Temporal variation in deaths related to alcohol intoxication and drinking

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Abstract
Background Temporal variation in deaths related to alcohol intoxication is examined using two approaches. First, we examine the risk of these deaths during festivals, on the day preceding them, and on the three days that immediately follow them. Second, we assess the weekday variation in deaths, and compare this with survey-based data on weekday variations in drinking. Previously no data existed on the temporal association between intoxication-related deaths and drinking occasions according to the severity of intoxication. Methods We used population registration data on 15–69-year-old men and women, linked with the national cause of death register for the years 1987–2001, and the Finnish Drinking Habits Survey carried out in 2000. Intoxication-related deaths were defined on the basis of underlying and contributory causes of death. Results The largest increased risk of intoxication-related deaths was observed for Midsummer Day [Observed deaths/Expected deaths (O/E) = 2.88 (95% confidence interval 2.48–3.31) for men and O/E = 2.21 (1.43–3.27) for women respectively], Midsummer Eve [O/E = 2.70 (2.32–3.12) and 3.18 (2.23–4.41)], May Day [O/E = 1.80 (1.50–2.16) and 2.65 (1.79–3.79)], Christmas Eve [O/E = 1.58 (1.29–1.91) and 2.21 (1.43–3.27)], and New Year's Day [O/E = 1.48 (1.20–1.80) and 1.77 (1.08–2.74)]. Among men, the increased risk at Midsummer lasted for three consecutive days. The weekday distribution of different levels of intoxication and of intoxication-related deaths was similar, with a clear increase observed on Friday, Sunday, and, particularly, Saturday. Conclusions Intoxication-related deaths peak during weekends and around festival days when alcohol is widely consumed in excess. Public awareness of the risks attached to binge drinking should be increased.