The burden of alcohol-related morbidity and mortality in Ottawa, Canada

<div><p>Objectives</p><p>Alcohol-related morbidity and mortality are significant public health issues. The purpose of this study was to describe the prevalence and trends over time of alcohol consumption and alcohol-related morbidity and mortality; and public attitudes of alcohol use impacts on families and the community in Ottawa, Canada.</p><p>Methods</p><p>Prevalence (2013–2014) and trends (2000–2001 to 2013–2014) of alcohol use were obtained from the Canadian Community Health Survey. Data on paramedic responses (2015), emergency department (ED) visits (2013–2015), hospitalizations (2013–2015) and deaths (2007–2011) were used to quantify the acute and chronic health effects of alcohol in Ottawa. Qualitative data were obtained from the “Have Your Say” alcohol survey, an online survey of public attitudes on alcohol conducted in 2016.</p><p>Results</p><p>In 2013–2014, an estimated 595,300 (83%) Ottawa adults 19 years and older drank alcohol, 42% reported binge drinking in the past year. Heavy drinking increased from 15% in 2000–2001 to 20% in 2013–2014. In 2015, the Ottawa Paramedic Service responded to 2,060 calls directly attributable to alcohol. Between 2013 and 2015, there were an average of 6,100 ED visits and 1,270 hospitalizations per year due to alcohol. Annually, alcohol use results in at least 140 deaths in Ottawa. Men have higher rates of alcohol-attributable paramedic responses, ED visits, hospitalizations and deaths than women, and young adults have higher rates of alcohol-attributable paramedic responses. Qualitative data of public attitudes indicate that alcohol misuse has greater repercussions not only on those who drink, but also on the family and community.</p><p>Conclusions</p><p>Results highlight the need for healthy public policy intended to encourage a culture of drinking in moderation in Ottawa to support lower risk alcohol use, particularly among men and young adults.</p></div

Age-specific rate of 100% alcohol-attributable ED visits by sex, 2013–2015, Ottawa.

<p>Age-specific rate of 100% alcohol-attributable ED visits by sex, 2013–2015, Ottawa.</p

Counts and rates of alcohol-related paramedic responses by age group and sex, Ottawa, 2015.

<p>Counts and rates of alcohol-related paramedic responses by age group and sex, Ottawa, 2015.</p

Distribution of alcohol-related risk among adults (19 years and older), Ottawa, 2013–2014.

<p><b>Note:</b> No risk = no alcohol use in past year; Low risk = no binge drinking in past year; Moderate risk = binge drinking three times or less a month in past year, and; High risk = binge drinking weekly or more often in past year.</p

Levels of concerns with drunk driving, violence, binge drinking, and underage drinking in Ottawa, 2016.

<p>Levels of concerns with drunk driving, violence, binge drinking, and underage drinking in Ottawa, 2016.</p

Annual number of alcohol-attributable ED visits (2013–2015), hospitalizations (2013–2015), and deaths (2007–2011) average by diagnosis and sex, Ottawa.

<p>Annual number of alcohol-attributable ED visits (2013–2015), hospitalizations (2013–2015), and deaths (2007–2011) average by diagnosis and sex, Ottawa.</p

Percentage of adults (19 years and older) who reported alcohol use in the past year, binge drinking, exceeding weekly limits, and heavy drinking by sociodemographic characteristics, Ottawa, 2013–2014.

<p>Percentage of adults (19 years and older) who reported alcohol use in the past year, binge drinking, exceeding weekly limits, and heavy drinking by sociodemographic characteristics, Ottawa, 2013–2014.</p

Word cloud representing the top alcohol concerns to work on first and why.

<p>Word cloud representing the top alcohol concerns to work on first and why.</p

Data_Sheet_1_Wastewater-based surveillance identifies start to the pediatric respiratory syncytial virus season in two cities in Ontario, Canada.docx

IntroductionDetection of community respiratory syncytial virus (RSV) infections informs the timing of immunoprophylaxis programs and hospital preparedness for surging pediatric volumes. In many jurisdictions, this relies upon RSV clinical test positivity and hospitalization (RSVH) trends, which are lagging indicators. Wastewater-based surveillance (WBS) may be a novel strategy to accurately identify the start of the RSV season and guide immunoprophylaxis administration and hospital preparedness.MethodsWe compared citywide wastewater samples and pediatric RSVH in Ottawa and Hamilton between August 1, 2022, and March 5, 2023. 24-h composite wastewater samples were collected daily and 5 days a week at the wastewater treatment facilities in Ottawa and Hamilton, Ontario, Canada, respectively. RSV WBS samples were analyzed in real-time for RSV by RT-qPCR.ResultsRSV WBS measurements in both Ottawa and Hamilton showed a lead time of 12 days when comparing the WBS data set to pediatric RSVH data set (Spearman’s ρ = 0.90). WBS identify early RSV community transmission and declared the start of the RSV season 36 and 12 days in advance of the provincial RSV season start (October 31) for the city of Ottawa and Hamilton, respectively. The differing RSV start dates in the two cities is likely associated with geographical and regional variation in the incidence of RSV between the cities.DiscussionQuantifying RSV in municipal wastewater forecasted a 12-day lead time of the pediatric RSVH surge and an earlier season start date compared to the provincial start date. These findings suggest an important role for RSV WBS to inform regional health system preparedness, reduce RSV burden, and understand variations in community-related illness as novel RSV vaccines and monoclonal antibodies become available.</p