Daniela V Pachito1, Frank Pega2, Jelena Bakusic3, Emma Boonen4, Els Clays5, Alexis Descatha6, Ellen Delvaux7, Dirk De Bacquer8, Karoliina Koskenvuo9, Hannes Kröger10, Marie-Claire Lambrechts11, Carolina O C Latorraca12, Jian Li13, Ana L Cabrera Martimbianco14, Rachel Riera15, Reiner Rugulies16, Grace Sembajwe17, Johannes Siegrist18, Lauri Sillanmäki19, Markku Sumanen20, Sakari Suominen21, Yuka Ujita22, Godelieve Vandersmissen23, Lode Godderis24. 1. Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, Rua Barata Ribeiro 142, Bela Vista, São Paulo, Brazil; Fundação Getúlio Vargas, Av. Paulista, 548, Bela Vista, São Paulo, Brazil. 2. Environment, Climate Change and Health Department, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Electronic address: pegaf@who.int. 3. Centre for Environment and Health of KU Leuven, Kapucijnenvoer 35/5, box 7001, 3000 Leuven, Belgium. Electronic address: jelena.bakusic@kuleuven.be. 4. KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium. Electronic address: emma.boonen@idewe.be. 5. Department of Public Health and Primary Care, Ghent University, Campus University Hospital Ghent, Cornel Heymanslaan 10, B-9000 Ghent, Belgium. Electronic address: els.clays@UGent.be. 6. AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France. Electronic address: alexis.descatha@inserm.fr. 7. KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium; Centre for Social and Cultural Psychology of KU Leuven, Dekenstraat 2, box 3701, 3000 Leuven, Belgium. Electronic address: ellen.delvaux@idewe.be. 8. Department of Public Health and Primary Care, Ghent University, Campus University Hospital Ghent, Cornel Heymanslaan 10, B-9000 Ghent, Belgium. Electronic address: dirk.debacquer@ugent.be. 9. The Social Insurance Institution of Finland, PO Box 450, FIN-00056 Kela, Finland; Department of Public Health, PO BOX 20, 00014 University of Helsinki, Finland. Electronic address: karoliina.koskenvuo@kela.fi. 10. Socio-Economic Panel (SOEP), German Institute for Economic Research (DIW), Berlin, Germany. Electronic address: hkroeger@diw.de. 11. Centre for Environment and Health of KU Leuven, Kapucijnenvoer 35/5, box 7001, 3000 Leuven, Belgium; VAD, Flemish Expertise Centre for Alcohol and Other Drugs, Vanderlindenstraat 15, Brussels, Belgium. Electronic address: marieclaire.lambrechts@kuleuven.be. 12. Discipline of Evidence-based Medicine, Universidade Federal de São Paulo, Rua Botucatu 740, Sao Paulo, Brazil. 13. Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, United States. Electronic address: jianli2019@ucla.edu. 14. Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), 536 Conselheiro Nébias, Santos, Brazil; Cochrane Brazil, Affiliate Center Rio de Janeiro, 136 Barão do Rio Branco, Petrópolis, Brazil; Centro Universitário São Camilo, 1501 Nazaré, Sao Paulo, Brazil. 15. Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, Rua Barata Ribeiro 142, Bela Vista, São Paulo, Brazil; Discipline of Evidence-based Medicine, Universidade Federal de São Paulo, Rua Botucatu 740, Sao Paulo, Brazil; Oxford-Brazil EBM-Alliance, Brazil. 16. National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark. Electronic address: rer@nfa.dk. 17. Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Donald and Barbara Zucker School of Medicine at Hofstra University, 175 Community Drive, NY 11021, United States; CUNY Institute for Implementation Science, CUNY Graduate School of Public Health and Health Policy, 55 W 125th Street, New York, NY 10027, United States. Electronic address: Grace.Sembajwe@sph.cuny.edu. 18. Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, D-40225 Duesseldorf, Germany. Electronic address: siegrist@uni-duesseldorf.de. 19. Department of Public Health, University of Helsinki, Mannerheimintie 172, 00300 Helsinki, Finland; Department of Public Health, University of Turku, Joukahaisenkatu 3-5, 20520 Turku, Finland; Turku Clinical Research Centre, Turku University Hospital, Finland. Electronic address: lauri.sillanmaki@utu.fi. 20. Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. Electronic address: markku.sumanen@tuni.fi. 21. Turku Clinical Research Centre, Turku University Hospital, Finland; University of Skövde, School of Health Sciences, Sweden. Electronic address: sakari.suominen@utu.fi. 22. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland. Electronic address: ujita@ilo.org. 23. KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium. Electronic address: lieve.vandersmissen@idewe.be. 24. Centre for Environment and Health of KU Leuven, Kapucijnenvoer 35/5, box 7001, 3000 Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium. Electronic address: lode.godderis@kuleuven.be.
