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Background To examine trends in alcohol-attributable morbidity (AAMorb) (2000/01–2009/10) and mortality (AAMort) (2000–07) by age, sex and region. Methods Time-series analyses of population data for Victoria, Australia. We used joinpoint regression to quantify trends by estimating quarterly percent change (QPC) for rates of morbidity and mortality. We present the average QPC (AQPC) as a weighted average of QPCs. A test of parallelism was used to examine pairwise differences. Results AAMorb increased significantly over time for Victoria (AQPC = 1.0%, 95% confidence interval 0.8–1.2). While females (1.6, 1.1–2.0), age groups 25–44 (1.0, 0.9–1.1) and 45–64 (1.2, 0.2–2.2), and metropolitan population (1.2, 0.5–1.9) were broad subgroups more at risk, multivariate analysis detected specific increases for metropolitan females aged 15–44 (1.8, 1.0–2.6) and 45+ (1.6, 0.2–3.0). Relatively greater increases in morbidity among metropolitan subgroups were widespread. AAMort remained stable for Victoria and for most subgroups, although significant declines in mortality were specifically experienced by metropolitan 15–24 (−2.0, −2.9 to −1.0) and 25–44 (−1.0, −1.7 to −0.3) age groups, and by regional males aged 45+ (−0.8, −1.3 to −0.3). Metropolitan males aged 45+ were a special high-risk population. Discussion Our study has identified overlooked subgroups as being at increasing risk for alcohol-attributable chronic harm necessitating their inclusion in future policies for harm reduction. [ABSTRACT FROM AUTHOR]

Aims To assess the relationship between ambulance attendances, emergency department ( ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. Design Time-series analysis was used to explore trends in intoxication in the context of major events. Setting Population of Melbourne, Victoria, Australia between 2000 and 2009. Participants All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. Measurement Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. Findings Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year's Day (ambulance 6.57, 95% confidence intervals ( CI): 3.4-9.74; ED 3.34, 95% CI: 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI: 0.68-6.75). The Australian Football League ( AFL) Grand Final ( ED 2.37, 95% CI: 0.55-4.19), Commonwealth Games ( ED 2.45, 95% CI: 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI: 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI: 6.8-11.15). Conclusions Acute alcohol intoxication cases requiring ambulance, emergency department and hospital in-patient treatment increase substantially on the day preceding public holidays and other major social events. [ABSTRACT FROM AUTHOR]

Background: Conventionally, cohort studies have assessed the association between alcohol and all-cause mortality by using alcohol intake at enrolment., Methods: In the Melbourne Collaborative Cohort Study, participants were asked about usual frequency and quantity of beverage-specific alcohol intake for 10-year periods starting at age 20 from which current, past and lifetime intakes were calculated. We used Cox regression to estimate hazard ratios for mortality for 39 577 participants of the Melbourne Collaborative Cohort Study aged 40-69 at baseline., Results: After a mean follow-up of 15 years/person, we identified 4639 deaths. Associations between all-cause mortality and lifetime, current (baseline) and past intake were J shaped, with lower mortality at low intake (e.g. <40 g/day for men and 10 g/day for women using lifetime intake) and elevated mortality at higher intake. For men, consistent light-to-moderate drinking (>0-39/>0-39 g/day) from age 20 to baseline age was associated with a 16% lower mortality, while heavy drinking at both ages (≥80/≥40 and ≥40/0 g/day) was associated with higher mortality compared with stable abstinence., Conclusions: Our findings support a reduced mortality risk associated with low-dose drinking but also highlight a higher mortality risk for consistent heavy drinking from a young age., (© The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

We studied the incidence and relative survival of 39 837 cases of lymphohematopoietic neoplasms (LHN) reported to the Victorian Cancer Registry during 1982-2004, classified according to the World Health Organization (WHO) classification. We modeled excess mortality using Poisson regression to estimate differences in survival by age, sex, and time period. Age-standardized incidence rates varied across subtypes of lymphoid and myeloid neoplasms. All major subtypes predominantly affected the elderly except Hodgkin lymphoma (incidence peaks at 20-24 and 75-79 years) and acute lymphoblastic leukemia (0-9 years). After an initial rise, overall lymphoid and myeloid incidence stabilized in the mid-1990s. The 5-year relative survival was 58% for lymphoid and 35% for myeloid neoplasms. Survival improved during 1990-2004 for diffuse large B-cell lymphoma, follicular lymphoma, acute myeloid leukemia, chronic myeloid leukemia, and myelodysplastic syndromes (p  < 0.001) and declined with advancing age for all subtypes (p <  0.001). Female sex was associated with higher survival for most myeloid subtypes. The results represent a rare epidemiological characterization of the whole range of LHN according to WHO subtypes.

Diagnosis in summer had been shown to be associated with better survival from some cancers, but such studies on malignant melanoma where sun exposure is a risk factor for disease are rare. We evaluated seasonality in melanoma diagnosis and its effect on survival in Victoria, Australia using 26,060 cases reported to the population-based Victorian Cancer Registry during 1986-2004. To estimate the amplitude of the seasonal variation, we calculated the ratio of the number of melanoma cases diagnosed in summer to that in winter. Linear regression was undertaken to assess the variation in thickness, the main prognostic indicator for melanoma, by season of diagnosis adjusting for sex, anatomical site, year of diagnosis and age at diagnosis. We modeled excess mortality using Poisson regression controlling for possible confounders in order to study the effect of season of diagnosis on survival. An overall 46% summer diagnostic excess was evident (summer-to-winter ratio 1.46; 95% CI 1.41, 1.52). Results of linear regression showed that melanoma diagnosed in winter were thicker than those diagnosed in any other season (percentage difference in thickness -2.01, -6.97 and -10.68 for spring, summer and autumn, respectively; p < 0.001). In the Poisson regression model of relative survival, cases diagnosed in spring, summer or autumn had slightly lower excess mortality than those diagnosed in winter before adjustment for other variables, but after adjustment the excess mortality ratios were close to unity. Our findings do not support the hypothesis that melanoma cases diagnosed in winter have worse prognosis than cases diagnosed in other seasons., (Copyright 2009 UICC.)