The prevalence and sociodemographic correlates of high-risk and problem drinking at an industrial worksite

The Interaction of Inflammatory Markers and Alcohol-Use on Cognitive Function in Korean Male Firefighters

OBJECTIVE

Cognitive functions have been shown to become impaired due to alcoholism. Recently, neuroinflammation gained attention for playing a role in the neurotoxic effect of alcohol. However, there is limited data on the relationship between alcohol and cognitive function, based on the mechanism of inflammation. This study examined whether the interaction between alcohol use and pro-inflammatory biomarkers is related to cognitive function in Korean male firefighters.

METHODS

A total of 474 firefighters were assessed for alcohol-related problems using CAGE, cognitive functions, and pro-inflammatory biomarkers (CRP, IL-6, TNF-α). Sequential multiple regression analyses were conducted to determine if inflammatory markers moderate the relationship between alcohol use and cognitive function.

RESULTS

Only a decreased attentional function was associated with the interaction of alcohol use and inflammatory markers, after controlling for age, sex, body mass index, lipid profiles, smoking, depression, fatigue, self-reported hypertension, diabetes, and musculoskeletal problems.

CONCLUSION

This study revealed that the interaction between alcohol use and inflammation is related to attentional function in Korean male firefighters. Additionally, this cross-sectional study suggests that diminishing attention, related to alcohol use, may be based on the mechanism of inflammation.

Gender Differences in the Association between Positive Drinking Attitudes and Alcohol-Related Problems. The WIRUS Study

Background: Alcohol consumption is deeply integrated in people's social- and work lives and, thus, constitutes a serious public health challenge. Attitudes toward drinking stand out as important predictors of drinking, but have to date been sparsely studied in employee populations. This study explores the association of employees' attitudes toward drinking with their alcohol-related problems, and whether this association is moderated by gender and employment sector. Methods: Cross-sectional data were collected from a heterogeneous sample of employees (N = 4094) at 19 Norwegian companies. Drinking attitudes were assessed using the Drinking Norms Scale. The AUDIT (Alcohol Use Disorders Identification Test) scale was then used to assess any alcohol-related problems. Data were analyzed using chi-square tests, analysis of covariance (ANCOVA), and multiple logistic regression. Results: Employees with predominantly positive drinking attitudes were almost three times as likely to report alcohol-related problems compared to employees with more negative drinking attitudes (OR = 2.75; 95% CI: 2.00-3.76). Gender moderated the association between positive drinking attitudes and alcohol-related problems (OR = 3.30; 95% CI: 2.10-5.21). The association was stronger in women (OR = 5.21; 95% CI: 3.34-8.15) than in men (OR = 3.10; 95% CI: 2.11-4.55). Employment sector did not moderate the association between drinking attitudes and alcohol-related problems. Conclusions: Employee attitudes toward alcohol should be monitored to better enable early workplace health promotion interventions targeting alcohol problems. These interventions might need to be gender-specific.

Current practices and perceived implementation barriers for working with alcohol prevention in occupational health services: the WIRUS OHS study

BACKGROUND

Alcohol is associated with detrimental health and work performance outcomes, and one to three out of ten employees may benefit from interventions. The role of occupational health services (OHS) in alcohol prevention has received little attention in research. The primary aims of this study were to explore current practices of alcohol prevention targeting employees in occupational health settings, and examine whether and which perceived implementation barriers were associated with alcohol prevention activity. The secondary aim was to explore whether barriers were differentially associated with primary, secondary and tertiary prevention activities.

METHODS

In this cross-sectional study, survey data were collected from 295 OHS professionals in Norway in 2018. Data were analysed by means of descriptive statistics, one-way analysis of variance, paired samples t-tests, and multivariate linear regression analyses.

RESULTS

Overall, seven out of ten OHS professionals worked with alcohol-related cases less than monthly, while only one out of ten did so on a weekly basis. Their activities were more focused on tertiary prevention than on primary and secondary prevention. Physicians, psychologists and nurses reported to handle alcohol-related issues more often than occupational therapists and physical therapists. Higher levels of implementation barriers internal to the OHS' organisation (competence, time and resources) were associated with lower alcohol prevention activity. Barriers external to the OHS' organisation (barriers concerning employers and employees) were not. This pattern was evident for primary, secondary and tertiary prevention activities. A majority of OHS professionals agreed that employees' alcohol consumption constitute a public health challenge, and that OHS' should focus more on alcohol prevention targeting employees.

