Early retirement in an international perspective II: The international study

Initially this article describes the development of disability pension and early retirement in the ages of forty and up till ordinary pensionable ages in nine industrialized countries from the year of 1965 to 1980. During the period there are rising parts of the populations in these pension forms in the countries. The background of this development is, however, somewhat unclear. The following explaining factors are amongst others taken up in the article: A growing sickness, a rising unemployment and especially among the rather old an increased tendency to withdraw from the labor market (for example depending on better pension benefits). The two last mentioned factors are, however, more probable than the first one because of lower mortality rates in the countries under the studied period. Finally the article is concluded with an example of a preparatory suggestion to solve the involved problems in the now existing pension schemes by knitting the pension payments to more productive ages in the future.     

Medico-social consequences and direct costs of stroke in a Swedish community

Two hundred and eighty-one patients who had sustained a stroke for the first time were investigated in the municipality of S?derhamn, Sweden, and its rural surroundings. Of these patients 226 (80%) had lived in their own homes before the insult, while the majority of the remainder had lived in old people's homes. One hundred and eighty-nine patients survived for at least 3 months. The proportion of stroke survivors who were living at home was 53% after 3 months, 65% after 1 year and 68% after 2 and 3 years. The average number of days in hospital was 65 for men and 81 for women after 1 year and 111 and 181 respectively after 3 years. Only 11% were gainfully employed before the attack. This proportion varied between 1 and 10% in the 3-year post-stroke period. About 85% were retired, while the rest were receiving sickness benefit or a disability pension (4-16%). The direct costs of stroke per stroke patient in the municipality of S?derhamn, was estimated at 129 000 Swedish kr. (25 800 US dollars); index 1980. The major part of this sum consisted of charges for hospital care (43-46%), followed by charges for nursing care in old people's homes (16-24%) and home-helps (8-16%), during the 3-year follow-up. Disability pension or sickness benefit accounted for only 5-11%, auxiliary equipment for 1-6%, medication for 1-3% and out-patient care at the medical department for 1%.(ABSTRACT TRUNCATED AT 250 WORDS)     

Problem drinkers among acute care inpatients

AIM: The objective of this study was to determine the prevalence of potential problem drinking among general hospital inpatients during a three-month period. METHOD: The study was conducted in a large Scottish teaching hospital. The wards involved were the general medical, general surgical, orthopaedic and short-stay wards as they had been identified as clinical areas with problem drinking among inpatients. Patients were interviewed using a structured interview schedule as a screening instrument to detect potential problem drinkers. RESULTS: Of the patients interviewed, 25 per cent were shown to drink in excess of the BMA's guidelines for low-risk drinking: 8 per cent had had previous treatment for alcohol problems; 2 per cent were bout or seasonal drinkers; and 15 per cent were newly identified potential problem drinkers. Of the newly identified group, 75 per cent were men and 25 per cent women. Those who were unemployed formed the largest group of potential problem drinkers according to occupation, and patients from the short-stay ward were more likely to have an alcohol problem than those from other wards in the study. CONCLUSION: The patients in this study found to be at risk of experiencing alcohol-related problems might not be routinely identified with current screening methods. This method of screening, by asking patients about their recent drinking patterns, will help nurses to identify those who are potential problem drinkers and enable them to provide relevant advice and education to these patients.     

Operant acquisition of alcohol by women

Alcohol acquisition and use patterns were studied in 26 women on a clinical research ward. Women could earn alcohol (beer, wine or distilled spirits) or 50 for 30 min of performance on a second-order fixed ratio 300 (fixed interval 1 sec: S) schedule of reinforcement. Points earned for money and for alcohol were not interchangeable. A 7-day drug-free base line was followed by 21 days of alcohol availability and a postalcohol drug-free period of 7 days. Heavy, moderate and occasional drinkers differed significantly in the average number of alcohol drinks purchased (P less than .001). Five heavy drinkers purchased an average of 164 (+/- 14) drinks during the study; 12 moderate drinkers purchased an average of 80 (+/- 4) drinks; 9 occasional drinkers purchased an average of 26 (+/- 4) drinks. Individual drinking patterns fluctuated markedly from day-to-day. Daily peak blood alcohol levels (milligrams per deciliter) were significantly correlated with variations in daily drinking patterns in 22 of the 26 subjects (P less than .02-.0001). Computer analysis of daily alcohol consumption patterns (alcohol peak frequency and peak amplitude) showed that moderate drinkers had significantly more peaks in alcohol consumption than occasional drinkers (P less than .05). The average number of drinks constituting each peak was significantly greater for the heavy and moderate drinkers than for the occasional drinkers (P less than .05). The interval between successive peaks in alcohol consumption averaged 4.6 (+/- 0.8) days for the occasional drinkers, 3.2 (+/- 0.2) days for the moderate drinkers and 3.6 (+/- 0.17) days for the heavy drinkers but these differences were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)     

