Association between alcohol consumption and impaired work performance (presenteeism): a systematic review

Alcohol use and alcohol use disorders in sub-Saharan Africa: A systematic review and meta-analysis

BACKGROUND AND AIMS

Population-level alcohol use data are available from high-income countries, but limited research has been conducted in sub-Saharan Africa. This systematic review and meta-analysis aimed to summarize population-level alcohol use in sub-Saharan Africa.

METHOD

Databases searched included PubMed, EMBASE, PsycINFO and AJOL, without language restrictions. Searches were also conducted in the Global Health Data Exchange (GHDx) and Google Scholar. Search terms encompassed 'substance' or 'substance-related disorders' and 'prevalence' and 'sub-Saharan Africa'. We included general population studies on alcohol use (including any use, high-risk alcohol use and alcohol use disorders) from 2018 onwards. Prevalence data for alcohol use among sub-Saharan African adolescents (10-17) and adults (18+) were extracted. Analyses included life-time and past 12- and 6-month alcohol use.

RESULTS

We included 141 papers. Among adolescents, the life-time prevalence of alcohol use was 23.3% [95% confidence interval (CI) = 11.3-37.1%], 36.2% (CI = 18.4-56.1%) in the past year and 11.3% (CI = 4.5-20.4%) in the past 6 months. Among adolescents, 12-month prevalence of alcohol use disorder and alcohol dependence were 7.7% (CI = 0.0-27.8%) and 4.1% (CI = 1.4-7.9%), respectively. Among adults, the life-time prevalence of alcohol use was 34.9% (CI = 17.7-54.1%), 27.1% (CI = 5.0-56.4%) in the past year and 32.2% (CI = 19.8-46.0%) in the past 6 months. Among adults, the 12-month prevalence of alcohol use disorder and alcohol dependence were 9.5% (CI = 0.0-30.4%) and 4.3% (CI = 0.8-9.8%), respectively. The highest weighted life-time prevalence of alcohol use, 86.4%, was reported in Tanzania among adults. The highest weighted past 6-month prevalence of alcohol use, 80.6%, was found in Zambia among adolescents.

CONCLUSION

Alcohol use patterns vary across countries and subregions within sub-Saharan Africa, and comprehensive population-level data on alcohol use remain scarce in numerous sub-Saharan African countries. The prevalence of alcohol use disorder is common among adolescents in sub-Saharan Africa.

The dynamic relationships between well-being, behavioral restrictions, and health behaviors during the COVID-19 pandemic: A large-scale intensive longitudinal network study

The behavioral restrictions disrupting daily life during the COVID-19 pandemic have profoundly impacted well-being, and health behaviors have been advocated to prevent decline. To understand how processes related to fluctuation in well-being unfold within individuals, analyses on the within-person level are required. In this preregistered intensive longitudinal study, 1,709 individuals from the Norwegian adult population provided data daily over 40 consecutive days during the pandemic. The responses were modeled in a multilevel vector autoregressive model to estimate within-person networks, across and within-day, and a between-person network. All three networks revealed productivity, relatedness, and optimism as positively associated. Social distancing was contemporaneously negatively associated with productivity and relatedness. Among behavioral factors, being physically active predicted lower relatedness across days but displayed positive associations with relatedness, productivity, and optimism contemporaneously. Alcohol consumption predicted lower productivity across and within-day, although revealing a positive association with optimism within-day. Being social online and feeling related to others displayed a temporal negative bidirectional relationship. In contrast, being social online was positively associated with optimism, productivity, and relatedness contemporaneously. Our study emphasizes the dynamic nature of well-being and its complex associations with behavioral factors during the pandemic. The study shed light on opposing associations of behavioral factors at the within- and between-person level.

Absenteeism, Presenteeism, and the Economic Costs of Alcohol Hangover in The Netherlands

The alcohol hangover is defined as the combination of negative mental and physical symptoms that can be experienced after a single episode of alcohol consumption, starting when the blood alcohol concentration (BAC) approaches zero. Alcohol hangover symptoms such as fatigue, nausea, and headache can negatively affect daily activities, including work performance. The alcohol hangover can therefore be a cause of both absenteeism (not going to work) and presenteeism (going to work while hungover). An online survey among a convenience sample of n = 347 Dutch adults examined the number of days of absenteeism and presenteeism associated with having a hangover as well as the loss of productivity when going to work when hungover during the year 2019. In the Dutch sample, 8.1% of employees reported one or more days of absenteeism due to hangover in 2019, and 33.4% reported one or more days of presenteeism. The analyses revealed that alcohol hangover was associated with 0.2 days of absenteeism and 8.3 days of presenteeism and a productivity loss of 24.9% on days worked with a hangover. The estimated associated costs for the Dutch economy in 2019 of absenteeism (EUR 234,538,460) and presenteeism (EUR 2,423,603,184) total EUR 2,658,141,644. In conclusion, the alcohol hangover is associated with absenteeism, presenteeism, and reduced performance at work while hungover. As such, the annual costs of the alcohol hangover have a significant impact on the Dutch economy. However, these first findings on the economic costs of the alcohol hangover should be considered a rough estimate. They should be verified in a longitudinal study to minimize recall bias, including a nationally representative sample of sufficient sample size.

Lifestyle factors associated with presenteeism among city government office workers: a cross-sectional study

OBJECTIVES

Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption.

METHODS

Anonymous data of 777 workers in a Japanese city were retrospectively obtained from City Government Office A. They included variables like absolute presenteeism scores (measured using the Japanese version of the World Health Organization Health and Work Performance Questionnaire short form), gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption. A binary logistic regression analysis was performed with gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption as the independent variables, and absolute presenteeism scores equal to or below 40 as the dependent variable. A gender-stratified binary logistic regression analysis was also performed.

RESULTS

The logistic regression analysis results revealed that absolute presenteeism was positively associated with poor subjective sleep quality among all respondents (odds ratio [OR], 1.70; 95% CI, 1.18-2.44) and men (OR, 1.85; 95% CI, 1.12-3.05) and with current drinkers among women (OR, 3.49; 95% CI, 1.36-8.92); it was negatively associated with age among those who were ≥50 years old (OR, 0.50; 95% CI, 0.27-0.93) and with current drinkers among men (OR, 0.43; 95% CI, 0.20-0.92).

CONCLUSIONS

The factors associated with presenteeism differed between men and women office workers, suggesting that gender differences need to be considered when working toward improving workers' productivity.

Presenteeism and Low Work Performance Among Fruit Farm Workers in Northeast Brazil

OBJECTIVES

The "decision" to go to work, or remain absent, when unwell undermines worker energy. I is therefore understandable that low work performance is one of the main consequences of the act of presenteeism. This study evaluated the association between presenteeism, and absolute and relative work performance among fruit farm workers in Northeast Brazil.

METHODS

A cross-sectional study investigated 340 paid employees of both sexes, aged 18 years or over, who worked during the 2019 irrigated fruit harvest in the municipality of Petrolina, Northeast Brazil. Absolute and relative work performance were measured using the Health and Work Performance Questionnaire. Workers who answered "one or more days" to the question "How many days have you worked this season when you were injured or unwell?" were considered presenteeists. Poisson regression with robust variance models was used to estimate the prevalence ratios of the main associations, adjusted for potential confounders.

RESULTS

Presenteeist workers presented lower absolute and relative work performance than non-presenteeist workers according to the strata for most of the investigated factors. The associations between presenteeism, and absolute (adjusted prevalence ratio = 1.31) and relative work performance (adjusted prevalence ratio = 1.45) remained strong, even after multiple adjustments for other relevant variables.

CONCLUSION

Presenteeist fruit culture workers self-assessed their work performance as lower than non-presenteeist ones.

Impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life of Australians: a population-based longitudinal data analysis

Background

Health risk factors, including smoking, excessive alcohol consumption, overweight, obesity, and insufficient physical activity, are major contributors to many poor health conditions. This study aimed to assess the impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life (HRQoL) in Australia.

Methods

We used two waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) Survey from 2013 and 2017 for the analysis. Healthcare resource utilization included outpatient visits, hospitalisations, and prescribed medication use. Work-related outcomes were assessed through employment status and sick leave. HRQoL was assessed using the SF-6D scores. Generalized estimating equation (GEE) with logit or log link function and random-effects regression models were used to analyse the longitudinal data on the relationship between health risk factors and the outcomes. The models were adjusted for age, sex, marital status, education background, employment status, equilibrium household income, residential area, country of birth, indigenous status, and socio-economic status.

