Longitudinal, population-based study of self reported alcohol habits, high levels of sickness absence, and disability pensions

Abstract

Study objective: To analyse the relation between self reported hazardous drinking on the one hand and high sickness absence and/or disability pensions in both sexes on the other hand.

Design: The study is based on data from a health survey, Stockholm Health of the Population Study, conducted in 1984. The mailed questionnaire covered alcohol consumption. Three different measures of alcohol habits were used: usual alcohol consumption, consumption during the previous week, and answers to the four CAGE questions on problem drinking. Information from the health survey and data from a subsequent health examination were related to information from the National Swedish Social Insurance Board for the year 1984 and the years 1986 to 1991 concerning sick leave and disability pensioning.

Setting: Four primary health care districts in Stockholm County.

Participants: The study group included persons who were aged 20 to 52 years in 1984, who answered the questionnaire (by mail or by telephone), and who participated in the health examination. The study group comprised 985 women and 870 men fulfilling the criteria for inclusion out of 6217 subjects aged 18 years and over randomly drawn.

Main results: In both sexes, a consistent pattern of increased sickness absence was seen for high consumers and for those with indications of problem drinking. In most comparisons, a clearly increased relative risk, although not always statistically significant, for an average of at least 60 sick days per year or for a disability pension during follow up was found. In multivariate analysis, controlling for age, socioeconomic group, smoking habits, and self reported health, a small reduction in the relative risks was found, suggesting that these factors could explain only a small part of the relative risks. The risks for abstainers were higher than for low and moderate consumers.

Conclusions: The effects of alcohol on subsequent high levels of sickness absence five to seven years after baseline as well as on the occurrence of disability pensions suggested that there is an effect on working incapacity independent of baseline health status, smoking, and socioeconomic group.