Patterns of sickness absence a decade after pain-related multidisciplinary rehabilitation

Multidisciplinary programmes using a vocational approach can enhance work return in chronic pain patients, but little is known about the long-term effects of rehabilitation. The current study examined the patterns of sickness absence 10 years after participation in 3 treatment groups (physiotherapy, cognitive behavioural therapy, and vocational multidisciplinary rehabilitation) in comparison to a control group receiving treatment-as-usual. Cost-effectiveness was also assessed. Two hundred fourteen patients participated in a randomized controlled trial and were followed-up via register data 10 years after the interventions. On average, persons in multidisciplinary rehabilitation had 42.98 fewer days on sickness absence per year compared to those treated-as-usual (95% confidence interval −82.45 to −3.52, P = 0.03). The corresponding reduction of sickness absence after physiotherapy and cognitive behavioural therapy was not significantly different from the control group. The effect of rehabilitation seems to be more pronounced for disability pension than for sick leave. The economic analyses showed substantial cost savings for individuals in the multidisciplinary group compared to the control group.     

Problem drinkers in acute care settings: validation of an assessment instrument.

This article reports a validation study of a screening procedure for detecting those patients whose patterns of alcohol consumption places them at risk of developing alcohol-related health problems. The sample comprised 998 patients who were admitted to the wards of a general hospital for treatment of conditions which were not primarily alcohol-related. Twenty-six per cent of patients reported drinking more than published guidelines for low-risk drinking. The use of a diary was found to be a valid means of assessing patients' levels of alcohol consumption, and its reliability and validity was confirmed as a method of distinguishing potential problem drinkers from those whose level of alcohol consumption does not place them at risk. As such, the diary is recommended as an assessment tool which can readily be incorporated into standard assessment procedures.     

A 7-year follow-up of multidisciplinary rehabilitation among chronic neck and back pain patients. Is sick leave outcome dependent on psychologically derived patient groups?

A valid method for classifying chronic pain patients into more homogenous groups could be useful for treatment planning, that is, which treatment is effective for which patient, and as a marker when evaluating treatment outcome. One instrument that has been used to derive subgroups of patients is the Multidimensional Pain Inventory (MPI). The primary aim of this study was to evaluate a classification method based on the Swedish version of the MPI, the MPI‐S, to predict sick leave among chronic neck and back pain patients for a period of 7 years after vocational rehabilitation. As hypothesized, dysfunctional patients (DYS), according to the MPI‐S, showed a higher amount of sickness absence and disability pension expressed in days than adaptive copers (AC) during the 7‐years follow‐up period, even when adjusting for sickness absence prior to rehabilitation (355.8days, 95% confidence interval, 71.7; 639.9). Forty percent of DYS patients and 26.7% of AC patients received disability pension during the follow‐up period. However, this difference was not statistically significant. Further analyses showed that the difference between patient groups was most pronounced among patients with more than 60days of sickness absence prior to rehabilitation. Cost‐effectiveness calculations indicated that the DYS patients showed an increase in production loss compared to AC patients. The present study yields support for the prognostic value of this subgroup classification method concerning long‐term outcome on sick leave following this type of vocational rehabilitation.     