Results

After adjusting for all other health risk factors covariates, physical inactivity had the greatest impact on healthcare resource utilization, work-related outcomes, and HRQoL. Physical inactivity increased the likelihood of outpatient visits (AOR = 1.60, 95% CI = 1.45, 1.76 p < 0.001), hospitalization (AOR = 1.83, 95% CI = 1.66-2.01, p < 0.001), and the probability of taking sick leave (AOR = 1.31, 95% CI = 1.21-1.41, p < 0.001), and decreased the odds of having an above population median HRQoL (AOR = 0.48, 95% CI = 0.45-0.51, p < 0.001) after adjusting for all other health risk factors and covariates. Obesity had the greatest impact on medication use (AOR = 2.02, 95% CI = 1.97-2.29, p < 0.001) after adjusting for all other health risk factors and covariates.

Conclusion

Our study contributed to the growing body of literature on the relative impact of health risk factors for healthcare resource utilization, work-related outcomes and HRQoL. Our results suggested that public health interventions aim at improving these risk factors, particularly physical inactivity and obesity, can offer substantial benefits, not only for healthcare resource utilization but also for productivity.

Addiction substitution and concurrent recovery in gambling disorder: Who substitutes and why?

Objectives

When individuals recover from gambling disorder, their involvement in other potentially addictive substances and behaviors may also subsequently increase (substitution) or decrease (concurrent recovery). The objectives of this study were to identify and compare recovery processes associated with substitution and concurrent recovery in gambling disorder.

Methods

A mixed-method study was conducted with 185 people who were recovered from gambling disorder. Semi-structured interviews were used to: (i) establish onset and recovery of gambling disorder as well as other substance and behavioral addictions; and (ii) assess processes (e.g., reasons, emotional state, helpfulness) associated with addiction substitution and concurrent recovery. Participants also completed a survey assessing demographic characteristics, gambling behaviors, and psychological characteristics to compare demographic and clinical differences between participants who engaged in addiction substitution, concurrent recovery, or neither (controls).

Results

The most frequently reported reason for engaging in addiction substitution was as a substitute coping mechanism. The most reported reason for engaging in concurrent recovery was due to the addictions being mutually influenced. Negative emotional states were common when engaging in both addiction substitution and concurrent recovery. Although the three groups did not differ on gambling characteristics, addiction substitution was associated with greater underlying vulnerabilities including childhood adversity, impulsivity, emotion dysregulation, and, maladaptive coping skills.

Conclusion

Transdiagnostic treatments that target the underlying mechanisms of addictions may reduce the likelihood of engaging in addiction substitution.

Prevalence and correlates of alcohol use, mental disorders, and awareness and utilization of support services among healthcare professionals in West Rand District, Gauteng, South Africa: a cross-sectional study

INTRODUCTION

Healthcare professionals (workers) are at an increased risk for developing mental and alcohol use disorders (risky drinking) due to increased psychological distress, long working hours, medical litigation, role conflict, and verbal/physical violence from colleagues and patients. Psychological well-being in healthcare workers is crucial to provide the best quality of care to patients. Current data are limited regarding alcohol abuse (risky drinking) rates and mental health condition among healthcare professionals in South Africa.

OBJECTIVES

To describe the prevalence and correlates of alcohol use disorder (risky drinking), depression, anxiety, suicidality, and covid anxiety during the coronavirus pandemic in healthcare professionals in West Rand District, Johannesburg, South Africa.

METHODS

We carried out a cross-sectional study on a sample of healthcare professionals including doctors, nurses, clinical associates, and dentists working in the West Rand District of Gauteng, South Africa, during Covid-19 pandemic. Participants were invited to complete a paper-based questionnaire addressing sociodemographic questions, a set of measures for alcohol use disorder (AUDIT-C), depression (PHQ-2), anxiety (GAD-7), suicidality (PSS-3), covid anxiety (CAS), and awareness and utilization of support services.

RESULTS

A total of 330 healthcare professionals (60.9% nurses, 33% doctors, 5.5% other) participated. Females comprised the majority of study participants with 78.8%, and 48.2% of the participants were in the age band 35-64 years. Overall, 20.9% of the healthcare professionals reported risky alcohol use. Females were 73% less likely to report risky alcohol use (AOR = 0.27;95% CI: 0.13-0.54). Prevalence of probable depression was 13.6% and female professionals were 5 times more likely to be classified as having probable depression (AOR = 4.86;95% CI: 1.08-21.90). The grouped prevalence of anxiety ranging from mild to severe was reported at 47.3%, female professionals were 3 times more likely to be classified as having anxiety disorder (AOR = 2.78;95% CI: 1.39-5.57). Furthermore, races other than African had higher rates of anxiety (AOR = 2.54; 95% CI: 1.00-6.42). The prevalence of suicide symptoms was 7.9% and that of covid dysfunctional anxiety 4.8%. Only 5% of participants were involved in an employee wellness program, with 60% expressing interest in joining one.

CONCLUSION

Alcohol use (risky drinking) and mental disorders were common among healthcare professionals in West Rand District, Johannesburg, South Africa. There is overall poor awareness and use of support structures highlighting urgent need for interventions. Future studies could also explore in-depth the drivers of mental disorders and lack of utilization of the available service and strategies to deliver alcohol and mental disorder screening, brief intervention, and referral to treatment.

Alcohol and marijuana use predicting next-day absenteeism and engagement at school and work: A daily study of young adults

This study examined effects of alcohol and marijuana use on next-day absenteeism and engagement at work and school among young adults (18-25 years old) who reported past-month alcohol use and simultaneous alcohol and marijuana use. Participants completed twice daily surveys for five, 14-day bursts. The analytic sample was 409 [64 % were enrolled in university (N = 263) and 95 % were employed (N = 387) in at least one burst]. Daily measures included: any alcohol or marijuana use, quantity of alcohol or marijuana use (i.e., number of drinks, number of hours high), attendance at work or school, and engagement (i.e., attentiveness, productivity) at school or work. Multilevel models examined between- and within-person associations between alcohol and marijuana use and next-day absenteeism and engagement at school or work. Between-persons, the proportion of days of alcohol use days was positively associated with next-day absence from school, consuming more drinks was positively associated with next-day absence from work, and the proportion of days of marijuana use was positively associated with next-day engagement at work. At the daily-level, when individuals consumed any alcohol and when they consumed more drinks than average, they reported lower next-day engagement during school and work. When individuals used marijuana and when they were high for more hours than average, they reported lower next-day engagement during school. Findings suggest alcohol and marijuana use consequences include next-day absence and decrements in next-day engagement at school and work, which could be included in interventions aimed at ameliorating harmful impacts of substance use among young adults.

Investigating the potential association of temporary employment and job dissatisfaction with alcohol use disorder and depressive symptoms: a 13-wave longitudinal analysis

BACKGROUND

There has been growing interest in protecting workers' mental health. Identifying social determinants that affect workers' mental health could play an important role in preventing psychiatric diseases.

AIMS

We investigated the effects of temporary employment and job dissatisfaction on alcohol use disorder and depressive symptoms.

METHOD

The Korea Welfare Panel Study data-set (2009-2021) was used, and 9611 participants with 52 639 observations were included. Generalised linear mixed models were employed to estimate odds ratios and 95% confidence intervals. The relative excess risk due to interaction (RERI) was calculated to assess supra-additive interactions between temporary employment and job dissatisfaction.

RESULTS

Increased risks for depressive symptoms were observed among fixed-term workers (odds ratio 1.12, 95% CI 1.00-1.26) and daily labourers (odds ratio 1.68, 95% CI 1.44-1.95). Daily labourers were associated with an increased risk of alcohol use disorder (odds ratio 1.54, 95% CI 1.22-1.95). Job dissatisfaction was associated with alcohol use disorder (odds ratio 1.78, 95% CI 1.52-2.08) and depressive symptoms (odds ratio 4.88, 95% CI 4.36-5.46). This effect became stronger when workers were concurrently exposed to temporary employment and job dissatisfaction. Daily labourers with job dissatisfaction showed the highest risks for alcohol use disorder (odds ratio 2.99, 95% CI 2.21-4.03) and depressive symptoms (odds ratio 9.00, 95% CI 7.36-11.02). RERIs between daily employment and job dissatisfaction were >0 for alcohol use disorder (0.91, 95% CI 0.06-1.76) and depressive symptoms (3.47, 95% CI 1.80-5.14), indicating a supra-additive interaction.

