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  • 1.
    Ervasti, Jenni
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, United Kingdom / Clinicum, University of Helsinki, Helsinki, Finland.
    Head, Jenny
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Goldberg, Marcel
    Population-based Cohorts Unit, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
    Airagnes, Guillaume
    Université Paris Descartes, Sorbonne Paris Cité, Paris, France / Department of Psychiatry and Addictology, AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France.
    Pentti, Jaana
    Clinicum, University of Helsinki, Helsinki, Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Jokela, Markus
    Medicum, University of Helsinki, Helsinki, Finland.
    Vahtera, Jussi
    University of Turku and Turku University Hospital, Turku, Finland.
    Zins, Marie
    Population-based Cohorts Unit, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden.
    Sickness absence diagnoses among abstainers, low-risk drinkers and at-risk drinkers: consideration of the U-shaped association between alcohol use and sickness absence in four cohort studies2018In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 9, p. 1633-1642Article in journal (Refereed)
    Abstract [en]

    Aims To estimate differences in the strength and shape of associations between alcohol use and diagnosis-specific sickness absence. Design A multi-cohort study. Participants (n = 47 520) responded to a survey on alcohol use at two time-points, and were linked to records of sickness absence. Diagnosis-specific sickness absence was followed for 4-7 years from the latter survey. Setting and participants From Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000-02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985-88 and 1991-94, respectively. Measurements We used standard questionnaires to assess alcohol intake categorized into 0, 1-11 and > 11 units per week in women and 0, 1-34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio-economic status, smoking and body mass index. Findings Women who reported drinking 1-11 units and men who reported drinking 1-34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22-1.88], musculoskeletal disorders (1.22, 95% CI = 1.06-1.41), diseases of the digestive system (1.35, 95% CI = 1.02-1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29-1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13-1.83). Conclusions In Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at-risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

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