Abstract
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing Joint Estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that exposure to long working hours may increase alcohol consumption and cause alcohol use disorder. In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from alcohol consumption and alcohol use disorder that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. OBJECTIVES: We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on alcohol consumption, risky drinking (three outcomes: prevalence, incidence and mortality) and alcohol use disorder (three outcomes: prevalence, incidence and mortality). DATA SOURCES: We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic bibliographic databases for potentially relevant records from published and unpublished studies, including the WHO International Clinical Trials Register, Ovid MEDLINE, PubMed, Embase, and CISDOC on 30 June 2018. Searches on PubMed were updated on 18 April 2020. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA: We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We considered for inclusion randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of exposure to long working hours (41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on alcohol consumption (in g/week), risky drinking, and alcohol use disorder (prevalence, incidence or mortality). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from publications related to qualifying studies. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project. RESULTS: Fourteen cohort studies met the inclusion criteria, comprising a total of 104,599 participants (52,107 females) in six countries of three WHO regions (Americas, South-East Asia, and Europe). The exposure and outcome were assessed with self-reported measures in most studies. Across included studies, risk of bias was generally probably high, with risk judged high or probably high for detection bias and missing data for alcohol consumption and risky drinking. Compared to working 35-40 h/week, exposure to working 41-48 h/week increased alcohol consumption by 10.4 g/week (95% confidence interval (CI) 5.59-15.20; seven studies; 25,904 participants, I2 71%, low quality evidence). Exposure to working 49-54 h/week increased alcohol consumption by 17.69 g/week (95% confidence interval (CI) 9.16-26.22; seven studies, 19,158 participants, I2 82%, low quality evidence). Exposure to working ≥55 h/week increased alcohol consumption by 16.29 g/week (95% confidence interval (CI) 7.93-24.65; seven studies; 19,692 participants; I2 82%, low quality evidence). We are uncertain about the effect of exposure to working 41-48 h/week, compared with working 35-40 h/week on developing risky drinking (relative risk 1.08; 95% CI 0.86-1.36; 12 studies; I2 52%, low certainty evidence). Working 49-54 h/week did not increase the risk of developing risky drinking (relative risk 1.12; 95% CI 0.90-1.39; 12 studies; 3832 participants; I2 24%, moderate certainty evidence), nor working ≥55 h/week (relative risk 1.11; 95% CI 0.95-1.30; 12 studies; 4525 participants; I2 0%, moderate certainty evidence). Subgroup analyses indicated that age may influence the association between long working hours and both alcohol consumption and risky drinking. We did not identify studies for which we had access to results on alcohol use disorder. CONCLUSIONS: Overall, for alcohol consumption in g/week and for risky drinking, we judged this body of evidence to be of low certainty. Exposure to long working hours may have increased alcohol consumption, but we are uncertain about the effect on risky drinking. We found no eligible studies on the effect on alcohol use disorder. Producing estimates for the burden of alcohol use disorder attributable to exposure to long working hours appears to not be evidence-based at this time. PROTOCOL IDENTIFIER: https://doi.org/10.1016/j.envint.2018.07.025. PROSPERO REGISTRATION NUMBER: CRD42018084077.
