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Influence of drinking alcohol on atherosclerotic risk in alcohol flushers and non-flushers of Oriental patients with type 2 diabetes mellitus.

AIMS: Facial flushing caused by alcohol drinking is a typical symptom of high sensitivity to alcohol in orientals. We investigated whether drinking alcohol influences atherosclerotic risk factors in alcohol flushers and non-flushers in patients with diabetes mellitus. METHODS: A cross-sectional study was performed using 225 subjects with type 2 diabetes. Sensitivity to alcohol was surveyed by a questionnaire on facial flushing. Subjects were divided into three groups by average amount of alcohol drinking (non-drinkers; light drinkers: <140 g/week; heavy drinkers: 140 g/week or more). RESULTS: Systolic blood pressure and blood HDL cholesterol were significantly higher in heavy drinkers than in non-drinkers. There were no significant differences in body mass index, blood pressure, blood total cholesterol, HDL cholesterol, uric acid, fibrinogen and sialic acid levels in flushers and non-flushers. In alcohol flushers, diastolic blood pressure and HDL cholesterol in heavy drinkers were significantly higher than those in non-drinkers, and systolic blood pressure was significantly higher in heavy drinkers than in non-drinkers and light drinkers. On the other hand, blood pressure and HDL cholesterol in non-flushers were not significantly different among non-, light and heavy drinkers. Serum total cholesterol was not significantly different among the three drinking groups both in flushers and non-flushers. CONCLUSIONS: Blood pressure and HDL cholesterol are more prone to be affected by drinking in flushers than in non-flushers, suggesting that alcohol sensitivity evaluated by flushing response due to drinking alcohol should be taken into account when the effects of alcohol drinking on atherosclerotic risk factors are considered in oriental patients with type 2 diabetes mellitus.

Aged↗

How similar are the smoking and drinking habits of men and women in non-manual jobs?

BACKGROUND: Men used to be more likely to smoke and drink heavily than women. However, as social roles changed, so have gender differences in health-related behaviours. This paper explores whether gender differences in these behaviours persist or disappear among men and women occupying similar social roles: working in the same non-manual jobs in Britain. METHODS: Self-completion questionnaires were distributed to full-time employees in a bank (n = 2,139) and a university (n = 1,611). Response rates were 76% and 67% respectively. Respondents were asked whether they smoked currently. Men who reported drinking more than 21 units of alcohol, and women who reported drinking more than 14 units, in the last week were classed as 'heavy' drinkers. RESULTS: In both organizations there were no significant gender differences in smoking, but men were significantly more likely than women to report drinking 'heavily'. Employees in clerical jobs in the university were more than twice as likely as their more senior colleagues to smoke, but were significantly less likely to report drinking 'heavily' in both organizations. High masculinity scores among both men and women were associated with smoking and 'heavy' drinking. CONCLUSION: Men and women occupying similar social roles are equally likely to smoke but men are significantly more likely to drink 'heavily'. The relationship between paid work variables and these health behaviours are similar for both men and women. The association between high masculinity scores and health-damaging behaviours in both men and women points to the importance of considering gender role orientation, rather than just comparing men and women.

Adult↗

Young people in 'drinking' societies? Norwegian, Scottish and Swedish adolescents' perceptions of alcohol use.

The paper studies young people's reported drinking behaviors and their views on various social aspects of alcohol, utilizing a sample of over 4000 rural adolescents aged 11.8-16.5 years in Norway, Scotland and Sweden. The methodology employed includes a common questionnaire and a range of varying qualitative approaches (essays and focus group interviews). The various venues and drinking contexts used by young people, their motives for drinking, and their 'learning' experiences with alcohol are described. Beyond nationality, the most powerful predictors of 'high' drinking are 'involvement with friends' and 'participation in commercial leisure'. The predictors for 'low' drinking are 'involvement in activities with parents' and 'parental concerns about drinking'. Results show that Scottish teenagers drink most, Norwegians least and no differences in the predictor variables are found that can explain this. Results are discussed in relation to social and cultural differences, and illustrated by quotations from rural young people in Scotland and Sweden.