CONCLUSIONS

Occupational health settings at workplaces may be particularly serviceable for alcohol prevention programmes since the majority of the population is employed and the majority of employees consume alcohol. An increase in overall prevention activity, and a shift from mainly focusing on tertiary prevention to an increased emphasis on primary and secondary prevention, may both hinge on increased training of OHS professionals, emphasising knowledge on the importance of working with alcohol prevention, and training in administering alcohol prevention programmes. Making alcohol prevention a priority may also require increased allocation of time and resources.

The associations between employees' risky drinking and sociodemographics, and implications for intervention needs

Background

Harmful alcohol consumption is a major risk factor for ill-health on an individual level, a global public health challenge, and associated with workplace productivity loss. This study aimed to explore the proportion of risky drinkers in a sample of employees, investigate sociodemographic associations with risky drinking, and examine implications for intervention needs, according to recommendations from the World Health Organization (WHO).

Methods

In a cross-sectional design, sociodemographic data were collected from Norwegian employees in 14 companies (n = 3571) across sectors and branches. Risky drinking was measured with the Alcohol Use Disorders Identification Test (AUDIT). The threshold for risky drinking was set at ≥8 scores on the AUDIT. Based on WHO guidelines, risky drinkers were divided into three risk categories (moderate risk: scores 8–15, high risk: scores 16–19, and dependence likely risk: scores 20–40). The association between sociodemographic variables and risky drinking were explored with chi square tests for independence and adjusted logistic regression. The risk groups were then examined according to the WHO intervention recommendations.

Results

11.0% of the total sample reported risky drinking. Risky drinking was associated with male gender (OR = 2.97, p < .001), younger age (OR = 1.03, p < .001), low education (OR = 1.17, p < .05), being unmarried (OR = 1.38, p < .05) and not having children (OR = 1.62, p < .05). Risky drinking was most common among males without children (33.5%), males living alone (31.4%) and males aged ≤39 (26.5%). 94.6% of risky drinkers scored within the lowest risk category. Based on WHO guidelines, approximately one out of ten employees need simple advice, targeting risky drinking. In high-risk groups, one out of three employees need interventions.

Conclusions

A considerable amount of employees (one to three out of ten), particularly young, unmarried males without children and higher education, may be characterised as risky drinkers. This group may benefit from low-cost interventions, based on recommendations from the WHO guidelines.

Circadian phase determines effects of repeated ethanol vapor exposure and withdrawal on body temperature and activity rhythms of male mice

BACKGROUND

Physiological responses to acute ethanol (EtOH) injection depend critically on the timing of their administration. Whether daily timing modulates effects of longer intoxication intervals characteristic of alcohol-dependent humans remains unknown. The present work examines time-of-day effects during EtOH exposure and withdrawal measured by locomotor activity (ActLoc ) and body temperature (Tb ) across multiple rounds of EtOH exposure/withdrawal.

METHODS

Two groups of C57BL/6J mice (n = 8 per group), implanted with radio-telemeters, were entrained to opposite light-dark periods (14:10 LD cycle) so that their rest/activity cycles were 12 hours apart. Under a 2-hour skeleton photoperiod animals were simultaneously exposed to 3 daily cycles of EtOH vapor inhalation (14 hours EtOH on) and withdrawal (10 hours EtOH off). During this time, air-only control groups (n = 4 per group) matched for entrainment were handled in a comparable manner. After the third cycle of EtOH vapor, the animals were left undisturbed for 11 days to recover. The 14-day protocol was repeated 3 additional times.

RESULTS

During intoxication, mice exposed to EtOH in the subjective night exhibited greater hypothermia and more overall disruptions in the Tb and ActLoc rhythms. Acute withdrawal induced hypothermia during the subjective night and hyperthermia during the subjective day. Animals in both phases demonstrated significant disruptions in ActLoc during withdrawal. ActLoc had little effect on Tb during EtOH exposure, but it significantly influenced Tb during acute withdrawal.