CONCLUSIONS

We revealed that temporary employment and job dissatisfaction had detrimental effects on alcohol use disorder and depressive symptoms.

Purchasing Under the Influence of Alcohol: The Impact of Hazardous and Harmful Patterns of Alcohol Consumption, Impulsivity, and Compulsive Buying

The current research examined how hazardous and harmful patterns of alcohol consumption, problematic online shopping when drinking alcohol, impulsivity, and compulsive buying were associated with and predicted the frequency of making purchases while under the influence of alcohol. A sample of American adults between the ages of 25 and 64 who reported having at least one drink per week over the past 6 months were surveyed. Regression-based path modeling revealed for those who made online purchases while moderately intoxicated, hazardous and harmful patterns of drinking alcohol and, problematic online shopping when drinking alcohol, predicted the frequency of making purchases while intoxicated. For those who made online purchases while heavily intoxicated, hazardous and harmful patterns of drinking alcohol, impulsivity, problematic online shopping when drinking alcohol, and compulsive buying predicted the frequency of making purchases while intoxicated. We explain our findings by suggesting individuals engage in frequent drunk purchases because they are motivated to alleviate their negative mood states.

Health check-ups as interventions for work disability management: supervisors and occupational healthcare follow the recommendations to a great extent

OBJECTIVES

Work disability management is a problem globally. This study was designed to find out whether the initiation, process and outcome of health check-ups (HCUs) follow the national legislation and whether supervisors and occupational healthcare (OHC) units act according to the legislation-based recommendations.

METHODS

Data of 1092 employees with reduced work ability were collected during 2013-2018 in 15 OHC units across Finland. Nine reasons for HCUs, eight process activities and three recommendations were analysed. Cross-tabulation and multinomial logistic regression analysis were used in the analyses.

RESULTS

Employees themselves initiated an HCU for early support more often (OR with 95% CI 2.37; 1.04 to 5.40) compared with supervisors. Personnel in OHC units initiated an HCU in musculoskeletal disorders more often (OR 1.58; 95% CI 1.05 to 2.37) and in mental disorders less often (OR 0.52; 95% CI 0.35 to 0.76) compared with supervisors. These findings were reflected in the recommendations after the HCU, where rehabilitation was recommended for employees with musculoskeletal disorders more often than for employees with mental disorders (ORs 5.48; 95% CI 1.91 to 15.67 and 1.59; 95% CI 0.74 to 3.43, respectively).

CONCLUSION

Supervisors and OHC units followed the recommendations for management of work disability to a great extent. Employees were active in looking for help early when they had problems with work ability. This positive finding should be promoted even more. OHC units did not initiate HCUs or recommend rehabilitation in mental disorders as actively as they did in musculoskeletal disorders. Support of employees with mental disorders should be improved and studied more. Registration of the study The study protocol was approved and registered on 22 September 2017 by the Doctoral Program of Health Sciences, Faculty of Medicine, University of Eastern Finland, registration no. 189067.

Intravenous ketamine for severe alcohol use disorder at Moi Teaching & Referral Hospital, Kenya: a case report

BACKGROUND

Alcohol use disorder is prevalent globally and in Kenya, and is associated with significant health and socio-economic consequences. Despite this, available pharmacological treatment options are limited. Recent evidence indicates that intravenous (IV) ketamine can be beneficial for the treatment of alcohol use disorder, but is yet to be approved for this indication. Further, little has been done to describe the use of IV ketamine for alcohol use disorder in Africa. The goal of this paper, is to: 1) describe the steps we took to obtain approval and prepare for off-label use of IV ketamine for patients with alcohol use disorder at the second largest hospital in Kenya, and 2) describe the presentation and outcomes of the first patient who received IV ketamine for severe alcohol use disorder at the hospital.

CASE PRESENTATION

In preparing for the off-label use of ketamine for alcohol use disorder, we brought together a multi-disciplinary team of clinicians including psychiatrists, pharmacists, ethicists, anesthetists, and members of the drug and therapeutics committee, to spearhead the process. The team developed a protocol for administering IV ketamine for alcohol use disorder that took into account ethical and safety issues. The national drug regulatory authority, the Pharmacy and Poison's Board, reviewed and approved the protocol. Our first patient was a 39-year-old African male with severe alcohol use disorder and comorbid tobacco use disorder and bipolar disorder. The patient had attended in-patient treatment for alcohol use disorder six times and each time had relapsed between one to four months after discharge. On two occasions, the patient had relapsed while on optimal doses of oral and implant naltrexone. The patient received IV ketamine infusion at a dose of 0.71 mg/kg. The patient relapsed within one week of receiving IV ketamine while on naltrexone, mood stabilizers, and nicotine replacement therapy.

DISCUSSION & CONCLUSIONS

This case report describes for the first time the use of IV ketamine for alcohol use disorder in Africa. Findings will be useful in informing future research and in guiding other clinicians interested in administering IV ketamine for patients with alcohol use disorder.

Anxiety, Stress, and Depression Among Healthcare Professionals During the COVID-19 Pandemic: A Cross-Sectional Study in Morocco

The COVID-19 pandemic has caused an enormous psychological impact worldwide. This study aimed to assess anxiety, depression, stress, and compensatory behaviors among Moroccan healthcare workers (HCWs) during COVID-19. This descriptive cross-sectional study was conducted using a snowball sampling strategy. This descriptive cross-sectional study was conducted using a snowball sampling strategy. Online surveys were sent to groups of HCWs working in Casablanca and Fez cities. Post-traumatic stress disorder (PTSD) was measured using the Impact of Event Scale revised (IES-R) scale, and the DASS-21 was used to measure anxiety, depression, and stress among participants. Compensatory behaviors used by HCWs to manage these symptoms were also investigated. The majority of participants (72.5%) experienced moderate to severe distress during the COVID-19 pandemic. The majority of participants (53.1%) reported symptoms of mild to extremely severe depression. Overall, nurses, female, and frontline HCWs experienced more stress, anxiety, and depression (P < .001). Leisure activities (29%), sport (19%), and drinking tea/coffee (19%) were the most common compensatory behaviors. Our findings suggest that psychological support and interventions targeting high-risk HCWs with heavy psychological distress are needed. It is of paramount importance to improve the psychological endurance and safeguard the mental and physical well-being of HCWs, who find themselves on the frontline of health and humanitarian crises, when they are needed the most.

Alcohol Consumption in the Specific Socio-Professional Context of the French Public Service: Qualitative Study Protocol

Alcohol, a psychoactive substance with addictive potential, has major consequences on the population and public health. In France, alcohol use disorder affects approximately 3.5 million people, and 41,000 persons died in 2015. Alcohol consumption is significantly correlated to the workplace. Thus, the workplace is an area of opportunity to change risky behaviors and must play a key role in the prevention of alcohol misuse. To do this, it is essential to understand the consumption framework and to identify specific environmental risk factors. This qualitative study aims to describe the framework of alcohol consumption in the French public service. A focus group will be organized in France from November to January 2023. The participants will be: (i) representatives of the Local Health Insurance; (ii) over 18 years old; (iii) active or retired civil servants; (iv) mutualist activists; and (v) representatives of the Union of Health Prevention for the Obligatory System of the Public Service. The exclusion criteria for the study will be: (i) lack of consent form; (ii) inability to participate in the focus group, and (iii) early departure during the focus group. The focus groups will be supervised by two researchers following an interview guide. The data will be analyzed using the methodological framework, which consists in carrying out a thematic analysis. This will allow for an understanding of the sources of usage behaviors, and the identification of the most appropriate intervention functions for suitable prevention actions in order to reduce the risk of a transition to alcohol use disorder.

Are workplace factors associated with employee alcohol use? The WIRUS cross-sectional study

OBJECTIVES

Sociodemographic predictors of employee alcohol use are well established in the literature, but knowledge about associations between workplace factors and alcohol use is less explored. The aim of this study was to explore whether workplace factors were associated with employee alcohol use (consumption and alcohol-related problems).

DESIGN

Cross-sectional study. Linear and binary logistic regression analyses.

SETTING

Heterogeneous sample of employees (workers and supervisors) from 22 companies across geographical locations and work divisions in Norway.

PARTICIPANTS

Employees (N=5388) responded on survey items measuring workplace factors and alcohol use.

OUTCOMES

Data on alcohol use were collected with the Alcohol Use Disorders Identification Test (AUDIT). Consumption was measured with the AUDIT-C (the first three items), and alcohol-related problems were operationalised as a sum score of 8 or higher on the full 10-item AUDIT.

