The study was set in three boroughs in the West Midlands with a total population of 837,000. Death rates were obtained from the Office for National Statistics.

Deaths from primary liver disease increased from 6 per 100,000 population in 1993 to 13 per 100,000 in 2000. The increase was almost exclusively the result of alcoholic liver disease, and death rates were similar for white men, white women, and Asian men.

After alcoholic liver disease, the largest cause of death was "unspecified" liver disease with an annual incidence of 2.5 per 100,000 population. Alcohol misuse was the presumed cause in 67% of cases identified by the research team.

This apparent increase might be the result of increasing alcohol consumption, but available evidence does not show any notable increase in the total national alcohol consumption in the past decade nor in the number of people drinking heavily, say the authors.

These data have important implications for public health and hospital physicians. The halting or reversal of the trend in deaths from alcoholic liver disease requires further public emphasis on the risk of fatal liver disease from excessive alcohol consumption, they conclude.

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Contact: Emma Wilkinson
ewilkinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
8-Aug-2002