Occupation and mortality related to alcohol, drugs and sexual habits

MRC Epidemiology Resource Centre, University of Southampton, UK.
Occupational Medicine (Impact Factor: 1.03). 08/2010; 60(5):348-53. DOI: 10.1093/occmed/kqq040
Source: PubMed


To identify opportunities for targeted prevention, we explored differences in occupational mortality from diseases and injuries related to alcohol consumption, sexual habits and drug abuse.
Using data on all deaths among men and women aged 16-74 years in England and Wales during 1991-2000, we derived age- and social class-standardized proportional mortality ratios (PMRs) by occupation for cause of death categories defined a priori as potentially related to alcohol consumption, sexual habits or drug abuse.
The highest mortality from alcohol-related diseases and injuries was observed in publicans and bar staff (both sexes) and in male caterers, cooks and kitchen porters and seafarers. Male seafarers had significantly elevated PMRs for cirrhosis (179), 'other alcohol-related diseases' (275), cancers of the liver (155), oral cavity (275) and pharynx (267) and injury by fall on the stairs (187). PMRs for human immunodeficiency virus infection (HIV)/acquired immunodeficiency syndrome (AIDS) were particularly high in tailors and dressmakers (918, 95% CI: 369-1890, in men; 804, 95% CI: 219-2060, in women) and male hairdressers (918, 95% CI: 717-1160). Most jobs with high mortality from HIV/AIDS also had more deaths than expected from viral hepatitis. Of seven jobs with significantly high PMRs for both drug dependence and accidental poisoning by drugs, four were in the construction industry (male painters and decorators, bricklayers and masons, plasterers, and roofers and glaziers).
Our findings highlight major differences between occupations in mortality from diseases and injuries caused by alcohol, sexual habits and drug abuse. Priorities for preventive action include alcohol-related disorders in male seafarers and drug abuse in construction workers.

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Available from: Terry Brown, May 28, 2014
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    • "Those with a BMI greater than 30 were found to take an extra 4 days sickness absence per annum. Using data on deaths of 16-to 74-year-olds in England and Wales, Coggon et al. [5] consider mortality relating to alcohol intake, sexual habits and drug abuse to generate proportional mortality ratios (PMRs) for various occupational groups. They report the highest mortality from alcohol intake in the catering industries and that the type of alcohol-related disease varies between occupational groups. "

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    ABSTRACT: The evidence review, Reducing alcohol-related harm in the workplace (An evidence review: full report) , found that harmful alcohol use is a significant preventable health issue. For the purposes of this report, work-related alcohol use incorporates alcohol-related harm that has an impact on the workplace (e.g. increased accident risk or reduced workplace productivity due to intoxication or hangover effects) resulting from drinking at work or outside of work, and drinking that is informed or influenced by workplace factors. Alcohol-related harm refers to both the short-term and long-term negative consequences of alcohol use. Alcohol use is widespread in many countries, including Australia. Approximately 90 per cent of the Australian workforce consumes alcohol. The majority of drinking takes place after the completion of a working day, or on days off, although sometimes it does occur during the working day. High risk/harmful alcohol use outside work, as well as at work, can have adverse impacts on the workplace. High risk alcohol use results in major health, social and economic consequences for the individual drinker, their families, organisations and society. It contributes significantly to injury, disease, disability and death, accounting for 3.2 per cent of the total burden of disease and injury in Australia; 4.9 per cent in males and 1.6 per cent in females. Alcohol is a major contributor to non-communicable disease, especially among young people, and is related to the causes of more than 60 different medical conditions. The cost to the Australian community from alcohol-related harm is estimated to be at least $15.3 billion per year. On top of this, it is estimated that the harm to others caused by Australian drinkers costs the community $20 billion a year. High risk alcohol use is associated with a range of adverse impacts on organisations. The impacts include workplace accidents and injuries, workplace fatalities, reduced productivity, poor work relations, and increased absenteeism (an employee’s time away from work due to illness) and presenteeism (decreased on-the-job performance due to the presence of health conditions). The economic benefits for workplaces in reducing alcohol-related harm are considerable; lost productivity in the workplace attributable to alcohol costs $3.5 billion annually. Other benefits include a safer working environment with decreased accidents, injuries and fatalities, and compliance with occupational health and safety and related legislation. Individual, community and workplace factors all influence high risk alcohol use. Population groups that are most at risk include men; young people aged 14–29 years; those in lower skilled and manual occupations; and those employed in the agriculture, retail, hospitality, manufacturing, construction and financial services industries. Increased availability of or access to alcohol – in the community and at work – is a critical factor, and is associated with high risk alcohol use. Research clearly shows that the harms associated with alcohol use can be reduced. In order to effectively reduce alcohol-related harm, workplace interventions should: • account for the complexity of the issue • be evidence-informed • be multifaceted with strategies that address individual staff and organisational factors • prioritise high risk occupations and workplaces • develop clear goals through consultation • engage all stakeholders • assess the risk, including a review of how alcohol is made available • be tailored to the individual workplace and culture.
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