RESULTS

Higher levels of alcohol consumption were associated with more liberal workplace drinking social norms (b=1.37, p<0.001), working full-time (b=0.18, p<0.001), working from holiday home (b=0.40, p<0.01), being a supervisor (b=0.25, p<0.001), having supervisors with less desired leadership qualities (b=-0.10, p<0.01), shorter working hours (b=-0.03, p<0.05), higher workplace social support (b=0.13, p<0.05) and higher income (b=0.02, p<0.001). Alcohol-related problems were associated with more liberal workplace drinking social norms (OR=3.52, p<0.001) and shorter working hours (OR=0.94, p<0.05).

CONCLUSIONS

Workplace drinking social norms were the supremely most dominant predictor of both consumption and alcohol-related problems. Results suggest that some workplace factors may play a role in explaining employee alcohol consumption, although the predictive ability of these factors was limited. This study points to the importance of drinking social norms, workplace drinking culture and leadership for understanding employee alcohol use.

Working with alcohol prevention in occupational health services: "knowing how" is more important than "knowing that" - the WIRUS OHS study

BACKGROUND

Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels' levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity.

METHODS

In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses.

RESULTS

OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η² = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, β = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units.

CONCLUSIONS

Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.

Gender specific early treatment for women with alcohol addiction (EWA): Impact on work related outcomes. A 25-year registry follow-up of a randomized controlled trial (RCT)

BACKGROUND

Alcohol contributes to substantial economic burden, at both individual and community levels. We investigated the effect of the Early treatment for Women with Alcohol Addiction (EWA) treatment program on sickness leave, income, unemployment and early retirement pension up to 25 years following intake to treatment.

METHODS

The EWA RCT included 200 women with alcohol use disorder from 1983 to 1984 at the Karolinska University Hospital, Sweden. Participants were randomized to the EWA program, a two-year specialized woman only treatment including psychiatric, interpersonal and family concerns, or treatment as usual (TAU) in a mixed gender setting. We followed the participants in the RCT from 1985 to 2009 through linkage with a national labor market registry and applied latent growth curve modeling to estimate level and change in sickness leave, income, unemployment and early retirement pension.

FINDINGS

Relative to TAU, the EWA group had less increase in sickness leave up to 21 years after treatment. Overall, we found no differences in income between treatment groups, yet, a two-year interval analysis showed greater rise in income up to 8 years after treatment for the EWA group. Level and change in unemployment and early retirement pension did not differ between treatment groups.

CONCLUSIONS

Gender specific treatment emphasizing psychiatric, interpersonal and family issues for women with alcohol addiction had long-term positive effects on sickness leave and income. These findings complement positive clinical outcomes of the EWA treatment program on drinking patterns, mental health and mortality.

Do health professionals' attitudes towards alcohol use matter for alcohol prevention efforts? Results from the WIRUS-OHS study

BACKGROUND

Use of alcohol is a major public health issue, representing the 7^th largest burden of disease in the world. Workplaces offer a unique arena for health initiatives addressing alcohol use, where occupational health services (OHS) personnel play an important role. However, we do not know if the extent of such initiatives may be influenced by personal drinking attitudes among OHS personnel. Thus, the aim of the study was to explore how drinking attitudes among OHS personnel were associated with their frequency of working with alcohol-related cases and with their views on alcohol prevention activities in the OHS.

METHODS

The WIRUS project included a cross-sectional survey of attitudes and practices among OHS personnel (n = 325) employed by Norwegian OHS services (n = 69), who informed about sociodemographic and professional characteristics, drinking attitudes, frequency of cases with alcohol-related issues, and perceptions toward the role of the OHS in primary, secondary, and tertiary alcohol prevention activities. Measures of associations were examined with linear and logistic regression models.

RESULTS

Drinking attitudes were unrelated to the frequency of working with alcohol-related cases. Physicians, psychologists, and nurses had higher frequency of working with alcohol-related cases, compared to those with other professional backgrounds (β = 0.46, p = 0.01). Drinking attitudes were also unrelated to attitudes towards primary/secondary/tertiary alcohol prevention activities in the OHS, while female OHS personnel were more positive towards increased primary alcohol prevention activities in the OHS (OR: 1.82, p < 0.05). Only marginal portions (1%-3%) of the variance in attitudes towards alcohol prevention activities in the OHS were accounted for by the models.

CONCLUSION

This study did not find evidence of associations between OHS personnel's drinking attitudes and their practices and attitudes towards alcohol prevention activities. The lack of association between OHS personnel's attitudes towards alcohol use and their attitudes and practices relating to alcohol prevention in the workplace might point towards professionalism, as personal attitudes appear not to interfere with their priorities and professional mission. Given the small amount of outcome variance explained by the tested models, other variables should be used in future studies.

Do Differences in Drinking Attitudes and Alcohol-Related Problems Explain Differences in Sick Leave? A Multilevel Analysis of 95 Work Units Within 14 Companies From the WIRUS Study

Background

Systematic reviews have shown a strong relationship between alcohol consumption and sick leave. The effect of alcohol consumption on sick leave may, however, vary according to the work environment. While attitudes toward drinking may impact sick leave, there is little research on the contribution of drinking attitudes to sick leave. Moreover, alcohol-related problems and drinking attitudes may be influenced by the broader sociocultural contexts of the organizational units where people work.

Objectives

This study aimed to explore the relationship of alcohol-related problems and drinking attitudes with sick leave while considering the nesting of employees within working units within companies.

Method

Data from the WIRUS (Workplace Interventions preventing Risky alcohol Use and Sick leave) study were linked to company-registered sick leave data for 2,560 employees from 95 different work units in public (n = 9) and private companies (n = 5) in Norway. Three-level (employee, work unit, and company) negative binomial regression models were estimated to explore the 12-month prospective association of alcohol-related problems and drinking attitudes with four measures of sick leave (one-day, short-term, long-term, and overall sick leave days). Models were adjusted for gender, age, cohabitation status, educational attainment, work position, and employment sector.

Results

We observed higher variation of one-day, short-term, and overall sick leave days between companies than between work units within companies (15, 12, and 30% vs. 0, 5, and 8%, respectively). However, neither alcohol-related problems nor drinking attitudes were associated with sick leave and, thus, those variations in sick leave were not explained by alcohol-related problems or drinking attitudes.

Conclusion

Our findings suggest company-level differences are more important than within company differences when explaining differences in sick leave. While alcohol-related problems or drinking attitudes were not associated with sick leave, future studies may need to explore the role of company policies, practices, or social norms in variations in sick leave rates.

PROTOCOL: The association between marital transitions and physical and mental health in late life: A systematic review

This is the protocol for a Campbell systematic review. The objectives are as follows: What is the association between marital transitions and physical health among people older than 60? What is the association between marital transitions and mental health among people older than 60? What is the role of gender, age, and education on the association between marital transitions and health among people older than 60? What is the influence of geographical region, housing, neighborhood, and social support on the association between marital transitions and health status among people older than 60?

Global, regional, and national cancer deaths and disability-adjusted life-years (DALYs) attributable to alcohol consumption in 204 countries and territories, 1990-2019

BACKGROUND

Alcohol consumption is a risk factor for a number of communicable and non-communicable diseases, including several types of cancer. This article reports the burden of cancers attributable to alcohol consumption by age, sex, location, sociodemographic index (SDI), and cancer type from 1990 to 2019.

METHODS

The Comparative Risk Assessment approach was used in the 2019 Global Burden of Disease study to report the burden of cancers attributable to alcohol consumption between 1990 and 2019.

RESULTS

In 2019, there were globally an estimated 494.7 thousand cancer deaths (95% uncertainty interval [UI], 439.7 to 554.1) and 13.0 million cancer disability-adjusted life-years (DALYs; 95% UI, 11.6 to 14.5) that were attributable to alcohol consumption. The alcohol-attributable DALYs were much higher in men (10.5 million; 95% UI, 9.2 to 11.8) than women (2.5 million; 95% UI, 2.2 to 2.9). The global age-standardized death and DALY rates of cancers attributable to alcohol decreased by 14.7% (95% UI, 6.4% to 23%) and 18.1% (95% UI, 9.2% to 26.5%), respectively, over the study period. Central Europe had the highest age-standardized death rates that were attributable to alcohol consumption(10.3; 95% UI, 8.7 to12.0). Moreover, there was an overall positive association between SDI and the regional age-standardized DALY rate for alcohol-attributable cancers.