Adolescent↗

Moderating binge drinking: it is possible to change behaviour if you plan it in advance.

Recent theories of enactment suggest that behaviour change is increased by planning how, where, and when to execute a behavioural response. Drawing on these theories, a brief planning intervention was designed and its effectiveness compared to an information-based health promotion programme (control). All participants were given information about the safe limits per drinking occasion and the adverse consequences of binge drinking, and were asked to drink within the safe limits in order to avoid these consequences. In addition, participants in the planning group received an option menu of possible responses for refusing a drink, asked to choose one strategy and specify a time and place in which the chosen strategy would be implemented. The planning intervention group did not differ from the control group on reported likelihood of future binge drinking, nor on levels of past drinking, age and gender. At a 2-week follow-up, members of the planning intervention group reported lower drinking frequency than controls. The implications of prior planning for interventions aimed at reducing alcohol-related harm are discussed.

Adolescent↗

Electroacupuncture stimulation suppresses the increase in alcohol-drinking behavior in restricted rats.

BACKGROUND: Although a number of studies on traditional eastern or Chinese medicine, such as acupuncture, moxibustion, and herbal drugs, have been reported, few reports describe electroacupuncture (EAC) effects on drug- and alcohol-seeking behaviors in animal models. The purpose of the present study was to investigate the effect of EAC on changes in alcohol-drinking behavior in rats challenged with restriction and immobilization stress. MATERIAL AND METHODS: Male Sprague Dawley rats (260-280 g) were tightly hung and immobilized in restriction models for 10 min. These immobilization stresses were performed twice a week for 1 week and for 3 consecutive weeks for the short- and long-restricted stress groups, respectively. EAC was applied for 10 min to the hindlimb point, Tsu-San-Li (ST 36), and the lumbar point, Shen-Shu (BL 23). These points are used to treat mental and psychosomatic disorders and are known clinically to produce a sedation effect. Time-access alcohol-drinking behavior was determined at 24 hr after the termination of EAC. Finally, brain dopamine (DA) levels were assayed in the two groups. A sham-control group underwent only restricted stress without EAC. RESULTS: Time-access alcohol-drinking behavior increased significantly in the long-restricted group compared with the short-restricted group and controls. EAC applied to the ST 36 (Tsu-San-Li) point suppressed the increased alcohol-drinking behavior in restricted rats. However, EAC applied to the Shen-Shu (BL 23) point was not effective, because alcohol-drinking behavior was significantly increased in long-restricted rats compared with short-restricted rats. Striatal DA levels of restricted rats with EAC stimulated at Tsu-San-Li were increased significantly compared with the rats with EAC applied to the Shen-Shu point. CONCLUSION: These findings suggest that EAC applied at ST 36 (Tsu-San-Li) was more effective for reducing the increased alcohol-drinking behavior in restricted rats, and they showed that a point specific in EAC procedure was associated with an increase of striatal DA levels. These findings provide new information for understanding alcohol-drinking behavior and for treating human alcoholics.

Alcohol Drinking↗

An evaluation of isotonic "sport drinks" during labor.

UNLABELLED: We compared the metabolic effects of allowing women isotonic "sport drinks" rather than water to drink during labor. The effect of these drinks on gastric residual volume was also evaluated. Sixty women in early labor (cervical dilation <5 cm) were randomized to receive either isotonic sport drinks or water only. Plasma beta-hydroxybutyrate, nonesterified fatty acids, and glucose were measured in early labor and at the end of the first stage of labor. Residual gastric volume was assessed within 45 min of delivery by use of an ultrasound scanner. The incidence and volume of vomiting was recorded. At the end of the first stage of labor, plasma beta-hydroxybutyrate (P = 0.000) and nonesterified fatty acids (P = 0.000) had increased and plasma glucose (P = 0.007) had decreased significantly in the Water-Only group. Gastric antral cross-sectional area after delivery was similar in the two groups. The incidence of vomiting and the volume vomited during labor and within the hour of delivery were also similar. There was no difference between the groups in any maternal or neonatal outcome of labor. In conclusion, isotonic drinks reduce maternal ketosis in labor without increasing gastric volume. IMPLICATIONS: Solid foods may endanger a woman's life if consumed during labor. Isotonic sport fluids were evaluated as a nutritional alternative. Results demonstrate that mothers who have not received parenteral opioids can safely drink isotonic drinks in active labor.

