Aim: To find out how the frequency of drinking one to two drinks, three to four drinks and five or more drinks of alcohol per drinking occasion predicts injury mortality in 16 years of follow-up among the Finnish 15-69-year-old male population.
Design: Three alcohol surveys conducted in 1969, 1976 and 1984 were pooled and linked with mortality information from the national cause of death register.
Method: Cox proportional hazard models were used for analysing the survival time data.
Findings: Drinking at the level of one to two drinks, regardless of frequency, did not elevate the risk of fatal injury, nor did drinking at the level of three to four drinks. Drinking five or more drinks at a time significantly increased the risk of fatal injury in graded relation, compared with those who never drank at that level. The risk was highest for those who drank five or more drinks at a time at least weekly (RR = 5.78, 95% CI = 2.80-11.94), when adjusted for possible confounders.
Conclusions: We found that besides the total volume of consumption, a drinking pattern that involves drinking occasions when consumption exceeds four drinks of alcohol at a time leads to a significant increase in the risk of fatal injury among Finnish men. The risk is highest among those who have the highest annual number of heavy drinking occasions. The finding does not support the hypothesis that alcohol tolerance would lower the risk of fatal injuries among frequent heavy drinkers.