Jenni Ervasti1, Mika Kivimäki1,2,3, Jenny Head2, Marcel Goldberg4,5, Guillaume Airagnes6,7, Jaana Pentti3, Tuula Oksanen1, Paula Salo1,8, Sakari Suominen9, Markus Jokela10, Jussi Vahtera11, Marie Zins4,5,12, Marianna Virtanen1. 1. Finnish Institute of Occupational Health, PB 40, 00032 TYÖTERVEYSLAITOS, Helsinki, Finland. 2. Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 7HB, UK. 3. Clinicum, University of Helsinki, PB 63, 00014 Helsingin yliopisto, Helsinki, Finland. 4. French National Institute of Health and Medical Research (INSERM), Population-based Cohorts Unit, INSERM, 101, rue de Tolbiac, 75013 Paris, Villejuif, France. 5. French National Institute of Health and Medical Research (INSERM), Research Unit 1168 Aging and Chronic Diseases-Epidemiological and Public Health Approaches, INSERM, 101, rue de Tolbiac, 75013 Paris, Villejuif, France. 6. Faculty of Medicine, Universite Paris Descartes, 15, rue de l'école de médecine, 75006 Paris, France. 7. Department of Psychiatry and Addictology, AP-HP, Hôpitaux Universitaires Paris Ouest, 75015 Paris, France. 8. Department of Psychology, University of Turku, 20014 Turun yliopisto, Finland. 9. University of Turku, Finland and University of Skövde, Box 408541 28 Skövde, Sweden. 10. Medicum, University of Helsinki, PB 63, 00014 Helsingin yliopisto, Helsinki, Finland. 11. University of Turku and Turku University Hospital, 20014 TURUN YLIOPISTO, Turku, Finland. 12. University Versailles Saint Quentin en Yvelines, 47 boulevard Vauban 78280 Guyancourt, Paris, France.
Abstract
AIMS: We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption. METHODS: We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an ~6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis. RESULTS: Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES. CONCLUSIONS: The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences. SHORT SUMMARY: In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES.
AIMS: We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption. METHODS: We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an ~6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis. RESULTS: Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES. CONCLUSIONS: The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences. SHORT SUMMARY: In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES.
Authors: Jenni Ervasti; Mika Kivimäki; Jenny Head; Marcel Goldberg; Guillaume Airagnes; Jaana Pentti; Tuula Oksanen; Paula Salo; Sakari Suominen; Markus Jokela; Jussi Vahtera; Marie Zins; Marianna Virtanen Journal: Addiction Date: 2018-06-05 Impact factor: 6.526
Authors: Päivi Leino-Arjas; Jorma Seitsamo; Clas-Håkan Nygård; Prakash K C; Subas Neupane Journal: Int J Environ Res Public Health Date: 2021-03-05 Impact factor: 3.390