3-Hydroxybutyric Acid↗

The reliability and validity of the self-reported drinking measures in the Army's Health Risk Appraisal survey.

BACKGROUND: The reliability and validity of self-reported drinking behaviors from the Army Health Risk Appraisal (HRA) survey are unknown. METHODS: We compared demographics and health experiences of those who completed the HRA with those who did not (1991-1998). We also evaluated the reliability and validity of eight HRA alcohol-related items, including the CAGE, weekly drinking quantity, and drinking and driving measures. We used Cohen's kappa and Pearson's r to assess reliability and convergent validity. To assess criterion (predictive) validity, we used proportional hazards and logistical regression models predicting alcohol-related hospitalizations and alcohol-related separations from the Army, respectively. RESULTS: A total of 404,966 soldiers completed an HRA. No particular demographic group seems to be over- or underrepresented. Although few respondents skipped alcohol items, those who did tended to be older and of minority race. The alcohol items demonstrate a reasonable degree of reliability, with Cronbach's alpha = 0.69 and test-retest reliability associations in the 0.75-0.80 range for most items over 2- to 30-day interims between surveys. The alcohol measures showed good criterion-related validity: those consuming more than 21 drinks per week were at 6 times the risk for subsequent alcohol-related hospitalization versus those who abstained from drinking (hazard ratio, 6.36; 95% confidence interval=5.79, 6.99). Those who said their friends worried about their drinking were almost 5 times more likely to be discharged due to alcoholism (risk ratio, 4.9; 95% confidence interval=4.00, 6.04) and 6 times more likely to experience an alcohol-related hospitalization (hazard ratio, 6.24; 95% confidence interval=5.74, 6.77). CONCLUSIONS: The Army's HRA alcohol items seem to elicit reliable and valid responses. Because HRAs contain identifiers, alcohol use can be linked with subsequent health and occupational outcomes, making the HRA a useful epidemiological research tool. Associations between perceived peer opinions of drinking and subsequent problems deserve further exploration.

Adult↗

Alcohol availability as a predictor of youth drinking and driving: a hierarchical analysis of survey and archival data.

BACKGROUND: Much attention has recently been directed toward developing preventive interventions to reduce drinking and driving through efforts to limit the numbers and locations of alcohol outlets at the community level. Although evaluations of these efforts have suggested linkages between alcohol outlets and problem outcomes, they have not addressed the linkage between outlets and drinking and driving among youth. The analysis reported here investigates the relationship between alcohol outlet densities and underage drinking and driving as self-reported on two telephone surveys conducted in California. METHODS: These analyses were based on data obtained from two telephone surveys conducted by the Prevention Research Center and archival data collected by the California Department of Alcoholic Beverage Control and the US Census Bureau. The sample for the first survey consisted of 15- to 20-year-old adolescents and young adults contacted by telephone, using a random digit dialing of exchanges in the greater San Francisco Bay Area. A second set of survey data was similarly collected by a random sample of households throughout California, and the Bay Area subset was also used for this analysis. RESULTS: At the individual level, older respondents were more likely to report drinking and driving and riding with drinking drivers, whereas females and Asians were less so. At the aggregate or city-level, alcohol outlet density, as measured by the number of on- and off-premises establishments licensed to sell alcohol, was associated with both drinking and driving and riding with drinking drivers. These effects were moderated by a number of individual level effects, with younger respondents and females more likely to be affected by outlet densities. CONCLUSIONS: The findings here provide support for the implementation of policies targeting alcohol outlet density reductions. Areas with large numbers of such outlets provide ample opportunities to youth for alcohol purchases.

Adolescent↗

Differential effects of alcohol drinking pattern on liver enzymes in men and women.

