Group differences in alcohol-related sickness absence and attitudes

Abstract

This thesis is a study on group differences in alcohol-related sickness absence. It consists of four papers: The first is an extensive review article of international research on the alcohol ?? sickness absence association. The second and third articles present studies of group differences in alcohol-related sickness absence in Norway. The fourth article is a study of group differences in attitudes towards alcohol-related sickness absence and presenteeism in Norway. Paper 1 is a review of the alcohol-absence association, to my knowledge the first review of studies on this topic. Following a literature search of peer reviewed journals, our inclusion criteria were met by 27 articles testing 48 associations. The study found that empirical evidence for an association between alcohol use and both long- and short-term absence was strong. All associations with a high quality score were statistically significant. The association did not vary systematically across measures of alcohol use. The association was found to apply to both genders and in all socio-economic strata, but in some instances more strongly in lower socio-economic strata. Paper 2 is a study of a sample of employees from the Young in Norway study. Self-reported measures on alcohol-related sickness absence and various drinking measures were applied to study differences according to gender and drinker types. Men reported alcohol-related absence almost twice as often as women did. Since none of the drinking-absence associations for the three alcohol measures were significantly stronger for men, it was concluded that the gender difference in alcohol-related absence was likely due to a gender difference in drinking patterns. The heaviest drinkers reported a disproportionally large share of alcohol-related sickness absence, but the vast majority of such absence was still found among the moderate drinkers. The results indicated that the prevention paradox applies to alcohol-related sickness absence among young employees of both genders. For paper 3 the sample used in paper 2 was merged with registry data on income, education and occupation, and differences in alcohol-related sickness absence according to socioeconomics and family roles was examined. Being male, single, not having children and having a low income were associated with alcohol-related sickness absence, but the association was not significant for education and social status. Introducing drinking frequency and drinking to intoxication in the regression model attenuated some associations with alcohol-related sickness absence, indicating that group differences are only partly a result of differences in drinking patterns. Paper 4 examine attitudes towards alcohol-related absence and reduced efficiency at work (presenteeism) due to alcohol. Results show that employees are more restrictive towards absence than towards presenteeism. Both behaviours were condemned more strongly with frequent occurrence. Employees with a high intoxication frequency and/or own experience with these behaviours were more tolerant. Women were less tolerant of alcohol-related absence than men, and employees with a higher educational level were less tolerant of alcohol-related presenteeism than those with a low educational level.