CONCLUSIONS

Despite decreases in age-standardized deaths and DALYs, substantial numbers of cancer deaths and DALYs are still attributable to alcohol consumption. Because there is a higher burden in males, the elderly, and developed regions (based on SDI), these groups and regions should be prioritized in any prevention programs.

Association between back and neck pain and workplace absenteeism in the USA: the role played by walking, standing, and sitting difficulties

PURPOSE

There is a paucity of literature identifying factors that influence the back and neck pain (BNP)-workplace absenteeism relationship. Therefore, this study aimed to investigate the association between BNP and workplace absenteeism and potential mediating variables in a large sample of the US population.

METHODS

Nationally representative data collected in 2019 from the RAND American Life Panel (ALP) were used for this retrospective study. Workplace absenteeism was defined as the number of days of absence in the past 12 months for health-related reasons (count variable), while BNP corresponded to the presence of back pain due to spinal stenosis, back pain due to other causes, or neck pain (dichotomous variable). Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, obesity, and diabetes. There were eight influential variables (depression, anxiety, sleep disorder, alcohol dependence, opioid dependence, walking difficulty, standing difficulty, and sitting difficulty). The association between BNP and workplace absenteeism was analyzed using a negative binomial regression model.

RESULTS

There were 1,471 adults aged 22-83 years included in this study (52.9% of men; mean [standard deviation] age 44.5 [13.0] years). After adjusting for control variables, BNP was positively and significantly associated with workplace absenteeism (incidence rate ratio = 1.40, 95% confidence interval: 1.07-1.83). Walking, standing, and sitting difficulties individually explained between 24 and 43% of this association.

CONCLUSIONS

Workplace interventions focusing on the management of BNP and overcoming difficulties in walking, standing, and sitting, potentially utilizing exercise, therapy, and ergonomic interventions, may prevent absenteeism.

Effectiveness of eHealth Interventions Targeting Employee Health Behaviors: Systematic Review (Preprint)

BACKGROUND

The number of people with noncommunicable diseases is increasing. Noncommunicable diseases are the major cause of disability and premature mortality worldwide, associated with negative workplace outcomes such as sickness absence and reduced work productivity. There is a need to identify scalable interventions and their active components to relieve disease and treatment burden and facilitate work participation. eHealth interventions have shown potential in clinical and general populations to increase well-being and physical activity and could be well suited for workplace settings.

OBJECTIVE

We aimed to provide an overview of the effectiveness of eHealth interventions at the workplace targeting employee health behaviors and map behavior change techniques (BCTs) used in these interventions.

METHODS

A systematic literature search was performed in PubMed, Embase, PsycINFO, Cochrane CENTRAL, and CINAHL in September 2020 and updated in September 2021. Extracted data included participant characteristics, setting, eHealth intervention type, mode of delivery, reported outcomes, effect sizes, and attrition rates. Quality and risk of bias of the included studies were assessed using the Cochrane Collaboration risk-of-bias 2 tool. BCTs were mapped in accordance with the BCT Taxonomy v1. The review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist.

RESULTS

In total, 17 randomized controlled trials met the inclusion criteria. The measured outcomes, treatment and follow-up periods, content of eHealth interventions, and workplace contexts had high heterogeneity. Of the 17 studies, 4 (24%) reported unequivocally significant findings for all primary outcomes, with effect sizes ranging from small to large. Furthermore, 53% (9/17) of the studies reported mixed results, and 24% (4/17) reported nonsignificant results. The most frequently targeted behavior was physical activity (15/17, 88% of the studies); the least frequently targeted behavior was smoking (2/17, 12% of the studies). Attrition varied greatly across the studies (0%-37%). Risk of bias was high in 65% (11/17) of the studies, with some concerns in the remaining 35% (6/17). Interventions used various BCTs, and the most frequently used were feedback and monitoring (14/17, 82%), goals and planning (10/17, 59%), antecedents (10/17, 59%), and social support (7/17, 41%).

CONCLUSIONS

This review suggests that, although eHealth interventions may have potential, there are still unanswered questions regarding their effectiveness and what drives the mechanism behind these effects. Low methodological quality, high heterogeneity and complexity, the characteristics of the included samples, and often high attrition rates challenge the investigation of the effectiveness and the making of sound inferences about the effect sizes and significance of the results. To address this, new studies and methods are needed. A megastudy design in which different interventions are evaluated in the same population over the same period on the same outcomes may solve some of the challenges.

TRIAL REGISTRATION

PROSPERO CRD42020202777; https://www-crd-york-ac-uk/prospero/display_record.php?RecordID=202777.

Association Between Workplace Absenteeism and Alcohol Use Disorder From the National Survey on Drug Use and Health, 2015-2019

IMPORTANCE

Alcohol use disorder (AUD) is common and associated with increased morbidity. The degree to which AUD currently factors into workplace absenteeism needs further characterization in the US.

OBJECTIVE

To examine the association between AUD and workplace absenteeism in a nationally representative sample.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used data from a nationally representative sample of noninstitutionalized US residents from the 2015-2019 National Survey on Drug Use and Health to examine the association of AUD with workplace absenteeism. Eligible respondents were aged 18 years and older who reported full-time employment. Data were analyzed from March to September 2021.

MAIN OUTCOMES AND MEASURES

Primary outcomes were markers of workplace absenteeism as defined by the number of days missed from work because of illness or injury and days skipped from work in the last 30 days. Descriptive statistics, prevalence ratios, and logistic regression analyses were performed to assess the association between AUD and absenteeism.

RESULTS

A total of 110 701 adults aged 18 years and older reported current full-time employment (58 948 [53.2%] men, 51 753 [46.8%] women; 12 776 [11.5%] Black, 18 096 [16.3%] Hispanic, and 69 506 [62.8%] White respondents). Weighted prevalence of AUD in this sample of working adults was 9.3% (95% CI, 9.0%-9.5%); 6.2% (95% CI, 6.0%-6.4%) of respondents met criteria for mild AUD, 1.9% (95% CI, 1.7%-2.0%) for moderate AUD, and 1.2% (95% CI, 1.1%-1.3%) for severe AUD. Mean days missed from work annually increased in a stepwise fashion with increasing AUD severity (no AUD, 13.0 days; 95% CI, 12.7-13.2 days; mild AUD, 17.7 days; 95% CI, 16.4-19.1 days; moderate AUD, 23.6 days; 95% CI, 21.5-25.7 days; severe AUD, 32.3 days; 95% CI, 27.5-37.0 days). People with AUD represented 9.3% of the full-time workforce and contributed to 14.1% of total reported workplace absences.

CONCLUSIONS AND RELEVANCE

In this cross-sectional study, AUD was disproportionately associated with an increased prevalence of workplace absenteeism, with individuals with AUD contributing over 232 million missed workdays annually. These results provide economic incentive for increased investment in AUD prevention and treatment, both for employers and policy makers.

A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference

AIM

Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term).

METHOD

Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078.

RESULTS

Fifty-nine studies (58% longitudinal) including 439,209 employees (min. 43, max. 77,746) from 15 countries were included. Most associations indicating positive and statistically significant results were based on longitudinal data (70%) and confirmed the strong/causal relationship between alcohol use and sickness absence. The meta-analysis included eight studies (ten samples). The increased risk for sickness absence was likely to be found in cross-sectional studies (OR: 8.28, 95% CI: 6.33-10.81), studies using self-reported absence data (OR: 5.16, 95% CI: 3.16-8.45), and those reporting short-term sickness absence (OR: 4.84, 95% CI: 2.73-8.60).

CONCLUSION

This review supports, but also challenges earlier evidence on the association between alcohol use and sickness absence. Certain types of design, data, and types of sickness absence may produce large effects. Hence, to investigate the actual association between alcohol and sickness absence, research should produce and review longitudinal designed studies using registry data and do subgroup analyses that cover and explain variability of this association.

A randomized controlled trial of the web-based drinking diary program for problem drinking in multi workplace settings

Objectives

To assess the effectiveness of a web‐based brief intervention (BI) program to record daily drinking among people with problem drinking in workplace settings.

Methods

A two‐armed, parallel‐group, randomized controlled trial were conducted at six workplaces in Japan. After obtaining written consent to participate in the study, workers with an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or higher were randomly assigned into two groups. The participants allocated to the intervention group recorded their daily alcohol consumption for 4 weeks using the program, while those allocated to the control group received no intervention. Outcome measures included the amount of alcohol consumption in past 7 days using the Timeline Follow‐Back method in the program at baseline, 8th week, and 12th week and written AUDIT score at baseline and 12th week.

