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.

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Changes in drinking as predictors of changes in sickness absence: a case-crossover study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-209777 ◽

2017 ◽

Vol 72 (1) ◽

pp. 61-67 ◽

Cited By ~ 2

Author(s):

Jenni Ervasti ◽

Mika Kivimäki ◽

Jaana Pentti ◽

Jaana I Halonen ◽

Jussi Vahtera ◽

...

Keyword(s):

Alcohol Use ◽

Sickness Absence ◽

Control Period ◽

Heavy Drinking ◽

Short Term ◽

Case Crossover ◽

Increased Risk ◽

Case Period ◽

Drinking Session

BackgroundWe investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design.MethodsFinnish public sector employees were surveyed in 2000, 2004 and 2008 on alcohol use and covariates. Heavy drinking was defined as either a weekly intake that exceeded recommendations (12 units for women; 23 for men) or having an extreme drinking session. The responses were linked to national sickness absence registers. We analysed the within-person relative risk of change in the risk of sickness absence in relation to change in drinking. Case period refers to being sickness absent within 1 year of the survey and control period refers to not being sickness absent within 1 year of the survey.ResultsPeriods of heavy drinking were associated with increased odds of self-certified short-term (1–3 days) sickness absence (multivariable-adjusted OR 1.21, 95% CI 1.07 to 1.38 for all participants; 1.62, 95% CI 1.19 to 2.21 for men and 1.15, 95% CI 1.00 to 1.33 for women). A higher risk of short-term sickness absence was also observed after increase in drinking (OR=1.27, 95% CI 1.07 to 1.52) and a lower risk was observed after decrease in drinking (OR=0.83, 95% CI 0.69 to 1.00). Both increase (OR=1.38, 95% CI 1.21 to 1.57) and decrease (OR=1.27, 95% CI 1.19 to 1.43) in drinking were associated with increased risk of long-term (>9 days) medically certified all-cause sickness absence.ConclusionIncrease in drinking was related to increases in short-term and long-term sickness absences. Men and employees with a low socioeconomic position in particular seemed to be at risk.

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Systematic Review and Dose–Response Meta-Analysis on the Relationship Between Alcohol Consumption and Sickness Absence

Alcohol and Alcoholism ◽

10.1093/alcalc/agab008 ◽

2021 ◽

Author(s):

Melvin Marzan ◽

Sarah Callinan ◽

Michael Livingston ◽

Geoffrey Leggat ◽

Heng Jiang

Keyword(s):

High Risk ◽

Alcohol Consumption ◽

Sickness Absence ◽

Dose Response ◽

Meta Analysis ◽

Population Based ◽

Heavy Episodic Drinking ◽

Economic Evaluations ◽

Cross Sectional ◽

The Relationship

ABSTRACT Aims Alcohol consumption (AC) may cause workplace absence, but the findings of individual studies vary markedly. To date, no dose–response meta-analysis (DRMA) of the relationship between AC and sickness absence (SA) has been completed. This paper aims to estimate the dose–response relationship between AC and the risk of SA based on published observational studies. Methods We used DRMA and modelling to investigate the effects of varying doses of AC (including heavy episodic drinking (HED)) onSA. Results The meta-analysis included 21 studies (12 cohort studies and 9 cross-sectional). It showed that HED, risky (20–40 g of alcohol/day) and high-risk (>40 g of alcohol/day) drinkers had an elevated risk of SA when compared with light-to-moderate drinkers for both sexes. Those who abstained from alcohol had a higher risk of SA than those who drink moderately. Conclusions Our results indicate that risky, high-risk drinking and HED may increase the risk of absenteeism. The implementation of population-based strategies may be appropriate to address the burdens of alcohol-related SA. Additionally, economic evaluations of alcohol policies should incorporate their impacts on SA. However, the current literature has substantial limitations, relying on modestly designed studies from just a few settings and more studies are needed—especially those that measure abstention in more nuancedways.

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Alcohol consumption and risk of fatty liver disease: a meta-analysis

PeerJ ◽

10.7717/peerj.2633 ◽

2016 ◽

Vol 4 ◽

pp. e2633 ◽

Cited By ~ 14

Author(s):

