alcohol database, maintained by the WHO. Alcohol consumption indicators are updated annually for each member state based on data from multiple sources; Europe A, WHO subregion defined by very low child and very low adult mortality


estimated adult (15 years and above) per capita alcohol consumption (in liters of pure alcohol consumed within one year)


high density lipoprotein



This study has been supported by the Swiss Federal Office of Public Health (FOPH-Project “Alkoholbedingte Mortalitaet und Krankheitslast in der Schweiz – von der Epidemiologie zu Empfehlungen hinsichtlich alkoholpolitischer Massnahmen”; contract 05.001178). The methodology was in part developed for the Comparative Risk Assessment for Alcohol, financially supported by the Swiss FOPH, the World Health Organization (WHO) and the Research Institute for Public Health and Addiction, a WHO collaborative centre.


  1. Augustin R, Kraus L. (2005). Sucht. 51: S29–S39.Google Scholar
  2. Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Grube J, Grunewald P, Hill L, Holder H, Homel R, Österberg E, Rehm J, Room R, Rossow I. (2003). Alcohol: No Ordinary Commodity - Research and Public Policy. Oxford University Press, Oxford.Google Scholar
  3. Boffetta P, Hashibe M. (2006). Lancet Oncol. 7: 149–156.PubMedCrossRefGoogle Scholar
  4. Bundesamt für Statistik. (2004). Schweizerische Gesundheitsbefragung (2002). Bundesamt für Statistik, Neuchatel.Google Scholar
  5. Chaloupka F, Grossman M, Saffer H. (2002). Alcohol Res Health. 26: 22–34.PubMedGoogle Scholar
  6. Chisholm D, Rehm J, Van Ommeren M, Monteiro M. (2004). J Stud Alcohol. 65: 782–793.PubMedGoogle Scholar
  7. Cho E, Smith-Warner SA, Ritz J, van den Brandt PA, Colditz GA, Folsom AR, Freudenheim JL, Giovannucci E, Goldbohm RA, Graham S, Holmberg L, Kim DH, Malila N, Miller AB, Pietinen P, Rohan TE, Sellers TA, Speizer FE, Willett WC, Wolk A, Hunter DJ. (2004). Ann Intern Med. 140: 603–613.PubMedGoogle Scholar
  8. Corrao G, Bagnardi V, Zambon A, La Vecchia C. (2004). Prev Med 38: 613–619.PubMedCrossRefGoogle Scholar
  9. Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. (2000). Addiction. 95: 1505–1523.PubMedCrossRefGoogle Scholar
  10. English D, Holman C, Milne E, Winter M, Hulse G, Codde G. (1995). The Quantification of Drug-Caused Morbidity and Mortality in Australia, Commonwealth Department of Human Services and Health, Canberra, Australia.Google Scholar
  11. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. (2002). Lancet. 360: 1347–1360.PubMedCrossRefGoogle Scholar
  12. Foxcroft DR, Ireland D, Lister-Sharp DJ, Lowe G, Breen R. (2003). Addiction. 98: 397–411.PubMedCrossRefGoogle Scholar
  13. Gmel G, Rehm J. (2004). Contemp Drug Probl. 31: 467–540.Google Scholar
  14. Gruppe Schweizer Alkoholpolitik (2005). Alkoholpolitische Massnahmen in der Schweiz 2004 – was ist realisiert und was bringt die Zukunft? In: Babor T, Caetano R, Casswell S, Edwards G, Giesbrecht N, Graham K, Grube J, Grunewald P, Hill L, Holder H, Homel R, Österberg E, Rehm J, Room R, Rossow I (eds) Alkohol: kein gewöhnliches Konsumgut. Forschung und Alkoholpolitik. Hogrefe, Göttingen, pp. 334–344.Google Scholar
