Socio-demographic differences in alcohol-related work impairment

Abstract

Background and Aims: The costs of alcohol-related presenteeism (being at work in an impaired state due to alcohol use) have been estimated as substantially larger than the costs of alcohol-related absenteeism. Past studies indicate that employees with lower socio-economic status experience more alcohol-attributable problems than employees in higher socio-economic strata. We aimed to estimate the prevalence of alcohol-related presenteeism among Norwegian adults and its association with sex, age, income and education. Design and Setting: Annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2016–19) among Norwegian adults. Participants: A total of 5430 full- and part-time employees aged 16–79 years; 53% were men. Measurements: The main outcome was self-reported 12-month occurrence of work impairment due to alcohol use the previous day. Main predictors were income and education obtained from national registries, age and gender. A secondary outcome variable was self-reported alcohol-related absenteeism. Findings: The 12-month prevalence of alcohol-related work impairment was 8.7%, 95% confidence interval (CI) = 7.9, 9.4. Adjusted risk ratios (RR) indicated a higher risk for men compared with women (RR = 1.26, 95% CI = 1.06, 1.50) and higher risk for young employees (e.g. less than 26 years compared with 55+, RR = 7.64, 95% CI = 4.88, 11.95). The risk increased as a function of higher education (in order of increasing education, RR = 1.12, 95% CI = 0.87, 1.45; RR = 1.64, 95% CI = 1.26, 2.12; RR = 2.19, 95% CI = 1.63, 2.95). The risk was estimated as lower in the middle-income categories compared with the lowest (RR = 0.76, 95% CI = 0.58, 1.00, RR = 0.89, 95% CI = 0.66, 1.20, RR = 0.94, 95% CI = 0.68, 1.29) and higher for employees with the highest income (RR = 1.04, 95% CI = 0.73, 1.48; RR = 1.47, 95% CI = 1.09, 2.00). Conclusions: In Norway, the risk of alcohol-related work impairment for employees in the highest education category is approximately twice that of employees with secondary education or less. Except for employees in the lowest income category, who had a higher risk than those in the middle-income categories, higher income is associated with increased risk of work impairment. Being younger and male are also associated with increased risk of alcohol-related work impairment.