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Premature Deaths

Volume 713: debated on Tuesday 27 October 2009

Question

Asked by

To ask Her Majesty's Government what is the total number of life years lost in England and Wales in each of 2005, 2006, 2007 and 2008 for those dying prematurely for each of: (a) short-, medium- or long-term exposure to particulate matter (PM10); (b) alcohol abuse; (c) drug abuse; (d) road traffic accidents; (e) obesity; and (f) smoking. [HL5773]

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.

Letter from Jil Matheson, National Statistician, to Lord Berkeley, dated October 2009.

As National Statistician, I have been asked to reply to your recent Parliamentary Question asking what is the total number of life years lost in England and Wales in each of 2005, 2006, 2007 and 2008 for those dying prematurely of: (a) short-, medium- or long-term exposure to particulate matter (PM10), (b) alcohol abuse, (c) drug abuse, (d) road traffic accidents, (e) obesity, and (f) smoking. (HL5773)

The accurate reporting of deaths by specific causes depends on the complete recording of all relevant causes of death by medical practitioners and coroners. Medical practitioners are required to complete the Medical Certificate of Cause of Death (MCCD) to the best of their knowledge and belief. Internationally accepted guidance from the World Health Organisation requires only those conditions that contributed directly to death to be recorded. The MCCD is not designed to collect information on risk factors or exposures related to the development of disease, such as exposure to particulate matter or smoking behaviour. It is therefore not possible to provide answers to parts (a) or (f) of the question above, based on information collected at death registration.

Calculations done for the review of the Air Quality Strategy1 estimated that, if all man-made fine particulate matter (PM2.5) present in the UK in 2005 were removed for the lifetime of people born in 2005, the average life-expectancy per person would be 7-8 months greater than if the level of man-made PM2.5 had remained at 2005 levels for a lifetime. This calculation represents the effect of long-term exposure to fine particles. A similar calculation has not been done for PM10 since the evidence that it is a good metric for representing the effect of long-term exposure is much weaker2 than for PM2.5.

Studies of short-term exposure to PM10 do suggest a link with increased mortality but the studies do not give direct information on the life lost per person. It is thought that those affected are already seriously ill but that many of the deaths are brought forward by several months rather than just days or weeks. There are too few studies of the effects of medium term exposure for calculations such as those above to be made. All information on the estimated impact of particulate matter on life expectancy and mortality has been provided by the Health Protection Agency (HPA). Neither ONS nor the HPA are aware of comparable figures to those provided above for 2006-08.

ONS publishes annual figures on the number of years of life lost due to a selection of specific causes of death3 , including land transport accidents. Table 1 below presents figures for years of life lost due to land transport accidents, including the number of deaths, mean age at death and years of total life (to age 75) lost, by sex, for 2005 to 2007 (the latest year available). Figures are not readily available for years of life lost due to alcohol abuse, drug abuse or obesity.

Figures are available for the number of premature deaths, defined as deaths under the age of 75, for (i) deaths with an alcohol-related cause, (ii) drug misuse deaths, where the underlying cause was drug poisoning and where any drug controlled under the Misuse of Drugs Act 1971 was mentioned on the death certificate, and (iii) deaths with obesity as the underlying cause of death, for England and Wales, for 2005 to 2008 (the latest year available), and are provided in Table 2 below. These figures are presented to offer some information on the scale of premature deaths from these conditions, in England and Wales.

The figures provided in Table 2 relating to obesity reflect the number of deaths certified as due to obesity conditions. However, these figures are likely to underestimate the actual number of deaths in which this factor is involved since obesity may play an important role in deaths due to other conditions such as heart disease or diabetes, but it is rarely recorded on the death certificate.

1 http://www.defra.gov.uk/environment/quality/air/airquality/publications/stratreview-analysis/index.htm

2 http://www.advisorybodies.doh.gov.uk/comeap/pdfs/finallong termeffectsmort2009report.pdf

3 Latest figures available are for 2007, in the “Mortality statistics: Deaths registered in 2007” publication, available from: http://www.statistics.gov.uk/statbase/product.asp?vlnk=15096.

Table 1. Years of life lost due to land transport accidents: numbers of deaths, mean age at death and years of total life (to age 75) lost, by sex, 2005-071,2,3,4

Year

Sex

Deaths

Mean age at death

Total life (to age 75) years lost

2005

Male

2,023

40

72,000

Female

674

49

19,000

2006

Male

2,256

39

82,000

Female

734

48

21,000

2007

Male

2,191

40

77,000

 

Female

728

50

19,000

1 Figures for England and Wales include deaths of non-residents.

2 Figures for 2005 are for deaths occurring in 2005. Figures for 2006 and 2007 are for deaths registered in each of these years.

3 Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to V89, which includes deaths from all transport accidents with the exception of water, air and space, other and unspecified transport accidents.

4 Figures for years of life lost are extracted from the ‘Mortality Statistics’ publications for 2005 (Series DH1 no. 38), 2006 (DR_06) and 2007 (DR_07). Of the causes of death mentioned in the question, figures are only available where the underlying cause of death was a land transport accident.

Table 2. Number of deaths from alcohol-related conditions, drug misuse, land transport accidents and obesity, England and Wales, 2005-081,2,3,4,5,6

 

 

 

 

 Persons

Underlying cause of death

2005

2006

2007

2008

Alcohol-related conditions

5,928

6,288

6,369

6,655

Drug misuse

1,573

1,531

1,575

1,703

Land transport accident

2,606

2,610

2,511

2,256

Obesity

200

228

219

298

1 Figures for England and Wales include deaths of non-residents.

2 Figures are for deaths registered in each calendar year.

3 Alcohol-related deaths were defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes shown in Box 1 below.

4 Drug misuse deaths were defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes shown in Box 2 below and where a drug controlled under the Misuse of Drugs Act 1971 was mentioned on the death certificate.

5 Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes V01 to V89, which includes deaths from all transport accidents with the exception of water, air and space, other and unspecified transport accidents.

6 Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10) code E66 (obesity).

Box 1. Alcohol-related causes of death—International Classification of Diseases, Tenth Revision (ICD-10)

Cause of death description

ICD-10 code(s)

Mental and behavioural disorders due to use of alcohol

F10

Degeneration of nervous system due to alcohol

G31.2

Alcoholic polyneuropathy

G62.1

Alcoholic cardiomyopathy

I42.6

Alcoholic gastritis

K29.2

Alcoholic liver disease

K70

Chronic hepatitis, not elsewhere classified

K73

Fibrosis and cirrhosis of liver (excl. biliary cirrhosis)

K74 (excl. K74.3-K74.5)

Alcohol induced chronic pancreatitis

K86.0

Accidental poisoning by and exposure to alcohol

X45

Intentional self-poisoning by and exposure to alcohol

X65

Poisoning by and exposure to alcohol, undetermined intent

Y15

Box 2. International Classification of Diseases, Tenth Revision (ICD-10) codes used to define drug-related poisoning deaths by underlying cause

Cause of death description

ICD-10 Code(s)

Mental and behavioural disorders due to drug use (excluding alcohol and tobacco)

F11–F16, F18–F19

Accidental poisoning by drugs, medicaments and biological substances

X40–X44

Intentional self-poisoning by drugs, medicaments and biological substances

X60–X64

Assault by drugs, medicaments and biological substances

X85

Poisoning by drugs, medicaments and biological substances, undetermined intent

Y10–Y14