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Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data

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Virtanen, M., Jokela, M., Nyberg, S. T., Madsen, I. E. H., Lallukka, T., Ahola, K., Alfredsson, L., Batty, G. D. +36 more·2015·BMJ
DOI 10.1136/bmj.g7772PMC PMC4293546
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Abstract

OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. RESULTS: Cross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥ 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. CONCLUSIONS: Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.

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Authors
Virtanen, M., Jokela, M., Nyberg, S. T., Madsen, I. E. H., Lallukka, T., Ahola, K., Alfredsson, L., Batty, G. D., Bjorner, J. B., Borritz, M., Burr, H., Casini, A., Clays, E., De Bacquer, D., Dragano, N., Erbel, R., Ferrie, J. E., Fransson, E. I., Hamer, M., Heikkila, K., Jockel, K.-H., Kittel, F., Knutsson, A., Koskenvuo, M., Ladwig, K.-H., Lunau, T., Nielsen, M. L., Nordin, M., Oksanen, T., Pejtersen, J. H., Pentti, J., Rugulies, R., Salo, P., Schupp, J., Siegrist, J., Singh-Manoux, A., Steptoe, A., Suominen, S. B., Theorell, T., Vahtera, J., Wagner, G. G., Westerholm, P. J. M., Westerlund, H., & Kivimaki, M.
Affiliations
  • Finnish Institute of Occupational Health (FI)
  • University of Helsinki (FI)
  • National Research Centre for the Working Environment (DK)
  • Region Stockholm (SE)
  • Alzheimer Scotland (GB)
  • Federal Institute for Occupational Safety and Health (DE)
  • Université Libre de Bruxelles (BE)
  • Ghent University (BE)
  • Heinrich Heine University Düsseldorf (DE)
  • West German Heart and Vascular Center Essen (DE)
  • University of Bristol (GB)
  • Stockholm University (SE)
  • University College London (GB)
  • Mid Sweden University (SE)
  • Helmholtz Munich (DE)
  • Frederiksberg Hospital (DK)
  • Danish National Centre for Social Research (DK)
  • University of Copenhagen (DK)
  • University of Turku (FI)
  • German Institute for Economic Research (DE)
  • Uppsala University (SE)
Corresponding author
Virtanen, M.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2015-01-13
Volume
350
Issue
jan12 13
Pages
g7772-g7772
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj.g7772
PMC
PMC4293546
OpenAlex
W2167829053
Cited by
317
References
11
Citations by year
2026: 7 · 2025: 12 · 2024: 15 · 2023: 23 · 2022: 41 · 2021: 48 · 2020: 49 · 2019: 35 · 2018: 27 · 2017: 24 · 2016: 17 · 2015: 19
FWCI
5.26
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
  • Publications (Mid Sweden University) (submittedVersion, other-oa)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • Digital Access to Libraries (submittedVersion, other-oa)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
  • Loughborough University Institutional Repository (Loughborough University) (submittedVersion, cc-by-nc)
  • Econstor (Econstor) (submittedVersion, cc-by-nc)
  • Max Planck Institute for Plasma Physics (submittedVersion)
  • Loughborough University Research Repository (Loughborough University) (submittedVersion, cc-by-nc)
  • Site cant be reached (submittedVersion, cc-by-nc)
  • Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by-nc)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
  • Ministerie van Sociale Zaken en Werkgelegenheid
  • British Heart Foundation (R01AG034454, K013351)
  • Bupa Foundation
  • Academy of Finland (K013351, R01 AG034454, #258598, 265174)
  • Työsuojelurahasto
  • Deutsche Gesetzliche Unfallversicherung
  • Vetenskapsrådet (K013351)
  • NordForsk (75021)
  • Forskningsrådet om Hälsa, Arbetsliv och Välfärd
  • National Institutes of Health
  • Medical Research Council (MR/K013351/1, K013351, R01AG034454)
  • Economic and Social Research Council (R01AG034454, ES/J023299/1, R01HL036310)
  • National Institute on Aging (R01AG034454, P01AG020166, U19AG051426)
  • National Heart, Lung, and Blood Institute (R01HL036310)
Topics
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
long working hours, alcohol consumption, risky alcohol use, working time regulation, occupational health, individual patient data
MeSH terms
Age Factors, Alcohol Drinking, Cross-Sectional Studies, Humans, Prospective Studies, Sex Factors, Socioeconomic Factors, Prevalence, Odds Ratio, Workload

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