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Thursday, 20 December, 2001, 13:08 GMT
Six Forum: The BBC's science correspondent
In the latest BBC Six O'clock News forum, the BBC's science correspondent Fergus Walsh answered your questions on the increase in heavy drinking by young people.
To watch coverage of the forum, select the link below:
Heavy drinking among the young is having a highly damaging effect on health.
That's according to the annual report from England's chief medical officer, Professor Liam Donaldson.
He says the increase in alcohol consumption by young people is leading to an alarming rise in liver cirrhosis cases.
Cirrhosis deaths are rising sharply in women, after having increased in men for some time, and females are getting permanent liver damage at an earlier age.
How do you view the findings? Is enough being done to halt the increase in drinking among young people?
I have got the Health 2001 annual report in front of me from Professor Liam Donaldson, who is the chief medical officer for England. He says that large rises in death rates from chronic liver disease and cirrhosis have occurred in most age groups. In the 45 to 54 year-olds there's been a four-fold increase since the early 1970s - that's among men and a three-fold increase in women. Of the 35 to 44 year-olds, the rise has been even larger - an eight-fold increase in men and approaching a seven-fold increase in women. In the case of women, for example, cirrhosis of the liver now kills 1600 women every year - that's more than die from cervical cancer.
When it comes to symptoms - this is one of the big problems because cirrhosis of the liver and the damage that's being done, is largely hidden and can be hidden for years and years. It is often when you go along to the doctor with another problem that they pick up cirrhosis of the liver. The doctor can actually feel your liver. The liver is the largest organ in the body - it weighs about 3 pounds and is nearly the size of a football and it basically swells up with fatty tissue, when it gets damaged, and GPs can feel that. When the disease gets further on and there is further damage, it can be tenderness there, swelling and, in the extreme stage, the skin can go yellow, nausea and there are quite a few other symptoms but it is quite late on then.
Let me tell you what a unit of alcohol is - it is roughly a half-a-pint of beer and a glass of wine. Now that's not a very strong glass of wine and not fortified wine and it's not a very strong half-pint of beer. So it's an average glass of wine - 125 millilitres - a serving that you get in the pub and not the ones you would have at home. Transforming that into daily allowances - for a man, you can safely, as an adult, drink up to 2 pints of beer a day. But not every day of the week - say four or five times a week, or up to four small glasses. For women, assuming there are no other health problems, you could safely drink two or three small glasses of wine a day but not every day. It also partly depends if you're a huge great big man then you might be able to take a little bit more alcohol than if you are a very small woman.
Long term effects of liver damage
If you go to other European countries - if you go to France or you go to Italy or Germany, generally speaking it's not socially acceptable to turn round and say - we're going to go out and get hammered tonight, or we got hammered last night, I've got a terrible hangover. It's really not seen as anything smart or clever whereas you hear that comment here very often that people have gone out and drunk too much and then they brag about it the next day. There is something that needs to happen if we're going to change that. It needs to become not socially acceptable to go out and get so drunk that you lose either all control or you do permanent damage to your liver. That's the problem, it's this binge drinking, rather than small amounts every day that's really the problem.
These units I mentioned - the 21 units maximum a week for men and the 14 units maximum a week for women - the worse thing you can do is have them all in one go.
Other causes of liver damage
I have a whole list of things here - the top of the list of course is extensive intake of alcohol. But viral hepatitis, inherited and congenital diseases, problems with the bile duct, some forms of heart disease, severe reactions to drugs and a parasitic infection even. So your quite right Lisa, apologies for that. The problem we have is that when we're dealing with a news story, we tend to use this shorthand and if I had longer, as I do now, I could point out that there are many causes of this problem.
As I mentioned earlier, the doctor can actually sometimes feel whether the liver is enlarged. If the doctor wants to take it further, a doctor can refer you along to a hospital where they can take a biopsy. That's putting a very, very fine needle into the liver and they can take a sample of cells and see what's happening there. They can also check things with blood tests as well.
Women and alcohol
I take an interesting parallel here with the subject of drinking and drinking and driving. Now drinking and driving obviously affects not only your own health but can lead, as we all know, to tragedies. So the amount of drinking and driving and the amount of deaths relating to drinking and driving has gone down enormously. It used to be pretty much socially acceptable, 30 or 40 years ago, to drink and drive and in some countries it still is. But in the UK it is not. This was partly to do with the Government's legislation and police getting tough on drinking and driving. It was also partly to do with society - people saying, if your driving I am not going to serve you another glass of wine. Or if you're going down the pub, nominating somebody to have soft drinks so that everybody else can drink.
So maybe we have to do something there. But it can't just be government, it has to be something to do with society - it has to be to do with young people. Professor Liam Donaldson was saying to us today that it has got to start in the schools with better education but it's also got to be in the home as well with parents setting an example. So it's something for Government but also something for society as well.
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