Effects of an intervention brochure on emergency department patients' safe alcohol use and knowledge

Alcohol abuse is a leading cause of morbidity and mortality in the United States, contributing to over 100,000 deaths and costing society over 185 billion dollars each year. The objective of this study was to evaluate the effects of the American College of Emergency Physician's brief alcohol use intervention brochure on patients' hazardous drinking behavior and knowledge of safe alcohol use. We conducted a controlled trial comparing Emergency Department (ED) subjects receiving the alcohol use intervention brochure vs. receiving no brochure. One-month outcome measures included the following: 1) change in days of hazardous drinking; 2) change in knowledge of safe alcohol use; and 3) movement along a readiness-to-change continuum for excessive alcohol use. Of 277 subjects, 252 (91.0%) agreed to participate, and 188 of these (74.6%) were successfully contacted for 1-month follow-up assessment. We did not find any significant decreases in days of hazardous drinking or increases in knowledge of safe drinking limits for either the intervention or comparison groups. However, among the subgroup of excessive alcohol users (n = 100), we found that significantly more intervention subjects had advanced along the readiness-to-change continuum than comparison subjects (p < 0.01). This effect was even greater among the intervention group subjects who stated that they read the brochure (p < 0.001). A brief alcohol use intervention brochure does not affect ED patients' hazardous drinking behavior or knowledge of safe alcohol use. The brochure, however, may affect certain patients' motivation to change their drinking behavior. Changing drinking behavior requires more than simply handing out a brochure in the ED; referral to community resources for those motivated to change is likely an important component to successful management of this problem.     

Health, quality of life, social network and use of health care: a comparison between those granted and those not granted disability pensions

Purpose. The aim was to compare self-rated health, health-related quality of life (HRQoL), social networks and health care utilisation of those granted disability pension (DP) and those not granted disability pension (nDP).

Method. Demographic data and medical diagnoses were obtained from the records of the social insurance office. Data concerning self-reported health, HRQoL social networks, and use of health care were collected by a postal questionnaire. The nDP group included all those not granted full DPs between 1999 and 2000 (n = 99). The DP group were a random sample of those granted full DPs, during the same period (n = 197).

Results. The nDP group had more often multiple diagnoses, and lower self-reported health and HRQoL compared to those granted DP. In particular, their average scores were lower on the SF-36 scales social functioning, role limitations due to physical problems and mental health. The nDP group also had significantly smaller social networks.

Conclusions. Contrary to expectations, those not granted a disability pension do not seem to have better health, but rather to suffer from more sickness than those who were granted a disability pension.     

Alcohol use and problems in daily and non-daily coffee drinking college females

Background: For more than a decade, a large proportion of research on caffeine use in college students has focused on energy drinks (ED), demonstrating an association between ED consumption and heavy/problem alcohol use. The present study examined the relationship between daily coffee (DC) consumption and varied measures of alcohol use and problems in a sample of college women. Methods: Participants were undergraduate females (N = 360) attending an urban university in 2001–02 and prior to the rise in ED popularity on college campuses. Analyses compared women who reported drinking coffee daily (DC; 16.9%), to women who did not (non-daily coffee [NDC]; 83.1%) on standardized measures of alcohol use and problems. Results: For both past month and year of drinking, DC women generally reported consuming more alcohol and were 2.1–2.6 times more likely to screen at risk for alcohol problems than their NDC counterparts. DC women were also more likely than NDC women to report problems related to drinking (e.g., experiencing blackouts, inability to stop drinking after they had started). Conclusions: Findings support potential benefits of health education and screening that goes beyond EDs, focusing on varied forms of caffeine consumption.     

Substance Use Restraint: An Extension of the Construct to a Clinical Population

Restraint is a construct of potential use forunderstanding addictive behaviors. In terms of alcoholand other drug use, restrained individuals arecognitively and behaviorally preoccupied withcontrolling their substance use. Previous work in thecontext of alcohol consumption suggests that whenregulation fails, alcohol and other drug users are morelikely to engage in excessive substance use. Thisproposition was evaluated in a clinical population ofalcohol and other substance users admitted to aninpatient treatment program. A confirmatory factoranalysis of alcoholics' responses to the Temptation andRestraint Inventory, a measure of drinking restraint,replicated the two second-order factors previouslyreported for social drinkers: Cognitive and EmotionalPreoccupation (CEP) and Cognitive and Behavioral Control (CBC). CEP scores were a negative predictor ofpretreatment percentage of days abstinent and a positivepredictor of percentage of drinking days engaged inheavy drinking, drinks per drinking day, and drinking consequences. CBC scores were a negativepredictor onlyof drinks per drinking day. An analysis ofdrug users' responses to a drug version of theTemptation and Restraint Inventory also replicated thepreviously found CEP and CBC factors. Scores on the CEPfactor were a positive predictor and scores on the CBCfactor a negative predictor of drug use frequency. CEPscores also were a positive predictor of drug use consequences. The data taken together representa potentially useful extension of the restraintconstruct to alcoholics and other drug users and supporta multifactorial characterization of substance use restraint as reflecting a reciprocalrelationship between restricted and excessive substanceuse.     

