At-risk drinking among patients in an occupational medicine clinic

This study described the prevalence and characteristics of at-risk drinkers among adults receiving care at an urban occupational medicine clinic. Comparisons were also made between occupational medicine and primary care patients. Among occupational medicine patients, prevalences were: 11% at-risk drinking; 51% light-moderate drinking; 38% abstinence. Abstainers differed from alcohol users with regard to race (fewer Caucasian) and marijuana use (lower rates). Compared to light-moderate drinkers, at-risk drinkers were more likely to be smokers. Compared to a primary care sample, non-at-risk drinkers in occupational medicine reported poorer health, more activity limitations, higher rates of smoking and more stress and depressive symptoms. In contrast, at-risk drinkers in occupational medicine were quite similar to those in primary care. Occupational medicine clinics are viable settings in which to screen for at-risk drinking patterns and to implement primary and secondary prevention strategies.     

Alcohol Use and Problem Drinking among Women Firefighters

ObjectivesGiven high levels of occupational stress and toxic exposures, firefighters have a relatively high prevalence of occupationally related medical and mental health disorders compared with the general public. Previous research found high rates of heavy and binge drinking among male firefighters. This study is the first to examine alcohol use among women firefighters.MethodsData were collected as part of a national online survey of women, career firefighters.ResultsA total of 1,913 women firefighters completed questions regarding alcohol use. Nearly 40% reported binge drinking in the previous month and 4.3% reported driving while intoxicated. Among those who drank, 16.5% screened positive for problem drinking. Problem drinkers were more than 2.5 times as likely to have been diagnosed with depression or have symptoms of posttraumatic stress disorder, and were approximately 40% more likely to have been injured on the job in the previous year, when compared with other women firefighters. Those who screened positive for problem drinking also were significantly less likely to say that they would recommend a fire service career to other women.ConclusionsAs with male firefighters, heavy and problem drinking are prevalent among women firefighters and are associated with negative occupational outcomes.     

Cardiovascular risk factors and confounders among nondrinking and moderate-drinking U.S. adults

BACKGROUND: Studies suggest that moderate drinkers have lower cardiovascular disease (CVD) mortality than nondrinkers and heavy drinkers, but there have been no randomized trials on this topic. Although most observational studies control for major cardiac risk factors, CVD is independently associated with other factors that could explain the CVD benefits ascribed to moderate drinking. METHODS: Data from the 2003 Behavioral Risk Factor Surveillance System, a population-based telephone survey of U.S. adults, was used to assess the prevalence of CVD risk factors and potential confounders among moderate drinkers and nondrinkers. Moderate drinkers were defined as men who drank an average of two drinks per day or fewer, or women who drank one drink or fewer per day. RESULTS: After adjusting for age and gender, nondrinkers were more likely to have characteristics associated with increased CVD mortality in terms of demographic factors, social factors, behavioral factors, access to health care, and health-related conditions. Of the 30 CVD-associated factors or groups of factors that we assessed, 27 (90%) were significantly more prevalent among nondrinkers. Among factors with multiple categories (e.g., body weight), those in higher-risk groups were progressively more likely to be nondrinkers. Removing those with poor health status or a history of CVD did not affect the results. CONCLUSIONS: These findings suggest that some or all of the apparent protective effect of moderate alcohol consumption on CVD may be due to residual or unmeasured confounding. Given their limitations, nonrandomized studies about the health effects of moderate drinking should be interpreted with caution, particularly since excessive alcohol consumption is a leading health hazard in the United States.     

HBV- and HCV- infected workers in the Japanese workplace

Around three million Japanese are persistently infected with HBV or HCV. Though most of them work in various industries, little is known about the actual conditions in their workplaces. To clarify the workplace conditions of workers with hepatitis, three kinds of questionnaire surveys, answered by occupational health physicians and workers with hepatitis, were carried out. The rates of workers recognized as workers with hepatitis B or C by occupational health physicians were 0.82% and 0.48% of 130,092 workers, respectively. About 30% of workers with hepatitis were engaged in "hazardous work". The percentage of workers engaged in various types of hazardous work among workers with hepatitis was nearly the same as that among all Japanese workers. About 30% of occupational health physicians witnessed exacerbation of hepatitis in the workers at their workplaces, and 22% of workers with hepatitis experienced exacerbation of hepatitis. The rate of workers with hepatitis who had experienced exacerbation was not significantly different between workers with and without hazardous work. Workers with hepatitis have strong concerns about the relationship between work and exacerbation. As causes of exacerbation, occupational health physicians cited "unknown", "drinking" and "quit treatment" while workers with hepatitis answered "work-related causes", besides "unknown" and "drinking."     