CONCLUSIONS

The physiological responses of both EtOH exposure and withdrawal differ as a function of time of day. These findings suggest that controlling for the circadian phase of exposure and/or withdrawal may mitigate the severity of symptomatic withdrawal.

Ethanol consumption in mice: relationships with circadian period and entrainment

A functional connection between the circadian timing system and alcohol consumption is suggested by multiple lines of converging evidence. Ethanol consumption perturbs physiological rhythms in hormone secretion, sleep, and body temperature; and conversely, genetic and environmental perturbations of the circadian system can alter alcohol intake. A fundamental property of the circadian pacemaker, the endogenous period of its cycle under free-running conditions, was previously shown to differ between selectively bred high- (HAP) and low- (LAP) alcohol preferring replicate 1 mice. To test whether there is a causal relationship between circadian period and ethanol intake, we induced experimental, rather than genetic, variations in free-running period. Male inbred C57Bl/6J mice and replicate 2 male and female HAP2 and LAP2 mice were entrained to light:dark cycles of 26 or 22 h or remained in a standard 24 h cycle. On discontinuation of the light:dark cycle, experimental animals exhibited longer and shorter free-running periods, respectively. Despite robust effects on circadian period and clear circadian rhythms in drinking, these manipulations failed to alter the daily ethanol intake of the inbred strain or selected lines. Likewise, driving the circadian system at long and short periods produced no change in alcohol intake. In contrast with replicate 1 HAP and LAP lines, there was no difference in free-running period between ethanol naïve HAP2 and LAP2 mice. HAP2 mice, however, were significantly more active than LAP2 mice as measured by general home-cage movement and wheel running, a motivated behavior implicating a selection effect on reward systems. Despite a marked circadian regulation of drinking behavior, the free-running and entrained period of the circadian clock does not determine daily ethanol intake.

Self-perceived stress reactivity is an indicator of psychosocial impairment at the workplace

Background

Work related stress is associated with a range of debilitating health outcomes. However, no unanimously accepted assessment tool exists for the early identification of individuals suffering from chronic job stress. The psychological concept of self-perceived stress reactivity refers to the individual disposition of a person to answer stressors with immediate as well as long lasting stress reactions, and it could be a valid indicator of current as well as prospective adverse health outcomes. The aim of this study was to determine the extent to which perceived stress reactivity correlates with various parameters of psychosocial health, cardiovascular risk factors, and parameters of chronic stress and job stress in a sample of middle-aged industrial employees in a so-called "sandwich-position".

Methods

In this cross-sectional study, a total of 174 industrial employees were assessed for psychosocial and biological stress parameters. Differences between groups with high and low stress reactivity were analysed. Logistic regression models were applied to identify which parameters allow to predict perceived high versus low stress reactivity.

Results

In our sample various parameters of psychosocial stress like chronic stress and effort-reward imbalance were significantly increased in comparison to the normal population. Compared to employees with perceived low stress reactivity, those with perceived high stress reactivity showed poorer results in health-related complaints, depression, anxiety, sports behaviour, chronic stress, and effort-reward imbalance. The educational status of employees with perceived low stress reactivity is higher. Education, cardiovascular complaints, chronic stress, and effort-reward imbalance were moderate predictors for perceived stress reactivity. However, no relationship was found between stress reactivity and cardiovascular risk factors in our sample.

Conclusions

Job stress is a major burden in a relevant subgroup of industrial employees in a middle management position. Self-perceived stress reactivity seems to be an appropriate concept to identify employees who experience psychosocial stress and associated psychological problems at the workplace.

Service to Others in Sobriety (SOS)

Alcoholics Anonymous participation has been measured in addiction research, but few validated tools distinguish components of this multi-dimensional construct. This study provides psychometric findings for the scale "Service to Others in Sobriety (SOS)", a brief assessment of AA-related helping (AAH). Data are derived from a sample of treatment-seeking alcoholics, and SOS validity and response stability is reported by using a test-retest sample. Findings demonstrated adequate psychometric properties of the SOS, including convergent validity, internal consistency (alpha=0.92) and test-rest reliability (r=0.94). The SOS is a valid measure of AAH activities pertinent to the daily lives of recovering alcoholics.

