Abstract
BackgroundOveruse of alcohol is a significant risk factor for early retirement. This observational study investigated patient characteristics and work processes in occupational health care (OHC) affecting practices in tackling alcohol overuse.MethodsThe data were from 3089 patient contacts gathered for quality improvement purposes in fifteen OHC units during the years 2013–2019 in Finland. A two-proportion z-test was performed to find associations between reason for contact, and 17 other factors, and the probability of alcohol use being checked and overuse tackled.ResultsOHC personnel checked alcohol use twice as often with male patients as with female patients. Employees at risk of needing sick leave were checked for alcohol use more often (55.4, 95% confidence interval 49.2–61.6%) than those on > 30-day sick leave or working with permanent work disability (p < 0.01). Alcohol use was checked in 64.1% (59.5–68.7%) of patients while making an individual health promotion plan compared to 36.9% of those without a plan (33.1–40.6%, p < 0.0001). Patients with depression were actively checked for alcohol use, especially in cases of major depression (72.7%, 64.0–81.0%). Work processes in which OHC should have been more active in checking and tackling alcohol use included assessing the need for rehabilitation (36.5%, 32.0–41.0%) and health check-ups (HCUs) for mental reasons (43.8%, 38.1–49.4%). HCUs where alcohol overuse was detected led to brief interventions to tackle the overuse in 58.1% (43.4–72.9%) of cases.ConclusionsThe study showed factors that increased OHC personnel’s practices in checking and tackling alcohol use and work processes where the activity should be improved. Discussions about alcohol use took place more often with working-aged men than women, the younger the more. OHC personnel checked actively alcohol use with patients in danger of sick leave, patients treated for depression, while making an individual health promotion plan, and in planned HCUs with a confirmed protocol. More improvement is needed to conduct brief interventions in disability prevention processes, and especially when overuse is detected.
Highlights
Overuse of alcohol is a significant risk factor for early retirement
occupational health care (OHC) personnel were more active in discussing alcohol use with men, with younger patients, in planned health checkup (HCU) with a confirmed protocol, with employees known to overuse alcohol, with employees at risk of needing sick leave, with those who had a health promotion plan under preparation, and with depressed employees, especially when major depression was involved
The present results demonstrate the importance of implementing fixed protocols in OHC work processes when checking alcohol use and the need to perform brief interventions are crucial
Summary
Overuse of alcohol is a significant risk factor for early retirement. This observational study investigated patient characteristics and work processes in occupational health care (OHC) affecting practices in tackling alcohol overuse. Kuronen et al BMC Public Health (2022) 22:67 alcohol consumption, which can result in physical and psychological impairment, including alcohol dependence. All such drinking patterns, regardless of the degree of severity, are collectively known as alcohol use disorder (AUD). Prevalence estimates range from 4 to 29% of the general population for hazardous drinking and from less than 1 to 10% for harmful drinking [2]. The twelve-month prevalence of AUD was approximately 2% in Finland in 2011 [4]
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