Gene-environmental interactions in alcohol-related health problems--contributions of molecular biology to behavior modifications

High alcohol sensitivity among Asians is mainly due to a genetic polymorphism in the low Km aldehyde dehydrogenase (ALDH2) gene. Strong correlations between the ALDH2 genotype and alcohol sensitivity or alcohol drinking habits have been reported. Another prevalent polymorphism in the alcohol dehydrogenase beta-subunit (ADH2 gene) among Asians appears to modify skin flushing reactions after exposure to ethanol but does not influence alcohol drinking behavior. Both the ADH2 and ALDH2 genotypes have been significantly correlated with the risk of alcoholism. In a Japanese occupational population, a gene-environment interaction of the ALDH2 genotype and daily hassles scores for development of problem drinking behavior was observed. Habitual drinkers with the ALDH2*1/*2 genotype had higher frequencies of sister-chromatid exchange in cultured lymphocytes and higher 8-OHdG levels in polymorphonuclear leukocytes than those with the ALDH2*1/*1 genotype. Alcoholics and heavy drinkers with the ALDH2*1/*2 genotype have been shown to have significantly elevated risks for esophageal and multiple cancers in upper digestive organs than those with the ALDH2*1/*1 genotype. In Japan, bronchial asthma patients with the ALDH2*1/*2 genotype have been shown to have a significantly elevated risk for experiencing alcohol-induced asthma compared with the ALDH2*1/*1 genotype. Providing services to determine these genotypes would be of great help for each individual to make a plan for tailor-made health promotion.     

Smokers and drinkers in a health maintenance organization population: Lifestyles and health status

This study examines, among a large health maintenance organization population, the prevalence of two high-risk lifestyle practices (smoking and problem drinking), their interrelationships, and their relationships with other lifestyle practices, sociodemographic characteristics, and health status measures. Results, based on a random sample of 1,133 adults, showed that smoking and problem drinking are strongly correlated. Individuals with no drinking problems had an age-, sex-, and education-adjusted smoking prevalence of approximately 20%, while problem drinkers smoked at about twice that rate. In addition, reporting one type of problem drinking behavior (binge, chronic, or drinking and driving) at least doubled, and in one instance increased by sixfold, the likelihood of reporting another type of problem drinking behavior. Smokers and problem drinkers were more likely to be younger than age 65, to be irregular seat belt users (smokers and binge drinkers only), and not to belong to voluntary organizations. Results of the analysis suggest that detection, prevention, and treatment of drug use, in general, might prove more beneficial than only focusing on smoking and problem drinking. In addition, because binge drinking and drinking and driving were so widespread among younger age groups, it might prove more beneficial to consider preventive strategies that change the sale and distribution of alcohol and make the environment safer in which to drink, such as providing transportation to get drinkers back home.     

Drinking levels, knowledge, and associated characteristics, 1985 NHIS findings

Several questions in the 1985 Health Promotion and Disease Prevention Questionnaire, which was part of the 1985 National Health Interview Survey, addressed respondents' consumption of alcohol. Sociodemographic characteristics, knowledge of health risks related to heavy drinking, health practices, and the prevalence of certain health conditions were examined in relation to drinking levels. Although cause-effect relationships should not be inferred from the associations, the findings suggest some provocative areas for prevention and research. Heavier drinkers were more commonly found among men than women. Level of drinking was associated positively with years of education and family income, but was inversely related to age. Compared with light drinkers, heavier drinkers were much more likely to drive after they had had too much to drink. While more than 90 percent of the population knew that heavier drinking increases the risk of 'liver cirrhosis, less than half knew about the increased risk of throat cancer and cancer of the mouth. Most respondents aged 18-44 years (80 percent or more) knew that heavy drinking increases the chance of adverse pregnancy outcomes, and more women than men (62 versus 49 percent) had heard of fetal alcohol syndrome (FAS). However, 70 percent or more of those who had heard of FAS described the syndrome as a newborn addicted to alcohol rather than a child born with certain birth defects. Heavier drinkers of both sexes were less likely than others to be nonsmokers, and moderate drinkers were more likely than others to exercise or play sports regularly. Moderate drinkers also tended to have lower lifetime prevalence rates than others for hypertension and heart trouble.     