Prevalence and patterns of alcohol use in the Australian workforce: findings from the 2001 National Drug Strategy Household Survey

AIMS

To describe Australian workers' prevalence and patterns of alcohol use.

DESIGN

A secondary analysis of the 2001 National Drug Strategy Household Survey.

PARTICIPANTS

A total of 13 582 workers > or = 14 years old.

MEASUREMENTS

Alcohol consumption levels associated with National Health and Medical Research Council (NHMRC) guidelines for short- and long-term harm were stratified by occupation and industry.

FINDINGS

Approximately 8% of the workforce drank at least weekly at short-term risky or high risk levels, 17% drank at least monthly, 18% drank at least yearly and 11% drank at long-term risky or high risk levels. The prevalence of risky or high risk drinking was higher for younger than for older workers. Controlling for socio-demographic factors, the risk of workers frequently drinking at levels associated with short-term harm was lowest in the education industry and significantly higher in the hospitality, agriculture, manufacturing and construction industries. Drinking patterns associated with long-term harm were more prevalent in the agriculture, retail and manufacturing industries, compared to the education industry. Drinking patterns associated with both short- and long-term harm were more prevalent for blue-collar workers than professionals.

CONCLUSIONS

Risky and high risk drinking occurred at least occasionally in 44% of Australian workers. Workers in the hospitality, agriculture, manufacturing, construction and retail industries, workers in blue-collar occupations and young workers were identified as at-risk subgroups. These data provide evidence that patterns of consumption differ between occupational and industry groups, and highlight the pressing need to develop policies, prevention and intervention strategies to reduce harmful alcohol use in Australia, particularly among young adults.

Dispositional correlates of addictive behaviors in college women: binge eating and heavy drinking

Binge eating and alcohol abuse are often conceptualized as addictive behaviors. As these behaviors are relatively common among undergraduate college women, we examined whether common dispositional variables underlie their occurrence. Three hundred and thirty-five undergraduate women completed self-report questionnaires about their eating and alcohol use habits as well as dispositional measures of impulsivity, tolerance of deviance, self-esteem, rejection sensitivity, extraversion-introversion, conscientiousness, and emotional stability. Multiple regression analyses showed that women who either binge eat or abuse alcohol, but not both, have similar dispositional characteristics. Both groups exhibited a high degree of impulsivity and endorsed socially deviant attitudes; thus, both groups could be viewed as "externalizers." In contrast, women who admitted to both addictive behaviors, i.e., binge eating as well as alcohol abuse, were not particularly impulsive or socially deviant, but manifested a high degree of emotional instability ("neuroticism"); thus, these women might be considered "internalizers." The theoretical and clinical implications of these findings are discussed.

Avaliação de instrumento de detecção de problemas relacionados ao uso do álcool (CAGE) entre trabalhadores da prefeitura do campus da Universidade de São Paulo (USP) - campus capital

O uso do álcool pode ser responsável por acidentes, atrasos e faltas no trabalho. Sua detecção é limitada pelas dificuldades de pacientes e médicos quanto ao assunto. O questionário CAGE pode ser uma alternativa fácil, rápida e pouco intimidativa na detecção dos problemas relacionados ao uso de álcool (PRA). OBJETIVOS: Avaliar os indicadores de validade do CAGE - sensibilidade (S), especificidade (E), valor preditivo positivo, VPP e a área sob a curva ROC, ASC - entre funcionários da Prefeitura da Cidade Universitária, utilizando a Entrevista Clínica Estruturada para o DSM-IV, a SCID 2.0. MÉTODOS: Foram selecionados aleatoriamente 203 funcionários para entrevista com um questionário sociodemográfico seguido do CAGE e da SCID 2.0 Os indicadores de validade do CAGE foram analisados através dos resultados da SCID 2.0 para abuso e dependência do álcool e os dados sociodemográficos pelo cálculo do qui-quadrado. RESULTADOS: Entre os 192 funcionários entrevistados, a prevalência do CAGE positivo foi 19,8%, com os seguintes indicadores de validade para a detecção de PRA: S=84,4%, E=93,1%, VPP=71,1% e ASC=0,88 (p<0,01) e para dependência do álcool: S=91,3%, E=89,9%, VPP=55,3% e ASC=0,90 (p<0,01). Houve associações significativas entre o CAGE positivo e as seguintes características: 1) faixa etária de 61 anos ou mais (p=0,04); 2) sexo masculino (p=0,01); e 3) função operacional (p=0,02). CONCLUSÕES: O CAGE teve menos falsos positivos na detecção de PRA (abuso e dependência) que na detecção de dependência do álcool isoladamente. Os resultados para faixa etária e sexo podem refletir limitações do CAGE. Funções operacionais podem indicar um risco para PRA. O CAGE foi considerado válido na detecção de PRA no local de trabalho.