Results

Hundred participants were assigned to either the intervention group (n = 50) or control group (n = 50). The results of two‐way repeated measures ANOVA showed a statistically significant interaction between the group and the week factors in the two primary outcomes (number of alcohol‐free days, total drinks) and secondary outcomes (AUDIT score) (p = .04, .02, and .03, respectively). The between‐group effect sizes (Hedges' g; 95% CI) of the outcomes at 12th week were 0.53; 0.13–0.93 (total drinks), 0.44; 0.04–0.84 (AUDIT score), 0.43; 0.03–0.83 (number of alcohol‐free days).

Conclusions

The web‐based BI program for problem drinking was considered to be effective in reducing alcohol consumption and the AUDIT score in workplace settings.

Equity impact of minimum unit pricing of alcohol on household health and finances among rich and poor drinkers in South Africa

Introduction

South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa.

Methods

We draw from extended cost-effectiveness analysis (ECEA) methods and an epidemiological policy appraisal model of MUP for South Africa to simulate the equity impact of a ZAR 10 MUP over a 20-year time horizon. We estimate the impact across wealth quintiles on: (i) alcohol consumption and expenditures; (ii) mortality; (iii) government healthcare cost savings; (iv) reductions in cases of catastrophic health expenditures (CHE) and household savings linked to reduced health-related workplace absence.

Results

We estimate MUP would reduce consumption more among the poorest than the richest drinkers. Expenditure would increase by ZAR 353 000 million (1 US$=13.2 ZAR), the poorest contributing 13% and the richest 28% of the increase, although this remains regressive compared with mean income. Of the 22 600 deaths averted, 56% accrue to the bottom two quintiles; government healthcare cost savings would be substantial (ZAR 3.9 billion). Cases of CHE averted would be 564 700, 46% among the poorest two quintiles. Indirect cost savings amount to ZAR 51.1 billion.

Conclusions

A MUP policy in South Africa has the potential to reduce harm and health inequality. Fiscal policies for population health require structured policy appraisal, accounting for the totality of effects using mathematical models in association with ECEA methodology.

Harmful Alcohol Use Among Healthcare Workers at the Beginning of the COVID-19 Pandemic in Kenya

BACKGROUND

Healthcare workers play a key role in responding to pandemics like the on-going COVID-19 one. Harmful alcohol use among them could result in inefficiencies in health service delivery. This is particularly concerning in sub-Saharan Africa where the health workforce is already constrained. The aim of this study is to document the burden and correlates of harmful alcohol use among healthcare workers at the beginning of the COVID-19 pandemic in Kenya with the aim of informing policy and practice.

METHODS

This study was a cross-sectional analysis of data obtained from a parent online survey that investigated the burden and factors associated with mental disorders among healthcare workers during the COVID-19 pandemic in Kenya. We analyzed data obtained from a sub-population of 887 participants who completed the Alcohol Use Disorder Identification Test questionnaire. We used descriptive statistics to summarize the socio-demographic characteristics of the participants and multivariate analysis to determine the factors associated with harmful alcohol use.

RESULTS

Three hundred and eighty nine (43.9%) participants reported harmful alcohol use. The factors significantly associated with increased odds of endorsing harmful alcohol use were: being male (AOR = 1.56; 95% CI = 1.14, 2.14; p = 0.006), being unmarried (AOR = 2.06; 95% CI = 1.48, 2.89; p < 0.001), having 11-20 years of experience as compared to having 20+ years of experience (AOR = 1.91; 95% CI = 1.18, 3.12; p = 0.009), and being a specialist (AOR = 2.78; CI = 1.64, 4.78; p = < 0.001) or doctor (AOR = 2.82; 95% CI = 1.74, 4.63; p < 0.001) as compared to being a nurse.

CONCLUSIONS

A high proportion of healthcare workers reported harmful alcohol use at the beginning of the COVID-19 pandemic in Kenya. Males, the unmarried, those with 11-20 years of experience in the health field, doctors and specialists, were more likely to report harmful alcohol use. These findings highlight the need to institute interventions for harmful alcohol use targeting these groups of healthcare workers in Kenya during the COVID-19 pandemic in order to optimize functioning of the available workforce.

Associations between alcohol demand and both the experience and subjective evaluation of positive and negative alcohol-related consequences

BACKGROUND

Considerable variation exists in the extent to which alcohol-related consequences are evaluated as positive or negative. These evaluations, in turn, predict subsequent drinking behavior. Understanding the etiological pathways to positive and negative alcohol-related consequences is essential to the design of interventions aimed at reducing drinking consequences. Behavioral economic models posit that excessive alcohol valuation contributes to problematic use. Elevated alcohol demand (i.e., relative alcohol value) is associated with negative alcohol-related consequences; however, it is unclear whether demand is related to positive consequences or subjective consequence evaluations.

METHODS

College student drinkers (n = 114; 74.6% female) completed an online survey. Participants indicated whether they had ever experienced any of 24 negative and 14 positive consequences and subjectively evaluated their most recent experience of each consequence endorsed. An alcohol purchase task assessed hypothetical alcohol consumption across 14 prices and three observed demand indices were calculated: intensity (i.e., consumption at zero cost), O_max (i.e., maximum expenditure), and P_max (i.e., price associated with maximum expenditure). Bivariate correlations and hierarchical regressions were used to test associations between observed demand indices and the number and subjective evaluations of positive and negative (researcher- and participant-defined) consequences.

RESULTS

Intensity and O_max , but not P_max , were bivariately associated with researcher- and participant-defined negative and positive consequences. However, in hierarchical regression models that controlled for the maximum number of drinks consumed in a single day over the past month, only intensity was significantly associated with more negative and positive consequences. Intensity was associated with positive consequence evaluations in bivariate but not regression models.

CONCLUSION

Students with higher intensity reported more prior alcohol consequences (positive and negative), independent of drinking level. However, subjective evaluations of recent consequences did not vary as a function of demand. Results support using behavioral economic models to facilitate identifying etiologic pathways to alcohol consequences and suggest that novel interventions incorporating demand manipulation may reduce drinking consequences.

Impacts of heavy smoking and alcohol consumption on workplace presenteeism: A cross-sectional study

Presenteeism refers to the practice of going to work despite poor health, resulting in subpar performance. This study aimed to explore the impacts of smoking and alcohol consumption on workplace presenteeism based on demographic, health-related, and employment variables.The study adopted a cross sectional design with 60,051 wage workers from the database of the second and third Korean Working Conditions Surveys in 2010 and 2011, respectively. A total of 41,404 workers aged 19 years and older, who had worked for at least 1 hour in the previous week, answered the survey questions. Chi-square test as well as univariate and multiple logistic regression analyses were conducted using SPSS, version 18.0, to determine the impacts of smoking and alcohol consumption on workplace presenteeism.Of the 41,404 Korean workers, 8512 (20.6%) had experienced presenteeism in the past 12 months. There were significant differences among gender, age, educational status, income, health problems, absenteeism, shift work, night shift, weekly working hours, exposure to secondhand smoke at work, and satisfaction with the workplace environment. Based on the results of multiple regression analysis, heavy smoking (adjusted odds ratio = 1.38, 95% confidence intervals [1.11, 1.72]) and high-risk drinking (adjusted odds ratio = 1.19, 95% confidence intervals [1.08, 1.31]) were significantly related to presenteeism among workers.The results of our study confirmed that smoking and alcohol drinking were related to presenteeism even after controlling other variables (demographic, health-related, and employment variables) that affect presenteeism. Smoking and alcohol drinking are associated with and potentially influence presenteeism; in particular, heavy smoking and high-risk drinking contributed to presenteeism. Companies that encourage employees to receive treatments for reduction of smoking or alcohol consumption may benefit from greater productivity. Hence, we should consider the impact of smoking and alcohol consumption in the workplace and build appropriate strategies and programs to help reduce these behaviors.

L-Cysteine Containing Vitamin Supplement Which Prevents or Alleviates Alcohol-related Hangover Symptoms: Nausea, Headache, Stress and Anxiety

AIMS

Alcohol-related hangover symptoms: nausea, headache, stress and anxiety cause globally considerable amount of health problems and economic losses. Many of these harmful effects are produced by alcohol and its metabolite, acetaldehyde, which also is a common ingredient in alcohol beverages. The aim of the present study is to investigate the effect of the amino acid L-cysteine on the alcohol/acetaldehyde related aftereffects.

