A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference

Abstract

Aim Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term). Method Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078. Results Fifty-nine studies (58% longitudinal) including 439,209 employees (min. 43, max. 77,746) from 15 countries were included. Most associations indicating positive and statistically significant results were based on longitudinal data (70%) and confirmed the strong/causal relationship between alcohol use and sickness absence. The meta-analysis included eight studies (ten samples). The increased risk for sickness absence was likely to be found in cross-sectional studies (OR: 8.28, 95% CI: 6.33–10.81), studies using self-reported absence data (OR: 5.16, 95% CI: 3.16–8.45), and those reporting short-term sickness absence (OR: 4.84, 95% CI: 2.73–8.60). Conclusion This review supports, but also challenges earlier evidence on the association between alcohol use and sickness absence. Certain types of design, data, and types of sickness absence may produce large effects. Hence, to investigate the actual association between alcohol and sickness absence, research should produce and review longitudinal designed studies using registry data and do subgroup analyses that cover and explain variability of this association.

Contribution of compositional changes in the workforce to sickness absence trends in Finland

“…Other factors, such as changes in legislation, population health or health behaviour (especially alcohol consumption) and in work environment ( Lidwall & Marklund, 2011 ; S. Hashemi et al, 2022 ), can contribute to long-term sickness absence trends. However, no major changes occurred in the Finnish legislation related to sickness benefits during our study period 2005–2016.…”

Do Differences in Drinking Attitudes and Alcohol-Related Problems Explain Differences in Sick Leave? A Multilevel Analysis of 95 Work Units Within 14 Companies From the WIRUS Study

“…This study is part of the Norwegian national WIRUS (Workplace Intervention preventing Risky Use of Alcohol and Sick leave) project and was designed as a cohort study on a sample of employees in 14 companies in Norway. More details and other results from the WIRUS project are published elsewhere ( 3 , 12 , 14 , 59 , 72 – 80 ).…”

Working with alcohol prevention in occupational health services: “knowing how” is more important than “knowing that” – the WIRUS OHS study

“…Risky drinking constitutes a drinking pattern that increases the risk of medical, social, legal, occupational, domestic and economic problems [ 15 ]. The majority of society’s risky drinkers are part of the active workforce [ 16 ], and alcohol consumption among employees is associated with higher levels of sickness absenteeism [ 17 – 20 ] and presenteeism (impaired on-the-job performance) [ 21 – 23 ].…”