Evaluation of a workplace brief intervention for excessive alcohol consumption: the workscreen project

BACKGROUND

The workplace provides a useful setting for early identification and intervention with individuals who have unhealthy lifestyles. The objective was to evaluate the effects of a workplace-based lifestyle intervention (Workscreen) to reduce excessive drinking.

METHOD

There were eight Australia Post networks randomly allocated to experimental and control conditions, comprising 67 worksites and 1206 employees. The experimental condition involved a broad spectrum lifestyle campaign, incorporating support from management, employee awareness of health, and brief interventions for high-risk behaviors, including excessive alcohol use. Focus groups identified relevant cultural factors. Changes in workplace culture and employee behavior were assessed 10 months after baseline. Males and females were analyzed separately.

RESULTS

Over half of APOST employees participated at each screening point. In the experimental condition 61% of employees overall and 58% of those identified as excessive drinkers in Phase 1 responded to the lifestyle campaign by attending health assessments. Analyses focusing on the organization as a whole did not reveal significant reductions in excessive alcohol consumption among men or women. However, a significant reduction in number of drinks was observed in the experimental condition among women for whom completion of baseline and follow-up could be confirmed (P < 0.001).

CONCLUSIONS

The present study indicates that a workplace-based lifestyle campaign can assist self-selected employees in reducing their alcohol consumption. There was a moderately high level of participation among those identified as drinking excessively, which supports our approach of embedding a low-intensity alcohol program within the context of a broader health promotion campaign.

A filter model to describe bias in official statistics on alcohol-related injuries

The paper describes a filter model that can be used to explore the possible biases that occur in reporting of alcohol-related injuries. These biases occur because of loss of data at various stages of injury reporting systems. The filter model consists of four levels or incidences, with a filter between each level. Level 1 is the total incidence of alcohol-related injuries. Level 2 is the incidence of reported alcohol-related injuries. Level 3 is the incidence of reported alcohol-related injuries where the contribution of alcohol has been correctly identified. Level 4 consists of official statistics on alcohol-related injuries. Between each of these levels is a filtering mechanism that allows some but not all data to pass through to the next level. The paper describes the nature of data at each level and the mechanisms operating at each filter to result in progressive loss of data. Estimates are provided regarding the extent of loss of data at each filter. Suggestions are provided for improving the quality of official statistics on alcohol-related injuries.

The Relationship between Work-Specific and Generalized Stress and Alcohol and Marijuana Use among Recent Entrants to the Labor Force

This study examined changes in alcohol and marijuana use and problem in relation to the transition into full-time work, and the effects of work-related and generalized stress among a group of recent entrants to the labor force. Data were obtained from a sample of males and females who were originally interviewed when they were eighteen years old and followed up twice more at three year intervals. We hypothesized that those who transit into and maintain a full-time job will not increase their level of consumption if they find the job to be the “right fit.” The data indicated that when age, gender, and marital status were controlled, there were few significant effects of the transition to full-time work on use measures. Data from this study provided evidence of a stronger role for generalized stress over that of work-specific stress in predicting changes in drug use in young adulthood.

