[Mortality among drug addicts in Bologna - A cohort study (1977-1997)]

Our study concerns the life status at the 31st december1997 of 1214 DA (drug addicts, mostly heroin addicted), enrolled by a SerT (Servizio per Tossicodipendenti, DA Healthcare Unit) in Bologna over the 1977-1996 period. All subjects were categorised by their HIV status (positive, negative or unknown), life status (alive or dead) and cause of death. Data were analysed with the Chi-square test and the test of difference between two proportions. We calculated the standard mortality ratio (SMR), the mortality rates per 100 person-years (P-Y), and the death probability according to Grevile's formula, both in the population of Bologna and in our DA population. We observed 182 deaths (14.99%) among the 1214 monitored over a 8012 person-year period. From 1984 to 1997 the mortality rate in the DA population was 2.27 per 100 P-Y. In the 1986-1996 period the death probability among DA was 4-to 5-fold higher than in the general population for the same age groups. From 1977 to 1983 no disease was recorded among the first 200 enrolled subjects. From 1984 to 1977 mortality was 28.1% among the 426 HIV-positive DA, 0.46% among the 433 HIV-negative DA, and 17.1% among the 355 DA with unknown HIV status. AIDS caused 106 deaths (58%), overdoses 40 (22%), car accident 15 (8%), hepatic cirrhosis 9 (5%), and other causes (miscellany) 11 (6%). In 1 (0.5%) case the cause of death was unknown. The mortality rate (MR) for AIDS was 12.8% for females, 7.4% for males (p<0.05); the MR for overdose was 3.8% for males, 0% for females; the MR for car accident was 1.2% for males, 1.3% for females; the MR for the miscellany of other causes was 1.3% for males and 0% for females. The SMR in the 20-49 age group in the 1984-1990 period was 34.7, while in the 1991-1996 period it was 143.4.