Association between job stressors and heavy drinking: age differences in male Japanese workers

The objective of the present study is to investigate the association between various occupational stressors and heavy drinking among male Japanese workers in different age groups. Using the Generic Job Stress Questionnaire, 13 occupational stressors and 2 workplace support indicators were assessed. The questionnaire survey was conducted of 25,104 workers, and the present study analyzed the data from 17,501 male workers. Heavy drinking was defined as weekly alcohol consumption of >275 g, and a total of 1,131 men (6.5%) were classified as heavy drinkers. After adjusting for shift work, occupational class, marital status and smoking, heavy drinking was related to "support from supervisor" for the 18-29 and 50-72 yr-old groups. For the 30-39 yr-old group, heavy drinking was related to "intragroup conflict", "job control" and "cognitive demands." For the 40-49 yr-old group, heavy drinking was related to "physical environment", "quantitative workload" and "underutilization of abilities." The present study clarified that certain occupational stressors relate to heavy drinking, and that this association varies among different age groups.     

Work experience and drinking behavior: alienation, occupational status, workplace drinking subculture and problem drinking

This study explored the association between alienating job conditions and problem drinking within the context of occupational status and workplace drinking subculture. From December 1994 to March 1995, a questionnaire survey was implemented in the manufactory sector in southern Taiwan. Within the questionnaire, any perceived self-estrangement, powerlessness and social isolation that the individual experienced in his work were measured as the alienating job conditions, and any negative physical, psychological and social consequences the individual experienced during the previous month were considered as affecting problem drinking. Of the 1117 subjects, 668 (61.8%) reported imbibing one or more drinks during the preceding month; the average daily alcohol consumption being 0.2+/-0.9 drinks. In addition, 188 (16.8%) subjects reported having experienced drinking-related problems in the preceding month. Workers with low occupational status were more likely to become problem drinkers when they felt comparatively self-estranged in their work. Further, those with a family history including any habitual drinker or those under more encouraging workplace drinking subculture were more likely to have drinking-related problems. For the prevention of problem-related drinking behavior, the workplace should be considered as the focus of our future intervention and management program.     

Associations of job strain and working overtime with adverse health behaviors and obesity: evidence from the Whitehall II Study, Helsinki Health Study, and the Japanese Civil Servants Study

Adverse health behaviors and obesity are key determinants of major chronic diseases. Evidence on work-related determinants of these behavioral risk factors is inconclusive, and comparative studies are especially lacking. We aimed to examine the associations between job strain, working overtime, adverse health behaviors, and obesity among 45-60-year-old white-collar employees of the Whitehall II Study from London (n=3,397), Helsinki Health Study (n=6,070), and the Japanese Civil Servants Study (n=2,213). Comparable data from all three cohorts were pooled, and logistic regression analysis was used, stratified by cohort and sex. Models were adjusted for age, occupational class, and marital status. Outcomes were unhealthy food habits, physical inactivity, heavy drinking, smoking, and obesity. In London, men reporting passive work were more likely to be physically inactive. A similar association was repeated among women in Helsinki. Additionally, high job strain was associated with physical inactivity among men in London and women in Helsinki. In London, women reporting passive work were less likely to be heavy drinkers and smokers. In Japan, men working overtime reported less smoking, whereas those with high job strain were more likely to smoke. Among men in Helsinki the association between working overtime and non-smoking was also suggested, but it reached statistical significance in the age-adjusted model only. Obesity was associated with working overtime among women in London. In conclusion, job strain and working overtime had some, albeit mostly weak and inconsistent, associations with adverse health behaviors and obesity in these middle-aged white-collar employee cohorts from Britain, Finland, and Japan.     