BACKGROUND: Increasing evidence suggests that drinking pattern may have powerful implications for health; however, very few studies have focused on the association between drinking pattern and risk of alcoholic liver damage. This study was aimed at examining the association of gamma-glutamyltransferase (GGT), aspartate aminotransferase, and alanine aminotransferase with current alcohol consumption and with some aspects of drinking pattern (e.g., drinking frequency during the week and in relation to food consumption). METHODS: A cross-sectional analysis was conducted of a random sample of 2943 white residents of Erie and Niagara Counties in New York State who were 35 to 80 years of age and free from known hepatic disease. RESULTS: The most significant associations were found for GGT; in both sexes, average levels were significantly higher in current and former drinkers compared with lifetime abstainers. In analyses based on quartiles of alcohol consumption, only participants in the two top quartiles showed significantly elevated enzymes compared with both lifetime abstainers and participants in other quartiles. For drinking pattern, there was evidence of sex-specific associations. In men, daily drinkers showed the highest levels of GGT, whereas in women, the highest level of GGT was observed in weekend drinkers. Women (but not men) who consumed alcohol without food exhibited higher levels of GGT compared with women who consumed alcoholic beverages in relation to food. CONCLUSIONS: These findings support the hypothesis that, in addition to amount, drinking pattern may affect liver function and that differences exist between sexes with regard to the effect of drinking pattern on liver function and potential liver damage.

Adult↗

Increased ethanol drinking after repeated chronic ethanol exposure and withdrawal experience in C57BL/6 mice.

BACKGROUND: The development of dependence may have significant motivational consequences regarding continued use and abuse of ethanol. We have developed a mouse model of ethanol dependence and repeated withdrawals that demonstrates sensitization of seizures and other symptoms of withdrawal. It is unclear whether such experience influences ethanol drinking behavior. The present series of experiments were designed to examine whether repeated cycles of chronic ethanol exposure and withdrawal has an impact on subsequent motivation to voluntarily self-administer ethanol. METHODS: With the use of a modified sucrose-fading procedure, adult male C57BL/6J mice were trained to drink 15% (v/v) ethanol in a limited access procedure (2 hr/day). The animals were not food or water deprived at any time during the experiments. Once stable baseline intake was established, mice were exposed to four cycles of 16 hr of ethanol vapor (or air) in inhalation chambers separated by 8-hr periods of withdrawal. At 32 hr after the last cycle of ethanol exposure, all mice were tested for ethanol intake under limited access conditions for 5 consecutive days. The animals then received a second series of chronic ethanol exposure and withdrawal followed by another 5-day test period for ethanol drinking. RESULTS: Stable daily baseline intake was established in mice that drank 15% ethanol combined with 5% sucrose (experiment 1), 15% ethanol alone (experiment 2), 5% sucrose alone (experiment 3), or 15% ethanol when presented as a choice with water (experiment 4). After repeated cycles of chronic ethanol exposure and withdrawal experience, consumption of ethanol solutions increased over baseline levels and in comparison with control (air-exposed) groups. However, sucrose consumption did not change in mice that were trained to drink 5% sucrose. The increase in ethanol consumption after chronic ethanol exposure and withdrawal experience resulted in a significant increase in resultant blood ethanol levels. CONCLUSIONS: Once the positive reinforcing properties of ethanol were established, chronic ethanol exposure and withdrawal experience resulted in a significant increase in voluntary ethanol drinking that yielded a >2-fold increase in resultant blood ethanol levels. This increase in ethanol intake occurred whether ethanol was presented in combination with sucrose, alone (unadulterated), or as a choice with tap water. Furthermore, this effect seems to be selective for ethanol in that animals that were trained to drink a sucrose solution did not exhibit a change in their intake after similar chronic ethanol exposure. As such, this model may be useful in studying the mechanisms and conditions in which chronic ethanol treatment influences motivation to resume drinking after a period of abstinence (relapse).

Alcohol Drinking↗

Influence of age at drinking onset on long-term ethanol self-administration with deprivation and stress phases.