Sickness certification for patients with acute cough/LRTI in primary care in Poland and Norway

Objective

To compare the frequency and duration of sickness certificates issued by GPs to Polish and Norwegian working adults with acute cough/lower respiratory tract infection (LRTI).

Design

Cross-sectional observational study with clinicians from nine primary care centres in Poland and 11 primary care centres in Norway. GPs filled out a case report form for all patients, including information on antibiotic prescribing, sickness certification, and advice to stay off work.

Setting

Primary care research networks in Poland and Norway.

Subjects

Working adults with a new or worsening cough or clinical presentation suggestive of LRTI.

Main outcome measures

Issuing sickness certificates and advising patients to stay off work.

Results

GPs recorded similar symptoms and signs in patients in the two countries. Antibiotics were prescribed more often in Polish than in Norwegian patients (70.4% vs. 27.1%, p < 0.0001). About half of the patients received a formal sickness certificate (50.5% in Norway and 52.0% in Poland). The proportion of patients advised to stay off work was significantly higher in the Polish sample compared with the Norwegian sample (75.2% vs. 56.1%, p = 0.002). Norwegian GPs less often issued sick certificates for more than seven days (5.6% vs. 36.9%, p < 0.0001).

Conclusion

The overall proportion of sickness certification for acute cough/LRTI was similar in Norwegian and Polish patients. However, in the Polish sample, GPs more often advised patients to take time off work without issuing a sick note. When sickness certificates were issued, duration of longer than seven days was more common in Polish than in Norwegian patients.Key Words: Acute cough, adults, GRACE-LRTI, primary care, sickness certificationIncreased numbers and duration of sickness certificates implies decreased productivity.

• Proportion of patients with cough/LRTI issued with sickness certificate was similar in the Polish and Norwegian sample.
• Duration of sickness certification was generally longer in Poland, but the Norwegian patients waited longer before visiting a GP.
• The Norwegian GPs were less likely to give advice to stay at home without issuing a sickness certificate.

Increased numbers and duration of sickness certificates implies decreased productivity. The Organization for Economic Cooperation and Development (OECD) in 2006 expressed concern about government spending on sickness and disability in Norway and Poland. Both countries spend a greater proportion of gross domestic product (GDP) on sickness and disability than the average for OECD countries [1]. A systematic review of sickness certification in Europe concluded that there was a general lack of research documenting the rate of sickness certification across Europe [2] and a need for comparable rates of certification.In Norway, respiratory tract disorders accounted for 18.0% of sickness spells certified by physicians in 2007 and 17.0% in 2008 [3]. Corresponding figures in Poland were 28.3% in 2007 and 27.0% in 2008 [4]. The average lengths of certificates in 2007 and 2008 were 5.5 and 5.6 workdays in Norway and 6.3 and 7.0 in Poland, respectively. The RTI sickness spells are generally short and the 17.0% of sickness spells accounted for 7.0% of workdays off in Norway in 2008. In a typical GP''s practice, respiratory tract disorders accounted for 13.0% of consultations in 2006 [5].Whereas self-certification of illness has not been implemented in Poland, some 56% of Norwegian employees are entitled to use self-certification for up to eight-day periods of illness but it may not exceed a total of 24 days a year [6]. The remainder are entitled to up to four periods of up to three days of self-certification. This right enables many short spells off work without consulting GPs and may explain some of the differences in the proportion of all sickness periods. The compensation rate is 100% benefits from day one in Norway compared with 80% in Poland. The employer pays for the first 16 days in Norway and 30 days in Poland.The aim of this study was to compare the frequency and duration of sickness certificates issued by GPs to Polish and Norwegian working adults with acute cough/lower respiratory tract infection (LRTI) and to add an additional perspective to the problems physicians experience in sickness certification in both countries.     