METHODS

Voluntary healthy participants were recruited through advertisements. Volunteers had to have experience of hangover and/or headache. The hangover study was randomized, double-blind and placebo-controlled. Nineteen males randomly swallowed placebo and L-cysteine tablets. The alcohol dose was 1.5 g/kg, which was consumed during 3 h.

RESULTS

The primary results based on correlational analysis showed that L-cysteine prevents or alleviates hangover, nausea, headache, stress and anxiety. For hangover, nausea and headache the results were apparent with the L-cysteine dose of 1200 mg and for stress and anxiety already with the dose of 600 mg.

CONCLUSIONS

L-cysteine would reduce the need of drinking the next day with no or less hangover symptoms: nausea, headache, stress and anxiety. Altogether, these effects of L-cysteine are unique and seem to have a future in preventing or alleviating these harmful symptoms as well as reducing the risk of alcohol addiction.

Willingness to Participate in Alcohol Prevention Interventions Targeting Risky Drinking Employees. The WIRUS Project

Background: The extent to which eligible individuals in a target population are willing to participate in interventions is important when evaluating the efficacy of public health interventions.

Objectives: As part of a process evaluation of an ongoing randomized controlled trial, this study aimed to identify the proportion of risky drinkers who were willing to participate in an alcohol prevention intervention in an occupational health setting, and correlates for such willingness.

Methods: Risky drinking employees from 22 companies in Norway were identified through an alcohol screening survey. Risky drinkers' (N = 779) willingness to complete a health examination and to be randomized into an alcohol prevention intervention (digital or face-to-face intervention, or control) was recorded by personnel from occupational health services. The proportion of employees who were willing to participate was assessed on 31 potential correlates (sociodemographic, alcohol-related, work-related, and lifestyle/daily activity). Adjusted (multiple logistic regression) analyses were utilized to explore associations between potential correlates and willingness to participate.

Results: Altogether, 38.1% of employees were willing to participate in prevention interventions. In the adjusted analysis, only 5 out of 31 potential correlates were significantly associated with willingness to participate. Managers were more than twice as willing to participate than workers (OR = 2.17, p < 0.01). Willing employees had less workplace decision latitude (perceived control over workplace decisions and less possibility of utilizing personal skills in the job) (OR = 0.62, p < 0.05), and were more overcommitted with exorbitant work ambition and need for approval (OR = 1.49, p < 0.05). Willing employees had to some extent less alcohol-related impaired work performance (presenteeism, OR = 0.78, p < 0.05), and they spent less time on care activities (OR = 0.84, p < 0.05).

Conclusions: Reaching four out of ten with risky drinking habits for prevention interventions strengthens the rationale for targeting this public health problem in occupational health care settings. In particular, this study suggests the importance of ensuring secure commitment among workers, who were less willing til participate than managers. Nevertheless, tailoring recruitment and implementation strategies based on easily identifiable correlates may be onerous.

Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study

Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work.

Alcohol intoxication incidence differences at companies in Lithuania

INTRODUCTION

Employee alcohol consumption is a major challenge to both the health of the employee and productivity of the company. Our study investigates the overall alcohol intoxication rates of employees at companies in Lithuania, alcohol intoxication incidence rates during the work week and associations between company variables and employee alcohol intoxication at work.

METHODS

Data for our study were collected at 153 different companies in Lithuania during the year 2018. Overall 2 455 997 alcohol breath tests were analysed. Data were analysed using descriptive statistics and Poisson regression analysis.

RESULTS

Descriptive statistics showed that the alcohol intoxication (blood alcohol concentration ≥ 0.01%) incidence rate was 0.31% (n = 7535). Average alcohol intoxication was 0.04%. Furthermore, higher alcohol intoxication incidence rates were found on Mondays and in the morning than at any other day or time. The results of Poisson regression analysis showed that the alcohol intoxication incidence rate ratios were highest among small companies, companies from the farming sector and companies from rural areas.

DISCUSSION AND CONCLUSIONS

We found a relationship between company variables, testing time and incidence rates of alcohol intoxication. The increased alcohol intoxication at work throughout the weekend and on Monday is consistent with the alcohol consumption patterns in the Lithuanian population. Relatively low alcohol intoxication rate for the majority of the positively tested cases may indicate consumption of small amounts of alcohol just before starting work or excessive alcohol consumption the day before. Our findings could be an indicator of an underlying problem and have implications for alcohol prevention strategies.

Can high workplace social capital buffer the negative effect of high workload on patient-initiated violence? Prospective cohort study

BACKGROUND

High workload seems to increase the risk of patient-initiated workplace violence (patient-initiated violence). However, the temporal association between workload and violence remains uncertain. Understanding the interplay of factors in the psychosocial working environment and patient-initiated violence is important to future preventive initiatives.

AIM

To assess whether a high workload increases the risk of patient-initiated violence, and whether intraorganizational relationships based on trust, reciprocity, justice and collaboration, known as workplace social capital, moderate this risk.

METHOD

Baseline survey data on 1823 social educators was collected followed by 12 monthly surveys on patient-initiated violence exposure. Poisson regressions, in mixed models, were conducted to assess the risk of violence at four levels of workload. Further, moderation analyses were conducted to assess the moderating effects of three sub-types of workplace social capital.

RESULTS

High and very high workload increased the risk of patient-initiated violence: RR = 1.5 [1.4-1.6], p < .001 and RR = 1.4 [1.3-1.4], p < .001. All three levels of workplace social capital had a moderating effect on the workload-violence association: Workload*Workplace social capital_(co-worker): F (3, 16,712) = 3.4, p = .017, Workload*Workplace social capital_{(local management)}: F (3, 16,748) = 11.9, p < .001, Workload*Workplace social capital_{(general management)}: F (3, 16,556) = 5.5, p < .001. Only high Workplace social capital _(co-workers) reduced the risk of violence at all levels of workload. Workplace social capital _{(general management)} reduced the risk of violence at high, medium and low workload, and Workplace social capital _{(local management)} reduced the risk of violence at medium and low workload.

CONCLUSION

High workload clearly increases the risk of patient-initiated violence. A high workplace social capital appears to be a viable protective factor and should be investigated further in studies of patient-initiated violence prevention.

Socio-demographic differences in alcohol-related work impairment

BACKGROUND AND AIMS

The costs of alcohol-related presenteeism (being at work in an impaired state due to alcohol use) have been estimated as substantially larger than the costs of alcohol-related absenteeism. Past studies indicate that employees with lower socio-economic status experience more alcohol-attributable problems than employees in higher socio-economic strata. We aimed to estimate the prevalence of alcohol-related presenteeism among Norwegian adults and its association with sex, age, income and education.

DESIGN AND SETTING

Annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2016-19) among Norwegian adults.

PARTICIPANTS

A total of 5430 full- and part-time employees aged 16-79 years; 53% were men.

MEASUREMENTS

The main outcome was self-reported 12-month occurrence of work impairment due to alcohol use the previous day. Main predictors were income and education obtained from national registries, age and gender. A secondary outcome variable was self-reported alcohol-related absenteeism.

FINDINGS

The 12-month prevalence of alcohol-related work impairment was 8.7%, 95% confidence interval (CI) = 7.9, 9.4. Adjusted risk ratios (RR) indicated a higher risk for men compared with women (RR = 1.26, 95% CI = 1.06, 1.50) and higher risk for young employees (e.g. less than 26 years compared with 55+, RR = 7.64, 95% CI = 4.88, 11.95). The risk increased as a function of higher education (in order of increasing education, RR = 1.12, 95% CI = 0.87, 1.45; RR = 1.64, 95% CI = 1.26, 2.12; RR = 2.19, 95% CI = 1.63, 2.95). The risk was estimated as lower in the middle-income categories compared with the lowest (RR = 0.76, 95% CI = 0.58, 1.00, RR = 0.89, 95% CI = 0.66, 1.20, RR = 0.94, 95% CI = 0.68, 1.29) and higher for employees with the highest income (RR = 1.04, 95% CI = 0.73, 1.48; RR = 1.47, 95% CI = 1.09, 2.00).

CONCLUSIONS

In Norway, the risk of alcohol-related work impairment for employees in the highest education category is approximately twice that of employees with secondary education or less. Except for employees in the lowest income category, who had a higher risk than those in the middle-income categories, higher income is associated with increased risk of work impairment. Being younger and male are also associated with increased risk of alcohol-related work impairment.

