A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference

Neda S Hashemi; Jens Christoffer Skogen; Aleksandra Sevic; Mikkel Magnus Thørrisen; Silje Lill Rimstad; Hildegunn Sagvaag; Heleen Riper; Randi Wågø Aas

doi:10.1371/journal.pone.0262458

A systematic review and meta-analysis uncovering the relationship between alcohol consumption and sickness absence. When type of design, data, and sickness absence make a difference

PLoS One. 2022 Jan 11;17(1):e0262458. doi: 10.1371/journal.pone.0262458. eCollection 2022.

Authors

Neda S Hashemi¹, Jens Christoffer Skogen^{1

2

3}, Aleksandra Sevic¹, Mikkel Magnus Thørrisen^{1

4}, Silje Lill Rimstad^{1

5}, Hildegunn Sagvaag¹, Heleen Riper^{6

7

8

9}, Randi Wågø Aas^{1

4}

Affiliations

¹ Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
² Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
³ Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.
⁴ Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway.
⁵ West Norway Competence Centre (KoRus Stavanger)/Rogaland A-Centre, Stavanger, Norway.
⁶ Department of Clinical, Neuro, & Developmental Psychology, Faculty of Behavioral and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands.
⁷ Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands.
⁸ Department of Clinical Research, Research Unit for Telepsychiatry and e-Mental Health, University of Southern Denmark, Odense, Denmark.
⁹ Research Centre for Child Psychiatry, University of Turku, Turku, Finland.

Abstract

Aim: Earlier research has revealed a strong relationship between alcohol use and sickness absence. The aim of this review was to explore and uncover this relationship by looking at differences in type of design (cross-sectional vs. longitudinal), type of data (self-reported vs. registered data), and type of sickness absence (long-term vs. short term).

Method: Six databases were searched through June 2020. Observational and experimental studies from 1980 to 2020, in English or Scandinavian languages reporting the results of the association between alcohol consumption and sickness absence among working population were included. Quality assessment, and statistical analysis focusing on differences in the likelihood of sickness absence on subgroup levels were performed on each association, not on each study. Differences in the likelihood of sickness absence were analyzed by means of meta-analysis. PROSPERO registration number: CRD42018112078.

Results: Fifty-nine studies (58% longitudinal) including 439,209 employees (min. 43, max. 77,746) from 15 countries were included. Most associations indicating positive and statistically significant results were based on longitudinal data (70%) and confirmed the strong/causal relationship between alcohol use and sickness absence. The meta-analysis included eight studies (ten samples). The increased risk for sickness absence was likely to be found in cross-sectional studies (OR: 8.28, 95% CI: 6.33-10.81), studies using self-reported absence data (OR: 5.16, 95% CI: 3.16-8.45), and those reporting short-term sickness absence (OR: 4.84, 95% CI: 2.73-8.60).

Conclusion: This review supports, but also challenges earlier evidence on the association between alcohol use and sickness absence. Certain types of design, data, and types of sickness absence may produce large effects. Hence, to investigate the actual association between alcohol and sickness absence, research should produce and review longitudinal designed studies using registry data and do subgroup analyses that cover and explain variability of this association.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Absenteeism*
Alcohol Drinking / adverse effects*
Humans
Research Design / statistics & numerical data*
Sick Leave / statistics & numerical data*

Grants and funding

The WIRUS project is funded by the Norwegian Directorate of Health, the Research Council of Norway. Grant number: 260640. https://www.forskningsradet.no/en/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.