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing Joint Estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that exposure to long working hours may increase alcohol consumption and cause alcohol use disorder. In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from alcohol consumption and alcohol use disorder that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. OBJECTIVES: We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on alcohol consumption, risky drinking (three outcomes: prevalence, incidence and mortality) and alcohol use disorder (three outcomes: prevalence, incidence and mortality). DATA SOURCES: We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic bibliographic databases for potentially relevant records from published and unpublished studies, including the WHO International Clinical Trials Register, Ovid MEDLINE, PubMed, Embase, and CISDOC on 30 June 2018. Searches on PubMed were updated on 18 April 2020. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA: We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (<15 years) and unpaid domestic workers. We considered for inclusion randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of exposure to long working hours (41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on alcohol consumption (in g/week), risky drinking, and alcohol use disorder (prevalence, incidence or mortality). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from publications related to qualifying studies. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project. RESULTS: Fourteen cohort studies met the inclusion criteria, comprising a total of 104,599 participants (52,107 females) in six countries of three WHO regions (Americas, South-East Asia, and Europe). The exposure and outcome were assessed with self-reported measures in most studies. Across included studies, risk of bias was generally probably high, with risk judged high or probably high for detection bias and missing data for alcohol consumption and risky drinking. Compared to working 35-40 h/week, exposure to working 41-48 h/week increased alcohol consumption by 10.4 g/week (95% confidence interval (CI) 5.59-15.20; seven studies; 25,904 participants, I2 71%, low quality evidence). Exposure to working 49-54 h/week increased alcohol consumption by 17.69 g/week (95% confidence interval (CI) 9.16-26.22; seven studies, 19,158 participants, I2 82%, low quality evidence). Exposure to working ≥55 h/week increased alcohol consumption by 16.29 g/week (95% confidence interval (CI) 7.93-24.65; seven studies; 19,692 participants; I2 82%, low quality evidence). We are uncertain about the effect of exposure to working 41-48 h/week, compared with working 35-40 h/week on developing risky drinking (relative risk 1.08; 95% CI 0.86-1.36; 12 studies; I2 52%, low certainty evidence). Working 49-54 h/week did not increase the risk of developing risky drinking (relative risk 1.12; 95% CI 0.90-1.39; 12 studies; 3832 participants; I2 24%, moderate certainty evidence), nor working ≥55 h/week (relative risk 1.11; 95% CI 0.95-1.30; 12 studies; 4525 participants; I2 0%, moderate certainty evidence). Subgroup analyses indicated that age may influence the association between long working hours and both alcohol consumption and risky drinking. We did not identify studies for which we had access to results on alcohol use disorder. CONCLUSIONS: Overall, for alcohol consumption in g/week and for risky drinking, we judged this body of evidence to be of low certainty. Exposure to long working hours may have increased alcohol consumption, but we are uncertain about the effect on risky drinking. We found no eligible studies on the effect on alcohol use disorder. Producing estimates for the burden of alcohol use disorder attributable to exposure to long working hours appears to not be evidence-based at this time. PROTOCOL IDENTIFIER: https://doi.org/10.1016/j.envint.2018.07.025. PROSPERO REGISTRATION NUMBER: CRD42018084077.
Authors: Paul Whaley; Bas J Blaauboer; Jan Brozek; Elaine A Cohen Hubal; Kaitlyn Hair; Sam Kacew; Thomas B Knudsen; Carol F Kwiatkowski; David T Mellor; Andrew F Olshan; Matthew J Page; Andrew A Rooney; Elizabeth G Radke; Larissa Shamseer; Katya Tsaioun; Peter Tugwell; Daniele Wikoff; Tracey J Woodruff Journal: ALTEX Date: 2021-06-22 Impact factor: 6.250
Authors: Frank Pega; Natalie C Momen; Diana Gagliardi; Lisa A Bero; Fabio Boccuni; Nicholas Chartres; Alexis Descatha; Angel M Dzhambov; Lode Godderis; Tom Loney; Daniele Mandrioli; Alberto Modenese; Henk F van der Molen; Rebecca L Morgan; Subas Neupane; Daniela Pachito; Marilia S Paulo; K C Prakash; Paul T J Scheepers; Liliane Teixeira; Thomas Tenkate; Tracey J Woodruff; Susan L Norris Journal: Environ Int Date: 2022-02-16 Impact factor: 9.621
Authors: Natalie C Momen; Kai N Streicher; Denise T C da Silva; Alexis Descatha; Monique H W Frings-Dresen; Diana Gagliardi; Lode Godderis; Tom Loney; Daniele Mandrioli; Alberto Modenese; Rebecca L Morgan; Daniela Pachito; Paul T J Scheepers; Daria Sgargi; Marília Silva Paulo; Vivi Schlünssen; Grace Sembajwe; Kathrine Sørensen; Liliane R Teixeira; Thomas Tenkate; Frank Pega Journal: Environ Int Date: 2021-11-30 Impact factor: 9.621
Authors: Liliane R Teixeira; Frank Pega; Angel M Dzhambov; Alicja Bortkiewicz; Denise T Correa da Silva; Carlos A F de Andrade; Elzbieta Gadzicka; Kishor Hadkhale; Sergio Iavicoli; Martha S Martínez-Silveira; Małgorzata Pawlaczyk-Łuszczyńska; Bruna M Rondinone; Jadwiga Siedlecka; Antonio Valenti; Diana Gagliardi Journal: Environ Int Date: 2021-02-18 Impact factor: 9.621