Objective To quantify the association between long working hours and alcohol use.Design Systematic review and meta-analysis of published studies and unpublished individual participant data.Data sources A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies.
Review methodsThe search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.Results Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.Conclusions Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
To test the psychometric properties and criterion validity of the Japanese version of the EVortReward Imbalance (ERI) Questionnaire (Siegrist, 1996), a survey was conducted among 105 male dental technicians. The Japanese version of the questionnaire was developed through a backtranslation process. Internal consistency and factorial structure were tested and the criterion validity with respect to musculoskeletal symptoms was estimated with the help of a correlation matrix and logistic regression analysis. In psychometric terms, the factorial structure of the scales measuring the components of the theoretical concept was replicated satisfactorily, and internal consistencies of the scales measuring the extrinsic and intrinsic components of the model were appropriate. Signi® cant associations between components of the ERI and musculoskeletal symptoms were found. Logistic regression analysis revealed a signi® cantly elevated risk of musculoskeletal symptoms in participants scoring high on the scale measuring the model's intrinsic component,`overcommitment'. This study indicates that, at least for the occupational group under study, the Japanese version of the ERI Questionnaire is a feasible and psychometrically well justi® ed new measure for assessing psychosocial stress at work with relevance to health.
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