Reevaluating risk factors for women's drinking: a study of blue-collar wives

Social indicators for problem drinking among women are based on studies of women seeking treatment for alcoholism or alcohol-related problems. Prior studies of risk factors have focused on life history, personality, genetic predisposition, and sociocultural factors. Virtually no attention has been paid to antecedents of drinking patterns in nonclinical populations of women. In this study of alcohol use among 31 industrial workers and their families, most of the wives clearly exhibited known sociocultural risk factors for heavy or problem drinking among women, yet most were light or moderate drinkers. Based on an ethnographic and case study research design, we propose four explanations for this anomaly in relation to cultural characteristics of working-class life. Beliefs, attitudes, and other social constraints that appear to significantly inhibit the development of problem drinking among women in this apparently high-risk population are identified.     

Black-white differences in alcohol use by women: Baltimore survey findings

Although black women suffer disproportionately from alcohol-related illnesses and causes of death, little is known about the extent to which poorer outcomes are a function of differences in drinking, the use of health services, or some combination of these factors. This study, using interview data obtained in the Baltimore Epidemiologic Catchment Area household survey, compares racial differences in alcohol use and abuse among a sample of 2,100 women. After controlling for differences in sociodemographic characteristics, black women were found to be at no greater risk than whites for heavy drinking or for suffering from alcohol abuse or dependence. Racial differences, however, were observed in heavy drinking by years of education. A similar percentage of black women and white women who had not completed high school were heavy drinkers, but black women with 12 or more years of education were less likely to be heavy drinkers than whites with comparable education. These findings raise questions about the extent to which differences in drinking contribute to the poorer alcohol-related health outcomes of black women in Baltimore. Additionally, the finding that education was inversely related to heavy drinking among black women may be helpful in shaping early alcohol abuse intervention and treatment services that target black women.     

Alcohol dependence and depression among heavy drinkers in Canada

This article describes the prevalence of heavy drinking among the Canadian population and the prevalence of alcohol dependence among heavy drinkers aged 18 or older. It also examines the association of depression to alcohol dependence among the latter group and the correlates of depression and alcohol dependence comorbidity. The data are from a national representative sample of the Canadian population in 2000/01. One in five current drinkers aged 18 or older was classified as a regular heavy drinker. This constituted a significant increase of approximately 2% in the prevalence of heavy drinking from 1996/97 to 2000/01 in Canada (p<0.001). Although men were more likely to be regular heavy drinkers (29.0%) than women (11.1%), male and female heavy drinkers were about equally as likely to be classified as alcohol dependent (11.6% and 11.1%, respectively). While the prevalence of alcohol dependence among men has remained stable, it has decreased by almost 4% among women (p<0.05). Among persons who have experienced a depressive episode in the year prior to their 2000/01 interview, the prevalence of alcohol dependence was estimated at 32.3% while it was 9.5% for persons without depression. When several indicators believed to be risk factors for alcohol dependence including personal characteristics, psychosocial factors, lifestyle behaviours and physical health were included in the logistic regression models, the marked difference in alcohol dependence among depressed and non-depressed heavy drinkers remained. The former had 3.6 times the odds of being classified as alcohol dependent compared to the latter (CI=2.9, 4.3). When the same personal, psychosocial, lifestyle and physical health measures were used to explain comorbidity of depression and alcohol dependence, perceived stress was the only factor that was consistently associated with comorbidity among both men and women.     

Sexual harassment and generalized workplace abuse among university employees: prevalence and mental health correlates

OBJECTIVES: This study hypothesized that interpersonal workplace stressors involving sexual harassment and generalized workplace abuse are highly prevalent and significantly linked with mental health outcomes including symptomatic distress, the use and abuse of alcohol, and other drug use. METHODS: Employees in 4 university occupational groups (faculty, student, clerical, and service workers; n = 2492) were surveyed by means of a mailed self-report instrument. Cross-tabular and ordinary least squares and logistic regression analyses examined the prevalence of harassment and abuse and their association with mental health status. RESULTS: The data show high rates of harassment and abuse. Among faculty, females were subjected to higher rates; among clerical and service workers, males were subjected to higher rates. Male and female clerical and service workers experienced higher levels of particularly severe mistreatment. Generalized abuse was more prevalent than harassment for all groups. Both harassment and abuse were significantly linked to most mental health outcomes for men and women. CONCLUSIONS: Interpersonally abusive workplace dynamics constitute a significant public health problem that merits increased intervention and prevention strategies.     

