Mortality among men alcoholics in Iceland, 1951--74.

Abstract

Mortality trends during the period 1951-1974 were compared in the general population of Icelandic men and in 2863 of the 2996 men aged 15 yr and older who had their 1st contact with an alcoholism treatment facility in Iceland during the period 1951-1970. The follow-up of the alcoholics ranged from 4-24 yr, the mean being 13, and their total man-years of exposure to the risk of death was 37,200. The average age at 1st treatment contact was 37. Data from Iceland''s National, Psychiatric and Cancer Registers and autopsy reports were examined. Compared with men in the general population, alcoholics were younger, more likely to be divorced and more likely to live in the Reykjavik area. Farmers were underrepresented and fishermen and seamen overrepresented. During the 24 yr period, 573 alcoholics died, compared with the 256 expected to die, yielding a mortality ratio of 2.24. In alcoholics who were treated for delirium tremens, the ratio was 3.93. In all alcoholics, 58% of the excess mortality occurred below age 55 yr, the highest mortality ratios being in the age group 30-34. Most of the alcoholics'' excess mortality was due to 5 causes; accidents (34.5%), heart diseases (20.2%), suicides (11%), cancer (9%) and pneumonia (6.4%). The highest mortality ratio were for deaths due to cirrhosis of the liver (11.29), alcoholism (11.21), suicide (4.41), accidents (3.96), pneumonia (3.34) and heart diseases (1.8). One-quarter of the alcoholics'' deaths were caused by accidents; 1/12 were suicides. Since deaths from fatty liver and cirrhosis of the the liver contributed only 4% to the total excess mortality, data on cirrhosis of the liver cannot be used to estimate the prevalence of alcoholism in Iceland. Factors implicated in specific causes of death are discussed.