The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression. (1st September 2021)

• Record Type: Journal Article
• Authors: Irizar, Patricia; Puddephatt, Jo-Anne; Gage, Suzanne H.; Fallon, Victoria; Goodwin, Laura
• Is Part Of: Drug and alcohol dependence. Volume 226(2021)
• Publication Date: 2021-09-01
• Subjects: Hazardous alcohol use -- Harmful alcohol use -- Occupational health -- Mental health -- Meta-analytic methods; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108858
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Hazardous and harmful alcohol use was highest in Armed Forces personnel. First responders showed higher levels of hazardous alcohol use than health care workers. Specifically, hazardous alcohol use was highest in military personnel and police officers. Studies with more males and a younger mean age had higher prevalence estimates. Abstract: Background: Trauma exposure is associated with hazardous and/or harmful alcohol use. Occupational groups frequently exposed to trauma may be at risk of alcohol harm. This meta-analysis determined the prevalence of hazardous and harmful alcohol use across trauma-exposed occupations and meta-regressions explored the impact of pre-defined covariates on the variance in prevalence estimates. Method: Literature was searched from 2000 to March 2020, using Scopus, Web of Science and PsycINFO. Studies were included in the meta-analysis if they used a standardized measure of alcohol use (e.g., Alcohol Use Disorder Identification Test (AUDIT)). Studies were excluded if they measured alcohol use following an isolated sentinel event (e.g., 9/11). The following occupations were included: first responders, health care workers, Armed Forces, war journalists and train drivers. Results: 1882 studies were identified; 55 studies were eligible. The pooled prevalence of hazardous use was 22% (95% Confidence Intervals [CI]: 17%–27%) and 11% (95% CI: 8%–14%) for harmful use. Hazardous alcohol use was significantly lower in health care workers (13%; 95% CI: 10%–16%) than first responders (26%; 95% CI: 20%–32%) and Armed Forces (34%; 95% CI: 18%–52%). There was marked heterogeneity across studies and higher prevalence rates in low-quality studies. The meta-regression identified higher proportion of males and younger mean age as predictors of variance. Conclusions: Male-dominated occupations, such as police officers and military personnel, showed higher levels of hazardous and harmful alcohol use, indicating that interventions tailored specifically for these occupational groups may be needed.