The health and health behaviors of people who do not drink alcohol

BACKGROUND: Compared to abstention, moderate drinking has been linked to better health, and heavy and hazardous drinking to increased morbidity and mortality. Many studies have failed to account for heterogeneity in health and drinking history among nondrinkers, however. If former drinkers quit in response to ill health, this could increase the risk in the nondrinker category and underestimate the effects of alcohol if illnesses leading to abstention are alcohol-related. In addition, health behaviors may vary with drinking status, affecting health outcomes often attributed to drinking. METHODS: Survey data were collected from a probability sample of a large health maintenance organization's membership. Regression analyses assess the relationship between drinking status (adjusting for covariates), mental and physical health and functioning, and health behaviors. RESULTS: Former drinkers and lifelong abstainers had worse health and functioning than current drinkers and, comparatively, former drinkers had worse health than lifelong abstainers. Former drinkers did not differ from light-to-moderate drinkers in regard to health behaviors (except for smoking), although lifelong abstainers and heavier drinkers were less likely to use preventive care or try to improve their health behaviors. CONCLUSIONS: Consistent with hypotheses that former drinkers may stop drinking because of poor health, former drinkers were less healthy than current drinkers and had slightly worse health than lifelong abstainers, compared to light-to-moderate drinkers. Former drinkers did not appear to be at risk because of poorer health behaviors (except smoking), but lifelong abstainers and heavier drinkers might benefit from outreach designed to increase use of preventive care and improve health behaviors.     

Associations of physical activity with smoking and alcohol consumption: a sport or occupation effect?

BACKGROUND: The aim of this study was to explore the associations of physical activity with smoking and alcohol consumption. It examined whether these associations are due to people participating in organized sports (the sport hypothesis), and/or reflect the concentration of drinking and smoking in manual occupational groups (the occupation hypothesis). METHODS: Data from the 2003 Health Survey for England (n=11,617) were analyzed from a multilevel perspective. Four models were specified to examine the variation of heavy drinking, smoking, sports activity, and occupational activity across different sociodemographic groups; and four sets of analyses further explored the associations of sports and occupational activity with heavy drinking and smoking. RESULTS: Some support was found for both the sport and occupation hypothesis. Sports activity and heavy drinking were more prevalent among sportsclub members, and occupational activity and heavy drinking were more prevalent among manual occupational groups. Sportsclub membership accounted for some of the association between sports activity and heavy drinking; and occupational position partly accounted for the association between occupational activity and heavy drinking. The occupation hypothesis is the more likely explanation for the association between physical activity and smoking. CONCLUSIONS: This study shows that it is worthwhile to distinguish between different types of physical activity; and that multiple processes underlie the clustering of health behaviors.     

Patterns of alcohol consumption in young Australian women: socio-demographic factors, health-related behaviours and physical health

OBJECTIVE: To determine which socio-demographic factors, health-related behaviours and physical health conditions are associated with non-drinking, binge drinking and hazardous/harmful drinking in young Australian women. METHODS: Cross-sectional data were obtained from the baseline survey of 14,762 young women (aged 18-23 years) enrolled in the Women's Health Australia study in 1996. Associations between a range of drinking patterns and socio-demographic factors, health-related behaviours and health conditions were examined. RESULTS: Half the women were 'low intake' drinkers, a third 'rarely drank' and 9% were non-drinkers; however, 70% reported binge drinking with one-quarter of the binge drinkers doing so at least weekly. Non-drinkers were more likely than drinkers to be married, pregnant, non-smokers, born in non-English speaking countries, to live in the Northern Territory, and to have lower levels of education, employment, and private health insurance. 'Low intake/binge weekly' drinkers (12%) and 'hazardous/harmful' drinkers (5%) were more likely than 'low risk' drinkers to be unmarried; to live in shared accommodation, alone or with their parents; to live in rural or remote areas; to have ever had any sexually transmitted infection; to be current smokers or ex-smokers and to have used unhealthy weight-control practices. CONCLUSIONS: The results confirm findings from other countries about the importance of social conditions as determinants of alcohol consumption by young women. IMPLICATIONS: Health promotion to reduce young women's alcohol consumption needs to be carefully targeted to take account of their demographies, living environments and beliefs.     