[Addiction problems in the occupational environment]

The article discusses the context of a topic currently very much under discussion in Switzerland. It provides reflections on the concept of "addiction"--better replaced by "dependence syndrome"--and summarizes the few research results concerning the Swiss situation. Due to the lack of basic epidemiological data the prevalence of "dependence-related" problems at the work place and the actual consequences and costs of substance abuse can only be estimated. In a society with rapidly changing working conditions and requirements the common stereotypes of "alcohol-prone" occupations need a critical revision. Theoretical hypotheses are most advanced in the area of substance abuse in relationship to work-related stress coping.

The relationship between stressful working conditions and high alcohol consumption and severe alcohol problems in an urban general population

The relationship between 15 measures of stressful working conditions and high alcohol consumption (35 g 100% ethanol per day or more for men and 25 g or more for women) was studied, using cross-sectional data from a general population survey of 1344 males and 1494 females; the ages 25-64 years in metropolitan Stockholm in 1984. In a longitudinal component of the study, hospitalization and mortality with alcohol-related diagnosis was assessed during 1984-90, and also the association between previous experience of unemployment and high alcohol consumption. Some of the associations, expressed as age-adjusted odds ratios, were positive and some were negative when high alcohol consumption was the endpoint, but there was a clear variation by sex and social class. Generally the positive associations were stronger among male non-manual employees. Among males, there was a clear association between stressful working conditions and subsequent risk of severe medical alcohol-related problems, but the precision of the estimates was low due to low number of cases. The odds ratio was 6.18 (95% confidence interval 1.86, 20.61) for twisted working positions and 6.74 (95% confidence interval 1.67, 27.19). Previous unemployment among males was associated with increased risk for high alcohol consumption, with an odds ratio of 5.71 (95% CI 1.39, 15.97) among those who had been unemployed more than once, and 1.67 (95% CI 0.76, 3.64) among those who had been unemployed once during the previous 5 years. Those and other increased odds ratios were lower when subjects with an alcohol diagnosis at inpatient care during 1980-84 were excluded in the analyses. On the whole, our findings are not conclusive. The strong, but imprecise associations between stressful working conditions and severe alcohol problems, are however challenging, and warrants further studies, preferably with longitudinal design and repeated measurements of both working condition and alcohol habits.

Prevalence and demographic correlates of alcohol-related problems in Japanese employees

To examine the relationship of basic sociodemographic characteristics to alcohol-related problem in Japanese employees, a questionnaire survey was conducted of a total of 2,581 employees of a computer factory in a suburb of Tokyo. The questionnaires included items on gender, age, marital status, social class (i.e., education, family income and occupation), alcohol consumption, and the Kurihama Alcoholism Screening Test (KAST). Data from 1098 male and 265 female current drinkers aged 20 years or older were analyzed; 15% and 6% of the male and female subjects, respectively, were classified as having alcohol-related problems on the basis of the KAST score (13% and 4% of the entire study population, respectively). Multiple logistic regression analysis indicated that alcohol-related problems were more prevalent in the less educated, managers and those who had a high alcohol consumption. The results suggested that education and occupation are important factors related to alcohol-related problems in Japanese employees.

The reliability and stability of a quantity-frequency method and a diary method of measuring alcohol consumption

The study aimed to assess the test-retest reliability of two commonly used measures of alcohol consumption, the quantity-frequency (QF) method and the diary method, as well as the stability of scores on the two measures over time. Two methods of assessing reliability and stability were employed. The first was a traditional method based on calculation of correlation coefficients for agreement between scores on repeated measures over a short retest interval to yield test-retest reliability coefficients, and over a long retest interval to yield stability coefficients. The second method was that devised by Wiley and Wiley (1970) to differentiate the effects of reliability and stability on repeated measures over time. The two methods were applied to a sample of heavy drinkers and to a sample of light drinkers. The results indicated that both the QF and diary measures are reliable in measuring alcohol consumption of light drinkers. Both measures are less reliable for heavy drinkers. The results indicate, in addition, that drinking consumption levels of light drinkers demonstrate a high degree of stability. However, the consumption levels of heavy drinkers demonstrate less stability, especially over a long time period. Heavy drinkers significantly reduced reported levels of alcohol consumption on both measures after the first test, suggesting a regression to the mean effect or the possibility of unintended intervention effects due to repeated measurement of drinking behaviour.