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

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.

Predicting severe alcohol use disorders in primary care using number of heavy drinking days

BACKGROUND AND AIMS

Although screening for unhealthy alcohol use is becoming more common, severe alcohol use disorders (AUDs) associated with the most severe medical and socio-economic sequelae still often go unidentified in primary care. To improve identification of severe AUDs and aid clinical decision-making, we aimed to identify a threshold of heavy drinking days (HDDs) associated with severe AUDs.

DESIGN, SETTING AND CASES

This cohort study analyzed electronic health record data of 138 765 adults who reported ≥ 1 HDD (4+ drinks/occasion for women and men aged ≥ 65 years, 5+ for men aged 18-64 years) during a 3-month period at a routine alcohol screening in primary care in a large Northern California, USA health-care system from 2014 to 2017. Our sample was 66.5% male, 59.7% white, 11.0% Asian/Pacific Islander, 5.0% black, 17.4% Latino/Hispanic and 7.0% other/unknown race/ethnicity; the mean age was 40.6 years (standard deviation = 15.2).

MEASUREMENTS

We compared sensitivity and specificity of different thresholds of the reported number of HDDs during a 3-month period for predicting severe AUD diagnoses in the following year, in the full sample and by sex and age.

FINDINGS

The prevalence of severe AUD diagnoses in the year after the screening was 0.6%. The optimal threshold predicting future severe AUD diagnoses in the full sample was ≥ 5 HDDs during a 3-month period [sensitivity = 68.9%, 95% confidence interval (CI) = 65.9, 72.0; specificity = 63.2%, 95% CI = 62.9, 63.4], but varied by sex and age. Women had a lower threshold than men (4 versus 6 HDDs), which decreased as women aged (from 5 HDDs among 18-24 years to 4 HDDs ≥ 25 years), but increased as men aged (from 5 HDDs among 18-24 years to 6 HDDs among 25-64 years, to 7 HDDs ≥ 65 years).

CONCLUSIONS

Five or more heavy drinking days in a 3-month period may indicate heightened risk of future severe alcohol use disorder in an adult primary care population. The optimal thresholds are lower for women than for men, and thresholds decrease as women age but increase as men age.

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.

Factors associated with alcohol abuse in nursing professionals in São Paulo State, Brazil

Abstract Objective: to identify factors associated with alcohol abuse in nursing professionals in São Paulo State. Methods: this is a case-control nested in a cross-sectional study. We collected data on demographic characteristics, lifestyle, work ability, occupational features, physical and psychosocial work environment, and alcohol abuse (CAGE Questionnaire). Multiple logistic regression analyses were performed. Results: the study involved 119 participants in the case group and 356 in the control group. After age adjustment, alcohol abuse was associated with male sex (OR: 3.39; 95%CI: 1.96;5.85), current or former smoking (OR: 2.11; 95%CI: 1.32;3.38), and poor sleep quality (OR: 1.91; 95%CI: 1.12;3.25); and negatively associated with ≥50 weekly working hours (OR: 0.54;95%CI: 0.32;0.92) and a monthly family income ≥6.1 minimum wages(OR: 0.37; 95%CI: 0.20;0.67). Conclusions: working hours and individual characteristics were associated with alcohol abuse. Workplaces should implement programs to prevent and treat alcohol abuse in nursing professionals to reduce workers’ and patients’ alcohol-related harms.

Fatores associados ao consumo abusivo de álcool em profissionais de enfermagem no estado de São Paulo, Brasil

Resumo Objetivo: identificar fatores associados ao consumo abusivo de álcool entre profissionais de Enfermagem no estado de São Paulo. Métodos: trata-se de um estudo caso-controle aninhado a um transversal. Foram coletados dados sobre características demográficas, do estilo de vida, capacidade para o trabalho, aspectos ocupacionais, do ambiente de trabalho físico e psicossocial e de consumo abusivo de álcool (questionário CAGE). Foi realizada análise de regressão logística múltipla. Resultados: o estudo envolveu 119 casos e 356 controles. Após ajuste por idade, o consumo abusivo de álcool foi associado ao sexo masculino (OR: 3,39; IC95%:1,96;5,85), tabagismo atual ou pregresso (OR: 2,11; IC95%: 1,32;3,38) e à qualidade do sono ruim (OR: 1,91; IC95%:1,12;3,25); e negativamente associado a carga horária de trabalho semanal ≥50 horas (OR: 0,54; IC95%:0,32;0,92) e renda familiar mensal de ≥6,1 salários-mínimos (OR: 0,37; IC95%: 0,20;0,67). Conclusões: jornada de trabalho e características individuais estiveram associadas ao consumo abusivo de álcool. Programas de prevenção e tratamento do consumo abusivo de álcool em profissionais da Enfermagem deveriam ser implementados nos locais de trabalho, visando reduzir os danos causados pelo álcool para trabalhadores e pacientes.

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.