Sickness absence due to musculoskeletal diagnoses and risk of diagnosis-specific disability pension: A nationwide Swedish prospective cohort study

Musculoskeletal disorders constitute major public health problems. Few studies have, however, examined risk of disability pension among persons sickness absent due to musculoskeletal diagnoses. Thus, we constructed a prospective nationwide population–based cohort study based on Swedish registers, consisting of all 4,687,756 individuals living in Sweden December 31, 2004/2005, aged 20–64 years, who were not on disability or old-age pension. Those individuals who were sickness absent in 2005 due to musculoskeletal diagnoses were compared to those sickness absent due to non-musculoskeletal diagnoses and those with no sickness absence. Musculoskeletal diagnoses were categorized as follows: 1) artropathies/systemic connective tissue disorders, 2) dorsopathies, and 3) soft tissue disorders/osteopathies/chondropathies/other musculoskeletal disorders. All-cause and diagnosis-specific incident disability pension were followed from 2006 to 2009. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In models adjusted for socio-demographic factors and morbidity, sickness absence due to all categories of musculoskeletal diagnoses was associated with 12- to 18-fold increased risks of all-cause disability pension (adjusted model, category 2 diagnoses, IRR = 18.57, 95% CI = 18.18–18.97). Similar associations were observed among both women and men sickness absent due to all 3 musculoskeletal diagnostic categories. Moreover, increased risks of disability pension because of cancer, mental, circulatory and musculoskeletal diagnoses were observed among individuals sickness absent because of any musculoskeletal diagnostic category (disability pension due to musculoskeletal diagnoses, adjusted model, category 2 diagnoses, IRR = 50.66, 95% CI = 49.06–52.32). In conclusion, this nationwide cohort study reveals strongly increased risks of all-cause and diagnosis-specific disability pension among those sickness absent due to musculoskeletal diagnoses.     

Utilisation of health care system by chronic pain patients who applied for disability pensions.

The objective of this study was to investigate how economic compensation for disability (disability pensions) to chronic pain patients affected their utilisation of health care services. The study was carried out as a register investigation. Inclusion of 144 study patients was based on records from 1989 and 1990 of the Rehabilitation and Pension Board in the Municipality of Copenhagen. Only patients of Danish origin with chronic non-malignant pain were included. The study period was divided into three: Subperiod 1: The year preceding the submission of the application for a disability pension. Subperiod 2: The period from the submission of the application to the decision was made. Subperiod 3: The year following the final decision of the health authorities. The patients were divided into 4 Subgroups according to whether disability pensions was awarded or rejected, or whether the patients accepted or appealed the decision. Based on number and charges of visits to the GPs the total costs of care in the primary sector were calculated. By means of number of bed days, visits to outpatients clinics, operations, blood samples, and various investigations, the total costs of hospital care were calculated. We found that application for a disability pension in chronic pain patients significantly influenced the health care utilisation. Chronic pain patients had a significantly lower health care utilisation after receiving a disability pension than before the pension was awarded. Chronic pain patients who did not get a disability pension and those who were not satisfied with the level of the pension awarded, maintained their health care utilisation after the decision. The mean health care use by the patients who appealed the level of the pension was three times higher than the mean health care use by the patients who accepted the level of the pension awarded. The study may indicate that lack of or insufficient economic compensation from the social system in chronic pain patients contribute to an inexpedient pain behaviour resulting in increased expenses for the health care sector.     

Health,quality of life,social network and use of health care: A comparison between those granted and those not granted disability pensions

Purpose. The aim was to compare self-rated health, health-related quality of life (HRQoL), social networks and health care utilisation of those granted disability pension (DP) and those not granted disability pension (nDP).

Method. Demographic data and medical diagnoses were obtained from the records of the social insurance office. Data

concerning self-reported health, HRQoL social networks, and use of health care were collected by a postal questionnaire.

The nDP group included all those not granted full DPs between 1999 and 2000 (n?=?99). The DP group were a random sample of those granted full DPs, during the same period (n?=?197).

Results. The nDP group had more often multiple diagnoses, and lower self-reported health and HRQoL compared to those granted DP. In particular, their average scores were lower on the SF-36 scales social functioning, role limitations due to physical problems and mental health. The nDP group also had significantly smaller social networks.

Conclusions. Contrary to expectations, those not granted a disability pension do not seem to have better health, but rather to suffer from more sickness than those who were granted a disability pension.     