BACKGROUND: Onset of alcohol use during adolescence has potentially long-lasting consequences, e.g., prospective alcohol dependence. To obtain new insight into the effects of early chronic ethanol consumption, we compared the drinking behavior of two adult male Wistar rat groups: one that initiated alcohol consumption during adolescence (adolescent group) and the other that initiated their drinking during adulthood (adult group) in a model of long-term alcohol self-administration. We investigated the magnitude of the effects of deprivation and stress on alcohol intake and the influence of these events on the alcohol drinking behavior across time. METHODS: Heterogeneous Wistar rats aged 31 days (adolescents) and 71 days (adults) were given ad libitum access to water, as well as 5% and 20% ethanol solutions during an observation period of 30 wk. A deprivation phase of 14 days was instituted after eight wk of access to alcohol. After 16 and 26 wk of alcohol access, all animals were subjected for three consecutive days to forced swimming and electric foot shocks, respectively. RESULTS: At the onset of drinking, adolescent animals consumed less alcohol and showed lower preference than adults. The deprivation phase was followed by increased intake of highly concentrated ethanol solution without appreciable differences between age groups. Repeated swim stress produced a slight increase in ethanol consumption in both animal groups; however, alcohol intake was not significantly different between groups, whereas the foot shock stress-induced increase in alcohol intake was significantly higher in the animal group that initiated alcohol consumption during adolescence. After swim stress, the drinking behavior of the adolescent group resembled that of the adult group. In particular, the adolescent group increased their preference for 20% ethanol solution for the remainder of the experiment. CONCLUSIONS: Age of voluntary alcohol drinking onset does not appear to be a strong predictor for prospective alcohol intake and relapse-like drinking behavior under the present experimental conditions. However, male Wistar rats that initiated alcohol consumption during adolescence seem to be more susceptible to acute stressor-specific effects in terms of alcohol consumption.

Age Factors↗

Is pregnancy a time of changing drinking and smoking patterns for fathers as well as mothers? An initial investigation.

This paper describes changing smoking and drinking patterns before and during pregnancy in 313 expectant couples. Fathers were more likely to drink and smoke more heavily than mothers throughout. Before pregnancy in only 42% of couples were both partners safe drinkers and non-smokers. This increased to 50% during pregnancy. Most mothers reduced alcohol consumption during pregnancy and although about half of the fathers also changed their drinking patterns, only about a fifth decreased their consumption. Levels of paternal and maternal drinking in pregnancy were positively associated with pre-pregnancy levels. Rates and levels of both maternal and paternal smoking declined in pregnancy. There was a positive association between partners of both the prevalence and level of drinking and smoking between partners. There was some indication that mothers were more likely to reduce smoking and drinking if their partner joined them in doing so. Risk drinking in couples was more common in those who were older and of higher social status, but smoking was more common among the younger couples of lower social status.

Adult↗

Young adult drinking behaviour: a comparison of diary and quantity-frequency measures.

One hundred and twenty-two college students over a 2-week period completed a diary of their drinking habits and reasons for drinking, as well as a structured questionnaire about drinking attitudes and habits. Daily consumption based on the diary was compared with consumption based on a quantity-frequency measure within the questionnaire. There were no significant differences between estimates of consumption based on the two measures, and both measures were highly correlated. The questionnaire was more accurate in classifying drinkers and non-drinkers and led to better identification of those classified as hazardous and harmful drinkers. Sex differences in beliefs about drinking, as well as differences according to drinker classification, were found. Unsafe drinkers rated their drinking episodes as significantly more satisfying, comforting and exciting than other drinkers and were more likely to drink in order to get drunk and to relax. Their beliefs, attitudes and intentions also were more favourable towards the consumption of alcohol. Hotels or clubs were the most preferred locations for beer and spirits consumption while wine was consumed mainly at home. Most drinking took place within a mixed group or with close friends. Findings are discussed in terms of the relative advantages of both diary and quantity-frequency/questionnaire methods.

Adult↗

The alcohol content of self-report and 'standard' drinks.

