Sickness absence diagnoses among abstainers, low‐risk drinkers and at‐risk drinkers: consideration of the U‐shaped association between alcohol use and sickness absence in four cohort studies

Abstract

AimsTo estimate differences in the strength and shape of associations between alcohol use and diagnosis‐specific sickness absence.DesignA multi‐cohort study. Participants (n = 47 520) responded to a survey on alcohol use at two time‐points, and were linked to records of sickness absence. Diagnosis‐specific sickness absence was followed for 4–7 years from the latter survey.Setting and participantsFrom Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000–02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985–88 and 1991–94, respectively.MeasurementsWe used standard questionnaires to assess alcohol intake categorized into 0, 1–11 and > 11 units per week in women and 0, 1–34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio‐economic status, smoking and body mass index.FindingsWomen who reported drinking 1–11 units and men who reported drinking 1–34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22–1.88], musculoskeletal disorders (1.22, 95% CI = 1.06–1.41), diseases of the digestive system (1.35, 95% CI = 1.02–1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29–1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13–1.83).ConclusionsIn Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at‐risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

Health behaviours and psychosocial working conditions as predictors of disability pension due to different diagnoses: a population-based study

“…Our results that psychosocial working conditions predicted DP differently depending on DP diagnosis group confirms the importance to investigate the diagnosis groups instead of focusing on DP in general [12,13] or only one diagnosis group [10,11]. Furthermore, the assumption that health behaviours would be influential for the pathway to work incapacity in terms of DP [19][20][21][22] was confirmed in our study. In this study, the associations of job control, job demands and social support with DP varied if one had healthy or unhealthy behaviours based on tobacco and alcohol consumption and physical activity.…”

“…The assumed pathway is that even modest improvement in health behaviours could markedly affect the disease risk and consequently also the risk for DP. Thus, DP is known to be associated with various health behaviours [ 19 – 22 ] as has been also shown by earlier twin studies [ 23 , 24 ]. Since many health behaviours are clustered and various other (i.e.…”

Lifestyle factors and risk of sickness absence from work: a multicohort study

“…Available evidence on lifestyle and diagnosis-specific sickness absence is limited to investigations that have assessed one lifestyle factor or one diagnosis outcome at a time, thus preventing comparisons of the relative importance of different lifestyle factors for different diagnostic groups. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Some of these studies have been small in scale (sample size between 200 and 4000 participants) and have provided imprecise estimates. 11 , 12 , 13 , 14 , 17 The overall evidence is characterised by mixed findings.…”

“… 11 , 12 , 13 , 14 , 17 The overall evidence is characterised by mixed findings. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 …”

Cost and consequence analysis of the Healthy Choices at Work programme to prevent non-communicable diseases in a commercial power plant, South Africa

“… 48 Other studies found a U-shaped relationship between alcohol consumption and sickness absenteeism such that people who abstained from alcohol had higher sickness absenteeism than people who consumed alcohol moderately. 49 …”