Abstract
BackgroundThe role of alcohol consumption for disability pension (DP) is controversial and systematic reviews have not established causality. We aimed to assess the role of adolescent alcohol use for future DP. We wanted to find out whether an increased risk mainly would affect DP occurring early or late in life as well as whether the level of alcohol consumption and patterns of drinking contribute differently in DP receiving.Methodology/Principal FindingsThe study is a 39-year follow-up of 49 321 Swedish men born in 1949–1951 and conscripted for compulsory military service in 1969–1970. As study exposures (i) “risk use” of alcohol composed of measures related to pattern of drinking, and (ii) the level of consumption based on self-reported volume and frequency of drinking had been used. Information on DP was obtained from social insurance databases through 2008. “Risk use” of alcohol was associated with both “early DP” and “late DP”, i.e. granted below and above the approximate age of 40 years, with crude hazard ratio (HR) of 2.89 (95% confidence intervals (CI) 2.47–3.38) and HR of 1.87 (95%CI: 1.74–2.02), respectively. After adjustment for covariates, HR was reduced to 1.32 (95%CI: 1.09–1.59) and 1.14 (95%CI: 1.05–1.25), respectively. Similar patterns were seen for moderate (101–250 g 100% alcohol/week) and high (>250 g) consumption, though the risk disappeared when fully adjusted.Conclusions/SignificanceAlcohol use in adolescence, particularly measured as “risk use”, is associated with increased risk of future DP. The association is stronger for “early DP”, but remains significant even for DP granted in older ages. Therefore, pattern of drinking in adolescent should be considered an important marker for future reduced work capacity.
Highlights
The role of alcohol for disability pension (DP) still remains controversial
A history of alcohol intoxication in adolescence was not related to future work incapacity in another Swedish study on female DP, while for those diagnosed with alcohol use/dependence during adulthood the association with DP was significant [3]
We found that alcohol use in adolescence is associated with an increased risk of DP, in particular ‘‘early DP’’. ‘‘Risk users’’ of alcohol have a statistically significant increased risk regardless of adjustment
Summary
The role of alcohol for disability pension (DP) still remains controversial. Timing of exposure and measure of consumption differ substantially between studies contributing to a high variability in study results over time and place. The latter study, found only current problem drinking, but not high level of alcohol consumption, to be a strong predictor of work incapacity [5] In all these studies alcohol measures were based exclusively on self-reported information that could have potentially biased the results. Adjustment for health and lifestyle conditions, including socioeconomic position (SEP), often attenuate the risk of DP among drinkers [1,2,4,6], but a possible causal relation can still exist Another area of research is DP due to musculoskeletal disorders, in which some authors have assessed level of alcohol intake, but no effect of alcohol on DP was found [7,8,9,10]. We wanted to find out whether an increased risk mainly would affect DP occurring early or late in life as well as whether the level of alcohol consumption and patterns of drinking contribute differently in DP receiving
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