Guoli Cao ◽

Tingzhuang Yi ◽

Qianqian Liu ◽

Min Wang ◽

Shaohui Tang

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Meta Analysis ◽

Small Sample ◽

Cross Sectional ◽

Heavy Alcohol ◽

Increased Risk ◽

Heavy Alcohol Consumption

Background Observational studies have shown inconsistent results regarding alcohol consumption and risk of fatty liver. We performed a meta-analysis of published literature to investigate the association between alcohol consumption and fatty liver disease (FLD). Methods We searched Medline, Embase, Web of Science, and several Chinese databases, identifying studies that reported an association between alcohol consumption and the risk of FLD. Results A total of 16 studies with 76,608 participants including 13 cross-sectional studies, two cross-sectional following longitudinal studies, and one cohort study met the inclusion criteria. For light to moderate alcohol consumption (LMAC), there was a 22.6% reduction in risk of FLD (odds ratio [OR] = 0.774, 95% confidence interval CI [0.695–0.862], P <0.001), and subgroup analysis showed that a greater reduction in risk of FLD was found in the female drinkers (30.2%) and the drinkers with BMI ≥25 kg/m2(31.3%) compared with the male drinkers (22.6%) and the drinkers with BMI <25 kg/m2(21.3%), respectively. For heavy alcohol consumption, there was no significant influence on risk of FLD (OR = 0.869, 95% CI [0.553–1.364], P = 0.541) in Japanese women, but there was a 33.7% reduction in risk of FLD (OR = 0.663, 95% CI [0.574–0.765], P < 0.001) in Japanese men and a significant increased risk of FLD (OR = 1.785, 95% CI [1.064–2.996], P = 0.028) in Germans. Conclusion LMAC is associated with a significant protective effect on FLD in the studied population, especially in the women and obese population. However, the effect of heavy alcohol consumption on FLD remains unclear due to limited studies and small sample sizes.

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Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis

Epidemiology and Infection ◽

10.1017/s0950268810000774 ◽

2010 ◽

Vol 138 (12) ◽

pp. 1789-1795 ◽

Cited By ~ 61

Author(s):

A. V. SAMOKHVALOV ◽

H. M. IRVING ◽

J. REHM

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Alcohol Consumption ◽

Alcohol Use ◽

Dose Response ◽

Meta Analysis ◽

Alcohol Use Disorders ◽

Response Relationship ◽

Dose Response Relationship ◽

Increased Risk

SUMMARYThe aim of this study was to quantify the association between alcohol consumption and incidence of pneumonia and to examine possible pathways. This was done by a systematic review and meta-analyses on the dose–response relationship between alcohol consumption or alcohol-use disorders and the incidence of community-acquired pneumonia (CAP). The relative risk (RR) of CAP increased monotonically with increasing alcohol consumption. Individuals consuming 24, 60, and 120 g of pure alcohol daily demonstrated RRs for incident CAP of 1·12 (95% CI 1·02–1·23), 1·33 (95% CI 1·06–1·67) and 1·76 (95% CI 1·13–2·77), respectively, relative to non-drinkers. Clinically defined alcohol-use disorders were associated with an eightfold increased risk of CAP (RR 8·22, 95% CI 4·85–13·95). In conclusion, alcohol was found to be a risk factor for pneumonia with a clear statistical association, and a monotonic dose–response relationship.

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Problem Alcohol Use in Young Australian Adults

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670701264784 ◽

2007 ◽

Vol 41 (5) ◽

pp. 436-441 ◽

Cited By ~ 8

Author(s):

Sophie C. Reid ◽

Obioha C. Ukoumunne ◽

Carolyn Coffey ◽

Maree Teesson ◽

John B. Carlin ◽

...

Keyword(s):

High Risk ◽

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Abuse ◽

Alcohol Use Disorder ◽

Short Term ◽

Cross Sectional ◽

Drinking Status ◽

High Risk Drinking

Objective: To examine the extent to which excessive drinking in young adults is associated with alcohol abuse and dependence. Method: Cross-sectional analyses were conducted using data from the eighth wave of the Victorian Adolescent Health Cohort Study, which comprised 1943 Victorians currently aged 24–25 years drawn from 44 secondary schools across the state in 1992. The main outcome measures of interest were short-term risk drinking status (based on daily alcohol consumption) and long-term risk drinking status (based on total weekly alcohol consumption). Results: Two out of 5 participants drank at moderate to high risk levels for short-term harm. Yet, because young people tend to drink on only 1–2 days a week, fewer (22%) were at moderate to high risk for long-term harm. Although 20% of the participants met criteria for a diagnosis of alcohol abuse or dependence, most of those in the moderate- to high-risk drinking categories were not diagnosed with either alcohol disorder. Conclusion: Excessive alcohol use in one or two sessions a week appears to be common in young Australian adults. While short- and long-term risky drinking is more common in those with an alcohol use disorder, the majority of moderate- and high-risk drinking is done by those who do not meet criteria for an alcohol use disorder.

