Alcohol drinking, health-related functioning and work disability

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Sammanfattning

Alcohol drinking is a major potentially preventable risk factor for health and wellbeing worldwide. Alcohol drinking has increased markedly from the late 1960s in Finland until 2007. Alcohol-related causes of death and morbidity are common, especially among the working-age population. The majority of Finnish heavy drinkers are employed and there is a need to assess the contribution of alcohol drinking to health-related functioning and work disability using longitudinal data including several drinking habits. The aim of this study was to examine the associations between alcohol drinking, health-related functioning and work disability among ageing municipal employees. This study is part of the Helsinki Health Study. The baseline data were collected in 2000-02 among 40- to 60-year-old employees of the City of Helsinki (n=8960, response rate 67%). A follow-up survey was conducted in 2007 (n=7332, response rate 83%). The survey data were linked with sickness absence data, d! erived from the employer s personnel register, and with data on disability retirement, derived from the Finnish Centre for Pensions, among 78% and 74% of participants consenting to internal and external data linkages. Alcohol drinking was measured by weekly average drinking, frequency of drinking, binge drinking and problem drinking assessed by the CAGE scale. Logistic regression, Poisson regression and Cox regression were used in analysing the data. Heavy weekly average drinking, binge drinking and problem drinking were all associated with poor mental functioning, whereas concerning physical functioning associations were found for problem drinking only and non-drinkers also had an increased risk. Heavy weekly average drinking, binge drinking and problem drinking were associated with both self-certified and medically confirmed sickness absence from work with the exception of binge drinking among men. The association between weekly average drinking and medically confirmed si! ckness absence was U-shaped, both non-drinkers and heavy drink! ers havi ng increased risks compared to moderate drinkers. Working conditions had no major contributions to the associations, although psychosocial working conditions somewhat attenuated the associations, especially among men. When studying changes in alcohol drinking, associations were found for self-certified sickness absence more often than for medically confirmed sickness absence, as associations for the latter were mainly explained by health and other health behaviours. Also, reduced alcohol drinking and previous problem drinking increased the risk of sickness absence. Alcohol drinking was strongly associated with disability retirement due to mental disorders, whereas no associations were found for musculoskeletal diseases. Throughout the study, alcohol drinking showed the strongest associations with poor mental health. Problem drinking was the drinking habit with the most widespread associations with poor health-related functioning and work disability. The results of the study ! indicate that alcohol drinking is a risk factor for poor health-related functioning and work disability in the middle-aged working population. Heavy drinking, binge drinking and problem drinking were all associated with poor health-related functioning and work disability, but problem drinking showed the strongest and most widespread associations. The study suggests that problem drinking should be assessed in addition to the overall amount of drinking in future studies and clinical settings. The study highlights the importance of alcohol drinking for poor mental health and calls for recognition and early prevention of heavy alcohol drinking among both the occupational and primary health care systems.
Originalspråkengelska
UtgivningsortHelsinki
Förlag
Tryckta ISBN978-951-51-2700-6
Elektroniska ISBN978-951-51-2701-3
StatusPublicerad - 2016
MoE-publikationstypG5 Doktorsavhandling (artikel)

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