Number of recorded hospitalizations and visits and hospital days, associated with a diagnosis of FAS and the associated costs in Canada for 2008–2009.

*<p>Data from Quebec and Alberta are not included.</p><p>N/A – not applicable.</p><p>Note. In instances where there were fewer than five cases (<5), a midpoint of 2.5 was imputed on those cells. As a result, there may be rounding errors after collapsing the numbers.</p><p>Source: CIHI, 2011 (DAD, HMDB, NACRS, OMHRS).</p

Average cost per day/visit by expense type on a provincial/territorial and national level for Canada, 2008–2009.

<p>NA - not available.</p><p>Source: CIHI, 2011 (CMDB).</p

Percentage of records of the top most responsible DSM-IV diagnoses among individuals diagnosed with FAS who used adult inpatient mental health services (acute and psychiatric care) in Ontario in 2008–2009.

*<p>The MRDs listed above represents 100% of all the records with a diagnosis of FAS.</p><p>Source: CIHI, 2011 (OMHRS).</p

Percentage of records of the top most responsible diagnoses (MRDs) among individuals diagnosed with FAS who used acute care, psychiatric care, day surgery, and emergency department services in Canada in 2008–2009.

*<p>The MRDs listed above represents 55% of all the records with a diagnosis of FAS; Source: CIHI, 2011 (DAD, HMDB, NACRS).</p

The per person cost estimate for each service involved in the multidisciplinary FASD diagnostic process.

*<p>This stage is not limited to the individuals listed here.</p>**<p>Excluding screening and referral, intake, and general support.</p>***<p>Including screening and referral, intake, diagnosis, and general support.</p

Clinical capacity of FASD diagnosis in 2011, estimated number of people diagnosed with FASD per year (assuming a 50% and 70% FASD diagnosis rate), and the annual cost for FASD diagnosis in Canada, by available provinces and territory.

*<p>The final number is the full estimated capacity for FASD diagnosis in Canada as a whole, including additional slots from the rest of provinces and territories <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0060434#pone.0060434-Clarren2" target="_blank">[22]</a>.</p>**<p>Obtained from Clarren & Lutke <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0060434#pone.0060434-Clarren1" target="_blank">[18]</a>.</p

The relationship between different dimensions of alcohol use and the burden of disease - an update

Background and aims: Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). Methods: Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. Results: In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. Conclusions: Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge