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Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data
journal contributionposted on 29.10.2015, 09:54 authored by Marianna Virtanen, Markus Jokela, Solja T. Nyberg, Mark Hamer
Objective To quantify the association between long working hours and alcohol use. Design Systematic review and meta-analysis of published studies and unpublished individual participant data. Data sources A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. Review methods The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. Results Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. Conclusions Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
The IPD-Work Consortium is supported by the EU New OSH ERA Research Program (funded by the Finnish Work Environment Fund and the Academy of Finland, Finland; the Swedish Research Council for Health, Working Life and Welfare, Sweden; the German Social Accident Insurance, Germany; and the Danish Work Environment Research Fund, Denmark); the BUPA Foundation (grant 22094477), and the Dutch Ministry of Social Affairs and Employment, Netherlands. MV is supported by the Academy of Finland (grants 258598, 265174), MK is supported by the Medical Research Council (grant K013351), the Economic and Social Research Council, and the US National Institutes of Health (grants R01HL036310 and R01AG034454), and SN is supported by the Finnish Work Environment Fund.
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