Job stressors and the incidence of alcohol-related outcomes: prospective findings from the national French ESPS survey.

BACKGROUND

Prospective studies are lacking on the associations between job stressors and alcohol-related outcomes in the working population. The objectives were to explore the prospective associations of these exposures, including changes in exposure, with three alcohol-related outcomes.

METHODS

The study relied on the prospective data of the national French ESPS survey (Health, health care and insurance survey) collected among a sample of 2080 workers in 2010 and 2014. Ten job stressors, derived from the job strain and effort-reward imbalance models, in 2010 (baseline) and changes in these exposures between 2010 and 2014 were studied. The incidence of three alcohol-related outcomes in 2014 (follow-up) was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among the study sample of workers free of these outcomes at baseline: intermediate/heavy drinking, binge drinking, and alcohol misuse. Robust Poisson regression models were performed to study the exposure-outcome associations before and after adjustment for covariates. Gender-related interactions were tested.

RESULTS

Job insecurity at baseline predicted the incidence of binge drinking at follow-up [incidence rate ratio (IRR) = 2.18; 95% confidence interval (CI): 1.33-3.58], and persistent job insecurity in both 2010 and 2014 displayed the strongest association with the incidence of binge drinking (IRR = 2.74; 95% CI: 1.36-5.54). Redundancy plan at baseline was borderline significant as a predictive factor of the incidence of binge drinking. Low freedom at work at baseline predicted the incidence of alcohol misuse among women.

CONCLUSIONS

Job stressors, particularly those related to employment uncertainty, predicted the incidence of alcohol-related outcomes, especially binge drinking. Job stressors, including persistent exposures, may warrant more attention for preventing alcohol-related outcomes.