A stubborn problem in alcohol epidemiology is that of standardization of unit of measurement. Consistent use of the 'standard drink' in research reports is hampered by difficulties in the assessment of the alcohol content of, particularly, self-reported drinks. Alcohol content of a drink depends on strength of the beverage and volume of the glass or container from which the beverage is taken. Both factors vary considerably between times, regions and individuals. Interview protocols and questionnaires rarely take into account the fact that people consume alcoholic beverages from a large variety of glasses and containers. In the present study the common presumption is tested of equality of alcohol content of standard and self-reported drinks. The test consisted of measuring the amount of wine, fortified wine and spirits people usually pour in the glass typical for the beverage type. The sample was drawn from the general Dutch population in 1985. The results show that on average self-reported drinks taken at home contained more than the presumed standard (10 g per drink). The deviation was highest for spirits (+26%), followed by fortified wines (+14%) and least for wine (+4%). There seemed to be a positive relationship between deviation from 'standard' and strength of the alcoholic beverage. This result is in line with data on the coverage of sales data: aggregate, survey-based spirits consumption shows the lowest coverage of sales. The effect of the difference between actual and presumed content of drinks on estimates of consumption is an overall increase of 7.5%, higher for women (+12%) than for men (+6%). Results are discussed with respect to the use of the concept of 'standard unit' in research protocols and health education campaigns.

Adolescent↗

Teenage drinking and the onset of alcohol dependence: a cohort study over seven years.

AIM: To determine whether adolescent alcohol use and/or other adolescent health risk behaviour predisposes to alcohol dependence in young adulthood. DESIGN: Seven-wave cohort study over 6 years. PARTICIPANT: A community sample of almost two thousand individuals followed from ages 14-15 to 20-21 years. OUTCOME MEASURE: Diagnostic and Statistical Manual volume IV (DSM-IV) alcohol dependence in participants aged 20-21 years and drinking three or more times a week. FINDINGS: Approximately 90% of participants consumed alcohol by age 20 years, 4.7% fulfilling DSM-IV alcohol dependence criteria. Alcohol dependence in young adults was preceded by higher persisting teenage rates of frequent drinking [odds ratio (OR) 8.1, 95% confidence interval (CI) 4.2, 16], binge drinking (OR 6.7, 95% CI 3.6, 12), alcohol-related injuries (OR 4.5 95% CI 1.9, 11), intense drinking (OR 4.8, 95% CI 2.6, 8.7), high dose tobacco use (OR 5.5, 95% CI 2.3, 13) and antisocial behaviour (OR 5.9, 95% CI 3.3, 11). After adjustment for other teenage predictors frequent drinking (OR 3.1, 95% CI 1.2, 7.7) and antisocial behaviour (OR 2.4, 95% CI 1.2, 5.1) held persisting independent associations with later alcohol dependence. There were no prospective associations found with emotional disturbance in adolescence. CONCLUSION: Teenage drinking patterns and other health risk behaviours in adolescence predicted alcohol dependence in adulthood. Prevention and early intervention initiatives to reduce longer-term alcohol-related harm therefore need to address the factors, including alcohol supply, that influence teenage consumption and in particular high-risk drinking patterns.

Adolescent↗

Does alcohol advertising promote adolescent drinking? Results from a longitudinal assessment.

AIMS: To examine the relationship between exposure to different forms of alcohol advertising and subsequent drinking among US adolescents and assess whether exposure to an alcohol and drug prevention program mitigates any such relationship. DESIGN: Regression models with multiple control variables examined the relationship between exposure to alcohol advertising in grade 8 and grade 9 drinking for two groups of South Dakotan adolescents: (1) seventh-grade non-drinkers (n = 1206) and (2) seventh-grade drinkers (n = 1905). Interactions between the intervention program and the significant advertising predictors were tested. SETTING: Forty-one middle schools in South Dakota, USA. PARTICIPANTS: A total of 3111 seventh-graders followed through grade 9. MEASUREMENTS: Advertising variables were constructed for four types of alcohol advertising-television, in-store displays, magazines and concession stands. Other predictors tested included measures tapping social influences, social bonds, problem behavior, alcohol beliefs, television exposure and demographics. FINDINGS: For seventh-grade non-drinkers, exposure to in-store beer displays predicted drinking onset by grade 9; for seventh-grade drinkers, exposure to magazines with alcohol advertisements and to beer concession stands at sports or music events predicted frequency of grade 9 drinking. Although exposure to television beer advertising had a significant bivariate relationship with alcohol use for grade 7 non-drinkers, it was not a significant predictor of drinking for either group in multivariate analyses. Participation in the prevention program, ALERT Plus, reduced future drinking for both groups and counteracted the effect of in-store beer displays. CONCLUSIONS: Several forms of alcohol advertising predict adolescent drinking; which sources dominate depends on the child's prior experience with alcohol. Alcohol prevention programs and policies should help children counter alcohol advertising from multiple sources and limit exposure to these sources.

