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Alcohol consumption and impaired work performance. Interventions, and implementation barriers
Abstract and Figures
BACKGROUND: Alcohol consumption is deeply integrated in social life, and the majority of employees consume alcohol regularly. Alcohol represents a major public health challenge related to both health and participation, on individual as well as on societal levels. Although alcohol prevention programmes mostly have demonstrated favourable effects in research, such programmes have proved difficult to implement in practice. AIMS: This thesis aimed to generate a better understanding of employee alcohol consumption and intervention needs, impaired work performance associated with alcohol consumption, and current practices and barriers against implementing alcohol prevention programmes in occupational health services (OHS). MATERIALS AND METHODS: The thesis utilised data from three sources with the national WIRUS project (Workplace Interventions preventing Risky alcohol Use and Sick leave). Risky drinking and employee intervention needs were explored in a cross-sectional study of 3571 employees in 14 Norwegian companies (Paper I). The relationship between alcohol consumption and impaired work performance (alcohol-related presenteeism) was examined by reviewing the existing research literature (Paper II), as well as empirically in a cross-sectional study of 3278 employees in 14 Norwegian companies (Paper III). Current alcohol prevention activity in OHS' and associations between implementation barriers and prevention activity were explored in a cross-sectional study of 295 OHS professionals in 69 Norwegian OHS units (Paper IV). RESULTS: First, supporting the notion of alcohol-related presenteeism, employee alcohol consumption seemed to be associated with impaired work performance (Papers II and III). Drinking intensity (binge drinking) was more strongly associated with performance decrements than drinking frequency (Paper III). Second, a considerable proportion of employees (1-3 out of 10) were identified as risky drinkers that would benefit from interventions (Paper I), yet the majority (7 out of 10) of OHS professionals worked with alcohol prevention less than on a monthly basis (Paper IV). Risky drinking was associated with male gender, younger age, low education, being unmarried and not having children (Paper I). Competence, time and resources constituted the primary barriers against implementation of alcohol prevention programmes in OHS' (Paper IV). Third, the vast majority of risky drinkers (9 out of 10) would, according to international intervention guidelines, benefit from simple secondary prevention interventions (Paper I), yet OHS' alcohol prevention activity was more focused on tertiary than on secondary prevention (Paper IV). CONCLUSIONS: The thesis suggests that alcohol consumption is associated with impaired work performance, and that there seems to be a mismatch between employee intervention needs and OHS' prevention activity. Although further research is warranted, the thesis carries the promising message that OHS' may constitute an abeyant asset for preventing alcohol problems in the workforce, insofar that OHS professionals are ensured adequate training, time and resources.
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