Work Ability among Upper-Secondary School Teachers: Examining the Role of Burnout, Sense of Coherence, and Work-Related and Lifestyle Factors

Maintaining and promoting teachers’ work ability is essential for increasing productivity and preventing early exit from the teaching profession. This study aimed to identify the predictors of work ability among upper-secondary school teachers and examine the mediating role of burnout. A large and diverse group of Czech upper-secondary school teachers was surveyed to address this goal. The sample comprised 531 upper-secondary school teachers (50.0 ± 9.94 years, 19.9 ± 10.62 in the teaching profession, 57.6% females). Relatively greater empirical support was found for the effects of burnout, sense of coherence, work–life balance, and perceived relationships in the school environment on work ability than for the impact of age, homeroom teacher duties, workload, and caring for elderly relatives. Furthermore, burnout served as an important mediator of the relationship between sense of coherence and work ability. Teachers with a higher sense of coherence are thus better able to cope with adverse work circumstances and identify and mobilize internal and external resources to prevent professional exhaustion and the subsequent decline in work ability. The study can guide interventions on the work ability of teachers.

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.

Daily use of alcohol in the Norwegian general population: Prevalence and associated factors

Purpose

Harmful use of alcohol is a major public health problem. While harm is often researched in the context of heavy drinking episodes, high-frequency drinking, even when drinking moderate quantities, constitutes a health risk in a longer perspective. The purpose of this paper is to examine the prevalence of daily use of alcohol in the Norwegian general population and to assess sociodemographic, mental health-related and personal resource variables associated with daily use of alcohol.

Design/methodology/approach

A cross-sectional survey concerned with health, illness and serious life events was distributed to 5,500 persons in the general population in Norway (response rate 36%). Sociodemographic variables, personal resource variables (general self-efficacy, optimism and extraversion) and psychological distress (current anxiety and/or depression) were assessed with regards to their associations with daily drinking in unadjusted and adjusted regression models.

Findings

Daily use of alcohol was reported by 39 persons (2.2%) in the sample (3.1% of men and 1.4% of women). While general self-efficacy, optimism and extraversion were unrelated to daily drinking, the adjusted model revealed that male sex (OR: 2.18, p < 0.05), being unemployed/not in education (OR: 3.10, p < 0.05) and reporting current anxiety and/or depression (OR: 3.12, p < 0.01) were associated with daily use of alcohol.

Originality/value

The study has contributed to the knowledge about daily drinkers in a representative sample of the Norwegian population. A proportion of 2.2% was found to drink alcohol on a daily basis. Compared to their counterparts, the odds of daily drinking were higher for men, unemployed persons and persons reporting current psychological distress. Public health initiatives aiming at reducing harmful use of alcohol may pay particular attention to these subsets of the population.

The Effects of Alcohol Hangover on Mood and Performance Assessed at Home

The current study evaluated the next day consequences of a social night of drinking compared to a no alcohol night, with standardised mood and portable screen-based performance measures assessed in the morning at participants' homes, and a breathalyser screen for zero alcohol. A mixed sex group (n = 20) took part in the study. Participants reported consuming on average 16.9 units (135 g) alcohol, resulting in a hangover rating of 60 (out of 100) compared to 0.3 following the no alcohol night. Statistical significance comparisons contrasting the hangover with the no alcohol condition revealed an increase in negative mood and irritability during hangover and an (unexpected) increase in risk and thrill seeking. Performance scores showed an overall slowing of responses across measures, but with less impact on errors. The results support the description of hangover as a general state of cognitive impairment, reflected in slower responses and reduced accuracy across a variety of measures of cognitive function. This suggests a general level of impairment due to hangover, as well as increased negative mood. The use of a naturalistic design enabled the impact of more typical levels of alcohol associated with real life social consumption to be assessed, revealing wide ranging neurocognitive impairment with these higher doses. This study has successfully demonstrated the sensitivity of home-based assessment of the impact of alcohol hangover on a range of subjective and objective measures. The observed impairments, which may significantly impair daily activities such as driving a car or job performance, should be further investigated and taken into account by policy makers.

Work-Related Alcohol Use and Harm to Others

Drinking alcohol with coworkers is a common practice in many occupational cultures. This practice may produce negative consequences for some employees. Objectives: We estimate the prevalence of a set of negative consequences of work-related alcohol use and identify risk factors associated with experience of harm from coworkers' drinking. Methods: In an online survey, Norwegian employees (n = 3596) aged 20-69 reported whether they had experienced the following due to coworkers' drinking the past 12 months: (a) felt excluded, (b) experienced unwanted sexual attention, (c) been physically harmed, and (d) been verbally abused. Each outcome was regressed on socio-demographics (age, gender, education, and income), job characteristics (flexibility and autonomy), respondents' alcohol use, and perceived intoxication frequency in work contexts for a typical coworker (perceived coworker intoxication frequency). Results: The 12-month prevalence of experiencing any of the negative consequences was 18%. Having felt excluded (10.7%) and experienced unwanted sexual attention (7.0%) were more common than being verbally abused (4.8%) or physically harmed (1.9%). Perceived coworker intoxication frequency was strongly associated with all outcomes. Respondents' own drinking frequency predicted being verbally abused, being physically harmed, and experiencing unwanted sexual attention. Women experienced less physical harm and more unwanted sexual attention than men. Prevalence also varied by age, education, income, and job characteristics. Conclusions: Each year, approximately one-sixth of Norwegian employees experience harm from their coworkers' drinking. The frequency of intoxication in work contexts is strongly associated with harm to others.

Who reported having a high-strain job, low-strain job, active job and passive job? The WIRUS Screening study

Objective

The Job Demands and Control model classifies job types as active, passive, low-strain or high-strain, based on a combination of job demands and control. While studies have shown high-strain jobs to have adverse consequences for health and work participation, prognostic factors for the four job types have been less explored. The aim of this study was to assess the associations between sociodemographic factors and job descriptors and being in high-strain, low-strain, active and passive jobs.

Methods

The WIRUS Screening study targeted Norwegian employees in private and public enterprises. In this study, associations with job types among 4,487 employees were investigated with binary logistic regression analyses, adjusting for sociodemographic and job-related variables.

Results

In fully adjusted models, high-strain job was associated with female gender; lower education; shift work; and doing work outside the workplace. Low-strain job was associated with opposite scores on the same variables, and with lower job position. Active job was associated with lower age; female gender; higher levels of education; higher job position level; shift work; and not doing work outside the workplace. Passive job was associated with opposite scores on the same variables.

Conclusions

The study corroborates the role gender and education have for experiencing the job, and expands on existing knowledge on the role of job position and irregular working hours and spaces. By identifying factors associated with job types, the prevention of health problems and work disability may become be more targeted.

Sociodemographic characteristics associated with alcohol consumption and alcohol-related consequences, a latent class analysis of The Norwegian WIRUS screening study

BACKGROUND

For alcohol, the association with socioeconomic status (SES) is different than for other public health challenges - the associations are complex, and heterogeneous between socioeconomic groups. Specifically, the relationship between alcohol consumption per se and adverse health consequences seems to vary across SES. This observation is called the 'alcohol harm paradox'. This study aims to describe different patterns of alcohol use and potential problems. Next, the associations between sub-groups characterized by different patterns of alcohol use and potential problems, and age, gender, educational level, full-time employment, occupational level and income is analysed.

METHODS

Employing data from the ongoing cross-sectional WIRUS-study, N = 4311 participants were included in the present study. Individual response patterns of the ten-item Alcohol Use Disorders Identification Test (AUDIT) were analysed and latent class analysis (LCA) was used to identify latent groups. Next, the associations between the classes identified in the best fitting LCA-model and sociodemographic factors were analysed and presented.

RESULTS

We identified three classes based on the response patterns on AUDIT. Class 1 was characterised by low-level alcohol consumption and very low probability of negative alcohol-related consequences related to their alcohol consumption. Class 2 was characterised by a higher level of consumption, but despite this, class 2 also had a relatively low probability of reporting negative alcohol-related consequences. Class 3, however, was characterised by high levels of alcohol consumption, and a high probability of reporting negative consequences of their consumption. The classes identified were systematically differentially associated with the included measures of SES, with class 3 characterised by younger age, more males and lower educational attainment.

CONCLUSIONS

Our findings highlight the interconnectedness of alcohol consumption and alcohol-related consequences. Furthermore, the identified classes and SES yields further insights into to intricate relationship between various socioeconomic factors, alcohol use patterns and related negative consequences.