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An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions

The International Journal of Alcohol and Drug Research ◽

10.7895/ijadr.v2i1.45 ◽

2013 ◽

Vol 2 (1) ◽

pp. 99-110 ◽

Cited By ~ 15

Author(s):

Sarah E Woolf-King ◽

Craig M Steinmaus ◽

Arthur L Reingold ◽

Judith A Hahn

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Hiv Infection ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Future Research ◽

Research Directions ◽

Increased Risk ◽

Future Research Directions ◽

Sub Saharan

Woolf-King, S., Steinmaus, C. M., Reingold, A. L. & Hahn, J. A. (2013). An update on alcohol use and risk of HIV infection in sub-Saharan Africa: Meta-analysis and future research directions. International Journal of Alcohol and Drug Research, 2(1), 99-110. doi: 10.7895/ijadr.v2i1.45 (http://dx.doi.org/10.7895/ijadr.v2i1.45)Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region. We conducted a meta-analysis on studies of alcohol use and HIV infection in sub-Saharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research.Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV.Setting and participants: All of the studies included in the meta-analysis occurred with adults in sub-Saharan Africa.Measurements: Pooled odds ratio (OR) estimates were calculated using both the fixed inverse variance weighting method and the random effects method when evidence of heterogeneity was present.Findings: The pooled OR estimate for all studies was 1.61 (95% CI: 1.44–1.80). The association between alcohol use and prevalence or incident HIV infection was particularly large among samples who reported problem drinking (OR = 2.17, 95% CI: 1.64–2.87) and drinking in sexual contexts (OR = 1.79, 95% CI: 1.55–2.06). Some evidence of publication bias was present; however, the OR remained statistically significant in small and large studies and with population-based and high-risk samples.Conclusions: These results suggest that alcohol consumption, particularly at high levels and in sexual contexts, is associated with an increased risk of HIV infection. An increased focus on methods that allow for more sensitive tests of the event-level association between alcohol consumption and risk of HIV infection may provide a better understanding of the causal mechanisms underlying this relationship.

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Non-Pharmacological Interventions to Reduce Unhealthy Eating and Risky Drinking in Young Adults Aged 18–25 Years: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu10101538 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1538 ◽

Cited By ~ 2

Author(s):

Stephanie Scott ◽

Fiona Beyer ◽

Kathryn Parkinson ◽

Cassey Muir ◽

Alice Graye ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Eating Behaviors ◽

Vegetable Consumption ◽

Meta Analysis ◽

Early Adulthood ◽

Experimental Studies ◽

Population Group ◽

Targeted Interventions ◽

Unhealthy Eating

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This review aimed to systematically evaluate the effectiveness of preventative targeted interventions focused on reducing unhealthy eating behavior and linked alcohol use in 18–25-year-olds. Twelve electronic databases were searched from inception to June 2018 for trials or experimental studies, of any duration or follow-up. Eight studies (seven with student populations) met the inclusion criteria. Pooled estimates demonstrated inconclusive evidence that receiving an intervention resulted in changes to self-reported fruit and vegetable consumption (mean change/daily servings: 0.33; 95% CI −0.22 to 0.87) and alcohol consumption (mean reduction of 0.6 units/week; CI −1.35 to 0.19). There was also little difference in the number of binge drinking episodes per week between intervention and control groups (−0.01 sessions; CI −0.07 to 0.04). This review identified only a small number of relevant studies. Importantly, included studies did not assess whether (and how) unhealthy eating behaviors and alcohol use link together. Further exploratory work is needed to inform the development of appropriate interventions, with outcome measures that have the capacity to link food and alcohol consumption, in order to establish behavior change in this population group.

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Influence of Peers Drinking and Parental Drinking and Attitudes on Adolescent Drinking

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.195 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s304-s305

Author(s):

N. Smaoui ◽

N. Charfi ◽

M. Turki ◽

M. Maâlej-Bouali ◽

L. Zouari ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Drinking Behavior ◽

Critical Role ◽

Cross Sectional Study ◽

Cross Sectional ◽

Randomized Sampling ◽

Adolescent Drinking ◽

Increased Risk ◽

Competing Interest

IntroductionIt is widely recognized that parents and peers play a critical role in the adolescent's introduction to alcohol.ObjectivesThe aim of the study was to examine the relationship of parental and peers drinking to adolescent drinking behavior.MethodsA cross-sectional study was carried out in four colleges and schools in Sfax in Tunisia, in May and June 2016. The sample consisted of 317 pupils, and was determined through a simple randomized sampling. These adolescents were asked to answer a self-administered questionnaire, after their consent. Alcohol use disorders identification test (AUDIT) was used to evaluate alcohol dependence.ResultsThe mean age was 16 years, with a sex-ratio of 1.07. The participants reported having drunk alcohol at least once in 18.9% of cases and 41.66% of them still consume. According to AUDIT, 1.6% of alcohol users presented an alcohol misuse and 21.6% presented dependence. They reported that parents’ attitude toward their alcohol use was favorable in 27.11% of cases. Among dependent adolescents, the prevalence of fathers’ alcohol consumption was 20% while that of friends was 70%. Adolescent drinking was significantly correlated to fathers, mothers and peers drinking (P < 0.001, P = 0.004, P < 0.001 respectively), mothers and peers smoking (P = 0.05, P < 0.001 respectively), fathers and peer's cannabis use (P < 0.001, P < 0.001 respectively).ConclusionFindings suggest that negative family and peers influence increased risk of alcohol consumption in adolescents. Understanding the influences on parents’ beliefs about their children's drinking and the functions of social networks in preventing alcohol consumption may be necessary to address adolescent risky drinking.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Pattern of Alcohol Use and its Effects in Relation to the Age of Initiation of Alcohol Use among the Residents of Jhaukhel Area of Bhaktapur District