  15. Gutjahr E, Gmel G, Rehm J. (2001). Eur Addict Res. 7: 117–127.PubMedCrossRefGoogle Scholar
  16. Hill AB. (1965). Proc R Soc Med. 58: 295–300.PubMedGoogle Scholar
  17. Kuo M, Heeb J, Gmel G, Rehm J. (2003). Alcohol Clin Exp Res. 27: 720–725.PubMedCrossRefGoogle Scholar
  18. Midanik L. (1982). Br J Addict. 77: 357–382.PubMedCrossRefGoogle Scholar
  19. Mohler-Kuo M, Rehm J, Heeb JL, Gmel G. (2004). J Stud Alcohol. 65: 266–273.PubMedGoogle Scholar
  20. Popova S, Rehm J, Patra J, Zatonski W. (2007). Alcohol Alcohol. 42: 465–473.PubMedGoogle Scholar
  21. Rehm J, Room R, Monteiro M, Gmel G, Graham K, Rehn N, Sempos CT, Frick U, Jernigan D. (2004). In: Ezzati M, Lopez A, Rodgers A, Murray C (eds.) Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. vol. 1.World Health Organization, Geneva, pp. 959–1109.Google Scholar
  22. Rehm J. (1998). Alcohol Clin Exp Res. 22: 4S–14S.PubMedCrossRefGoogle Scholar
  23. Rehm J, Chisholm D, Room R, Lopez A (2006a). In: Disease Control Priorities in Developing Countries. Oxford University Press and World Bank, Washington, D.C, pp. 887–906.Google Scholar
  24. Rehm J, Klotsche J, Patra J (2007a). Int J Methods Psychiatr Res. 16: 66–76.PubMedCrossRefGoogle Scholar
  25. Rehm J, Patra J, Baliunas D, Popova S, Roerecke M, Taylor B. (2006b). Alcohol consumption and the global burden of disease 2002. World Health Organization, Department of Mental Health and Substance Abuse, Management of Substance Abuse, Geneva.Google Scholar
  26. Rehm J, Sempos CT, Trevisan M. (2003). J Cardiovasc Risk. 10: 15–20.PubMedCrossRefGoogle Scholar
  27. Rehm J, Sulkowska U, Manczuk M, Boffetta P, Powles J, Popova S, Zatonski W. (2007b). Int J Epidemiol. 36: 458–467.PubMedCrossRefGoogle Scholar
  28. Reynolds K, Lewis LB, Nolen JDL, Kinney GL, Sathya B, He J. (2003). JAMA 289: 579–588.PubMedCrossRefGoogle Scholar
  29. Rimm EB, Williams P, Fosher K, Criqui M, Stampfer MJ (1999). Br Med J. 319: 1523–1528D.Google Scholar
  30. Rimm EB, Moats C. (2007). Ann Epidemiol. 17: S3–S7.CrossRefGoogle Scholar
  31. Room R, Babor T, Rehm J. (2005). Lancet. 365: 519–530.PubMedGoogle Scholar
  32. Rothman KJ, Greenland S. (1998). Modern Epidemiology. Lippincott-Raven Publishers, Philadelphia, PA.Google Scholar
  33. United Nations. (2005). World Population Prospects. The 2004 revision. United Nations Department of Economic and Social Affairs, Population Division.Google Scholar
  34. Wagenaar AC, Toomey TL. (2002). J Stud Alcohol. 14: 206–225.Google Scholar
  35. Walter SD. (1980). Am J Epidemiol. 112: 409–416.PubMedGoogle Scholar
  36. Walter SD. (1976). Biometrics. 32: 829–849.PubMedCrossRefGoogle Scholar
  37. World Health Organization. (2006). Global Alcohol Database World Health Organization, Geneva.Google Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • M. Roerecke
    • 1
    • 2
  • J. Rehm
    • 1
    • 2
  • J. Patra
    • 1
  1. 1.Social, Prevention and Health Policy Research DepartmentCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Department of Public Health SciencesUniversity of TorontoTorontoCanada

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