Adolescent↗

Drinking in the Commonwealth of Independent States--evidence from eight countries.

AIMS: To describe the frequency of alcohol consumption and beverage preferences in eight countries of the Commonwealth of Independent States (CIS). DESIGN: Cross-sectional. SETTING: Populations of Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation and Ukraine. PARTICIPANTS: Representative samples of the adult population of each country (overall sample size 18,428; response rates: 71-88%). MEASUREMENTS: A standardised questionnaire was administered by trained interviewers to examine alcohol consumption frequency and usual intakes of beer, wine and strong spirits. FINDINGS: Between 11 and 34% of males and 26-71% of females reported never drinking alcohol. Abstention was lowest in the Russian Federation and Belarus, two traditional spirits-drinking countries. It was particularly high in Kyrgyzstan and Georgia, two countries with a relatively low frequency of alcohol consumption but large amounts consumed per occasion (particularly Georgia). On the contrary, Moldovan respondents drank frequently, but consumed smaller amounts per occasion. As expected, spirits were consumed in largest amounts in traditional spirits-drinking countries, as well as Armenia and wine in traditional wine-drinking countries. Beer consumption was relatively high in Russia, Belarus, Ukraine and Kazakhstan (males), particularly in young respondents. CONCLUSIONS: Although cross-country comparisons of alcohol intake should be interpreted cautiously, this study suggested that drinking patterns in the countries examined are not entirely typical of usual dry/wet drinking cultures, and confirms that the CIS is very diverse in terms of drinking patterns and beverage preferences. The study provides an important baseline for future comparisons as markets open to new products, as has been the case elsewhere in Europe.

Adolescent↗

Risk assessment of adenoviruses detected in treated drinking water and recreational water.

AIMS: Human adenoviruses (HAds) have previously been detected in sewage and polluted river and dam water, as well as treated drinking water. The 51 serotypes of HAds cause a wide range of infections with clinical manifestations associated with the gastrointestinal, respiratory and urinary tracts, and the eyes. Water may play a meaningful role in the transmission of many of these HAd serotypes, specifically the enteric HAds which are transmitted via the faecal-oral route. The presence of these viruses in water used for drinking and recreational purposes is considered to constitute a potential health risk. In this study, the risk of infection by the group of HAds previously detected over a period of 1 year in selected drinking water supplies, as well as river and dam water used for recreational purposes, was assessed. METHODS AND RESULTS: Adenoviruses were previously detected in nine of 204 (4.41%) samples of two drinking water supplies (A and B) treated and disinfected according to international specifications, in four of 51 (7.8%) samples of river water and nine of 51 (17.7%) samples of dam water. Application of these previously published results in an exponential risk assessment model indicated an annual risk of infection of 1.01 x 10(-1) and 1.7 x 10(-1) for drinking water supplies A and B, respectively, assuming a daily consumption of 2 l day(-1). The daily risk of infection constituted by HAds in the river water was calculated as 1.71 x 10(-4), and in the dam water as 3.12 x 10(-5), assuming a consumption of 30 ml of water per day. CONCLUSIONS: The risk of infection exceeded the tolerable risk of one infection per 10 000 consumers per year proposed for drinking water. However, the results for river and dam water used for recreational purposes were within the tolerable risk of one infection per 1000 bathers per day proposed for environmental waters used for recreational purposes. SIGNIFICANCE AND IMPACT OF THE STUDY: The study showed that the risk of HAd infection calculated for the drinking water supplies and the recreational water may overestimate the actual risk of infection, as conservative values were assumed for some of the variables. For a more accurate assessment of the potential risk of infection research should at least include a thorough investigation of the water consumption of individuals in South Africa, and the efficiency of recovery of the glass wool adsorption-elution method.

Adenoviridae↗