Nepal Medical College Journal ◽

10.3126/nmcj.v23i4.42228 ◽

2021 ◽

Vol 23 (4) ◽

pp. 340-346

Author(s):

Soman Gurung ◽

Ravi Kant Gupta ◽

Vinutha Silvanus

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Alcohol Dependence ◽

Binge Drinking ◽

Age Of Onset ◽

Early Initiation ◽

P Value ◽

Cross Sectional ◽

Increased Risk ◽

Drinking Age

Over the past few decades, alcohol consumption has increased in quantity and frequency. Several studies have suggested that people who start drinking at younger age have an increased risk of alcohol use disorder. This study was carried out to assess the pattern of alcohol consumption in relation to the age of initiation of alcohol use among the residents of Jhaukhel area of Bhaktapur district. A cross sectional descriptive survey was conducted in Jhaukhel area of Bhaktapur district among the permanent residents aged 15 years and above through a purposive sampling technique using a pre tested self-constructed proforma. Assessment of alcohol use, harmful/ hazardous drinking and alcohol dependence was done using an AUDIT questionnaire as a tool. Chi-square test and Fisher’s exact test were applied and ‘p’ value was calculated to see the association between age of onset of alcohol use and the alcohol use pattern and effects. The level of significance was set at 5%, and ‘p’ value of < 0.05 was considered statistically significant. A total of 190 respondents were interviewed. Mean age of the respondents was 41.25 ± 16.4 years while mean age of initiation of alcohol consumption was 20 ± 4.3 years and 31 (30.4 %) of drinkers initiated alcohol consumption before legal drinking age (18 years). This was more among males (36.5%) than females (14.3%), (p-value: 0.03, OR: 3.4, 95%CI: 1-11) Initiating alcohol consumption early in life before 18 years was strongly associated with binge drinking pattern (P value: <0.001, OR: 9.5, 95%CI: 2.7-33.3). Those who initiate drinking before 18 years were more likely to suffer from alcohol related medical problems compared to those who initiated drinking after 18 years (OR: 6.63, 95% CI: 2.3-19.3, P value: 0.001). Parental consumption of alcohol was found to be associated with the early initiation of alcohol use (OR: 2.7, 95%CI: 1.01-6.96, P value: 0.03). Early initiation of alcohol consumption before legal drinking age was not only a predictor for binge drinking and alcohol dependence, but also a risk factor for alcohol related medical problem, accidents and self-inflicted injuries. Hence this is a serious issue which needs to be addressed at the individual, family as well as community level.

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Prevalence and factors associated with alcohol use among pregnant adolescents

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692013000100020 ◽

2013 ◽

Vol 21 (1) ◽

pp. 433-441 ◽

Cited By ~ 7

Author(s):

Lorena Uchôa Portela Veloso ◽

Claudete Ferreira de Souza Monteiro

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Cross Sectional Study ◽

World Health ◽

Pregnant Adolescents ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Increased Risk ◽

Health Organization

AIM: to identify alcohol use and the associated factors in pregnant adolescents of the municipality of Teresina-PI. METHOD: this is cross-sectional study with 256 pregnant adolescents whose data were obtained through questionnaires covering socioeconomic, pregnancy and alcohol consumption characteristics and through the application of the Alcohol Use Disorders Identification Test, an instrument developed by the World Health Organization for screening for the excessive use of alcohol. Descriptive statistical analysis was performed using the chi-square test and odds ratio. RESULTS: the study indicates a prevalence of 32.4% for alcohol use during pregnancy in adolescents. Of these, 36.1% had scores consistent with risky use. The factors associated with an increased risk of alcohol use during pregnancy are: not having a partner, living on less than 1 minimum wage, not being religious, performing up to 3 prenatal consultations, having suffered violence and alcohol use in previous pregnancies. CONCLUSION: a high prevalence of alcohol consumption by pregnant adolescents and various risk factors involved in this process were identified. These data reflect the need for the use, by nurses, of screening technologies for alcohol consumption during pregnancy and health promotion strategies among groups of adolescents.

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