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Abstainers more likely to miss work due to mental illness than drinkers
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People who abstained from alcohol were more likely to take more sick days due to chronic mental, musculoskeletal, respiratory and digestive illnesses than low-risk drinkers, according to findings published in Addiction.
The results also showed that persistent at-risk drinkers took more sick days because of external causes compared with persistent low-risk drinkers.
“Previous studies have shown that both abstainers and at-risk drinkers are at an increased risk of sickness absence compared with low-risk drinkers,” Jenni Ervasti, PhD, from the Finnish Institute of Occupational Health in Helsinki, and colleagues wrote. “To date, however, it is still unclear which specific diagnoses are associated with the excess risk of sickness absence among abstainers, and whether they correspond to those observed among at-risk drinkers.”
In this multicohort study, researchers examined the differences in diagnosis-specific sickness absences between alcohol abstainers, former, persistent and new at-risk and low-risk drinkers in Finland, France and the U.K. Diagnosis-specific sickness included mental disorders, musculoskeletal disorders, circulatory system-related diseases, digestive disease and respiratory diseases. The investigators also examined whether external causes and sex impacted these differences. They used records from sickness absence registers.
In total, 47,520 participants responded to a survey on alcohol use at two timepoints. For participants in Finland, researchers assessed population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000 to 2002 and 2004; for those in France and the U.K., they examined employee cohort survey data from 1993 and 1997, and 1985 to 1988 and 1991 to 1994. Ervasti and colleagues used data from the questionnaires to evaluate alcohol intake and identify groups with stable and changing alcohol use over time.
Compared with the low-risk reference group — women who drank one to 11 units of alcohol and men who drank one to 34 units per week — those who reported no alcohol use in either survey were at higher risk for sickness absence due to mental illnesses (RR = 1.51; 95% CI, 1.22-1.88), musculoskeletal disorders (RR = 1.22; 95% CI, 1.06-1.41), digestive-related diseases (RR = 1.35, 95% CI, 1.02-1.77) and respiratory-related diseases (RR = 1.49; 95% CI, 1.29-1.72).
The results showed persistent at-risk drinkers had a higher risk for sickness absence due to external causes. Women who reported drinking more than 11 units of alcohol each week and men who reported consuming more than 34 units each week in both surveys had a greater risk for absence because of injury or poisoning (RR = 1.44; 95% CI, 1.13-1.83), according to the results.
“This pooled analysis of four cohorts from three countries provides new evidence about diseases underlying the U-shaped association between alcohol use and sickness absence,” the authors wrote. “Our results can help occupational health care and facilitate early interventions/auditing for at-risk alcohol use when accumulating sickness absence due to external causes are observed.” – by Savannah Demko
Disclosures: The authors report no relevant financial disclosures.