Maternal employment and reproductive risk factors

Studies of reproductive hazards in the workplace must address potential biases related to selection for employment. The National Natality Survey, a probability sample of live births to married women in 1980, was used to examine the relation between female employment during pregnancy and factors that might affect reproductive outcome by analyzing the 5,927 women with complete occupational data. Demographic and behavioral attributes as well as reproductive history were compared for the 3,712 women employed and the 2,215 women not employed during pregnancy. Employed mothers were of more optimal reproductive age, were more highly educated, had higher incomes, began prenatal care earlier, had greater weight gain during pregnancy, and were slightly less likely to be heavy smokers. Employed women had markedly fewer previous births and less favorable reproductive histories (more stillbirths, miscarriages, and induced abortions) than unemployed women, controlling for gravidity. Full- and part-time workers were similar with regard to demographic and behavioral characteristics, but part-time workers had higher parity. Differences were noted by employment sector: professional women had especially favorable demographic and behavioral traits, and women employed as operatives and service workers were less advantaged. These results indicate that substantial differences in pregnancy-related risk factors exist in relation to employment, with working women generally having more favorable demographic and behavioral characteristics and less favorable reproductive histories. This pattern could produce selection bias in studies of work and reproductive health, and it encourages the restriction of comparison groups to other employed women, with a need to consider heterogeneity among working women as well.     

Riskanter Alkoholkonsum und Rauschtrinken unter Berücksichtigung von Verletzungen und der Inanspruchnahme alkoholspezifischer medizinischer Beratung

The German Health Interview and Examination Survey for Adults (DEGS1) was conducted from 2008–2011 and comprised interviews, examinations and tests. The target population was the resident population of Germany aged from 18–79 years (n?=?8,152). Data on alcohol consumption, at-risk drinking and heavy episodic drinking was collected in a self-administered questionnaire with the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C). At-risk drinking is most common among young individuals aged from 19–29 years (men 54.9?%; women 36?%), becoming less common from an age of 65 years. With 41.6?%, at-risk drinking is more prevalent in men than in women (25.6?%). Men are three times more likely to be heavy episodic drinkers than women. Injuries are more common among individuals with at-risk or heavy episodic drinking. They receive advice on alcohol consumption during visits to general practitioners/specialists or outpatient departments more often than individuals without these drinking patterns. An English full-text version of this article is available at SpringerLink as supplemental.     

Examining Australia's heaviest drinkers

Objective : This study examined the distribution of alcohol consumption in Australia, identifying the heaviest drinking 10% of the population and examining their sociodemographic characteristics and their alcohol consumption and purchasing practices. Methods : Data came from the 2016 National Drug Strategy Household Survey and the 2013 International Alcohol Control Study. The heaviest drinking 10% of the population identified based on estimates of annual alcohol consumption. Logistic regression was then used to assess the factors that distinguished these heaviest drinkers from the rest of the drinking population. Results : The heaviest drinking 10% of the population consumed 54.4% of all alcohol consumed. These heavy drinkers were more likely to be men and to live in regional and remote areas. They were more likely to drink cask wine and full‐strength beer and to purchase cheaper alcohol than other drinkers. Conclusions : Australian alcohol consumption is heavily skewed. Alcohol consumption practices appear to differentiate the heaviest drinkers from others more clearly than sociodemographic factors. Implications for public health : Public health interventions that reduce drinking among the heaviest 10% of drinkers in Australia have the potential to markedly reduce per‐capita consumption and reduce alcohol‐related harm. Interventions focused on cheap alcohol may be effective with these drinkers.