Alcohol and health: a drink a day won't keep the doctor away

We should not advise patients to start drinking alcohol for its alleged cardiovascular benefits. The negative effects of alcohol are well established, and the evidence of alcohol's benefits comes mainly from epidemiologic studies that were not well controlled for other influences, such as lifestyle factors. Moreover, we have other means of lowering cardiovascular risk that are safe and proven. Those who are healthy and whose drinking history shows little risk of developing alcohol dependency may continue to drink moderate amounts. Heavy drinkers should be advised to quit.     

Predictive factors for 1-year and 5-year outcome for disability in a working population of patients with low back pain treated in primary care

Many patients seeking primary care for low back pain continue to report disability several years after their initial visit. The aims of this study were to assess the independent predictive value of a number of potential predictive factors for disability at the 1-year and 5-year follow-ups, and to examine whether prediction models were improved by replacing baseline health-state-related variables with corresponding variables after treatment. A further aim was to describe possible differences between those on sick leave, early retirement or disability pension, and those who were not. Baseline factors were age, gender, self-reported physical-activity-related and work-related factors, expectations of treatment, similar problems previously, duration of episode, more than one localization, sick leave, pain frequency, disability, and well-being. The study sample comprised 148 participants in a previous randomized trial who were eligible for sick-leave benefits. Multiple logistic regression was used to identify predictive factors. At the 5-year follow-up, 37% (n=19/52) of the patients with disability were on sick leave or were receiving early retirement or disability pension. For those without disability the corresponding figure was 9% (n=8/92). Being a woman, duration of the current episode, similar problems during the previous 5 years, exercise level before the current episode, pain frequency at baseline, and disability after treatment emerged as predictive factors for disability at the 5-year follow-up. Replacing baseline health-state-related measures with corresponding measures after the treatment period, and adding physical-activity-related and possibly work-related factors might improve the likelihood of predicting future disability.     

A tipple a day keeps the cardiologist away

Regular and moderate drinking throughout the week confers a low risk of IHD whereas binge drinking is associated with a higher risk, a study comparing drinking habits in France and the UK has found. Binge drinkers had almost twice the risk of MI or coronary death compared with regular drinkers. The Prospective Epidemiological Study of Myocardial Infarction (PRIME) study, in the BMJ, investigated the effects of alcohol intake patterns on the incidence of IHD in two countries with contrasting lifestyles. Overall, 683 of the 9,778 (7.0%) participants experienced IHD events during the 10 year follow-up of which 322 (3.3%) were hard coronary events and 361(3.7%) angina events. The annual incidence of hard coronary events per 1,000 person years was 5.63 in Belfast and 2.78 in France. After adjustment for classic cardiovascular risk factors and centre, although interestingly not for diet, the hazard ratio for hard coronary events for binge drinkers compared with regular drinkers was 1.97 The hazard ratio for never drinkers compared with regular drinkers was 2.03 and 1.57 for former drinkers compared with regular drinkers.     

Relation of drinking alcohol to atherosclerotic risk in type 2 diabetes

OBJECTIVE: The effects of drinking alcohol on atherosclerotic risks were investigated in 194 type 2 diabetic patients to determine whether drinking alcohol influences risk of atherosclerosis in diabetic subjects. RESEARCH DESIGN AND METHODS: The subjects were divided by the degree of their average weekly alcohol consumption into three groups: nondrinkers, light drinkers (ethanol consumption <210 g/week), and heavy drinkers (ethanol consumption > or = 210 g/week). The degree of atherosclerotic progression was evaluated using aortic pulse wave velocity (a-PWV), and possible atherosclerotic risks were evaluated using known atherosclerotic risk factors. RESULTS: a-PWV was significantly lower in light drinkers than in nondrinkers and heavy drinkers, but there was no significant difference in a-PWV between nondrinkers and heavy drinkers. Systolic blood pressure, HDL cholesterol, and triglyceride levels were significantly higher in heavy drinkers than in nondrinkers and light drinkers, whereas there was no significant difference in these levels between nondrinkers and light drinkers. The mean levels of BMI and blood HbA(1c), uric acid, and fibrinogen were not different between the three groups. There were significant positive correlations of a-PWV with age and systolic blood pressure and weak but significant negative correlations of a-PWV with alcohol consumption and HDL cholesterol level. CONCLUSIONS: Light drinking, but not heavy drinking, has preventive effects on atherosclerosis in type 2 diabetic subjects. The known beneficial effects of drinking alcohol on blood lipids and fibrinogen may not be involved in the preventive effect of light drinking on atherosclerosis in diabetic subjects.