Risky alcohol consumption in the workplace : the feasibility of early detection and brief intervention as a part of routine health examinations

There are a number of reasons why workplaces should focus on problems related to alcohol use and misuse. These include the associated risk of greater ill-health, accidents leading to injury, absenteeism, and negative effects on the atmosphere in the workplace.

The main purpose of this thesis was to examine the feasibility and limitations of alcohol screening as part of regular health examinations. A further aim was to examine the feasibility, limitations and effects of brief intervention in a workplace. The pilot project was carried out in workplaces in the paper, pulp and wood industry. The main project, a randomized controlled study, was carried out at a large workplace in the transport sector over a period of 48 months. In the main project, employees who came to the occupational health service (OHS) for a regular health examination were given the opportunity to undergo voluntary alcohol screening. The screening and follow-up consisted of self-reporting, using the Alcohol Use Disorders Identification Test (AUDIT), and the carbohydrate deficient transferrin in serum (CDT) blood test. The serum gammaglutamyl transferase (GGT) test was also used for comparison purposes.

The results from the pilot study suggest that alcohol screening is not time-consuming for the OHS. Offering employees voluntary alcohol screening in conjunction with a health examination may well encourage some people to seek advice and support for their alcohol problems. The results from the main study suggest that the AUDIT and CDT should be regarded as complementary test for alcohol screening in a routine workplace health examination, and that each is of value for identifying different segments of the at-risk drinking population. Our data indicate that individuals with moderately elevated or risky levels of alcohol consumption show an increase in sick-days. Individuals who screened positive on the AUDIT and/or CDT test did not demonstrate more long, continuous periods of sickness absence or absence on Monday or Fridays. Shift workers did not drink more alcohol than permanent day workers, according to the AUDIT, CDT and GGT results. In fact, the opposite was observed for 2-shift workers according to CDT. Of those employees who participated in the follow-up, almost 50% had negative test results. Despite this, there were no significant differences at screening and follow-up between the intervention groups and the control group, neither in relation to the AUDIT, CDT, or GGT. Nor was there any difference in the number of sick-days during the study period between those who screened positive and those who screened negative.

In summary: it appears to be feasible to carry out alcohol screening and brief intervention as part of regular health examinations and there is a good reason to use a more systematic approach to alcohol screening in conjunction with routine workplace health examination.

List of scientific papers

I. Hermansson U, Knutsson A, Ronnberg S, Brandt L (1998). Feasibility of brief intermention in the workplace for the detection and treatment of excessive alcohol consumption. Int J Occup Environ Health. 4(2): 71-8.
https://pubmed.ncbi.nlm.nih.gov/10026467

II. Hermansson U, Helander A, Huss A, Brandt L, Ronnberg S (2000). The Alcohol Use Disorders Identification Test (AUDIT) and carbohydrate-deficient transferrin (CDT) in a routine workplace health examination. Alcohol Clin Exp Res. 24(2): 180-7.
https://pubmed.ncbi.nlm.nih.gov/10698370

III. Hermansson U, Helander A, Brandt L, Huss A, Ronnberg S (2002). The Alcohol Use Disorders Identification Test and carbohydrate-deficient transferrin in alcohol-related sickness absence. Alcohol Clin Exp Res. 26(1): 28-35.
https://pubmed.ncbi.nlm.nih.gov/11821651

IV. Hermansson U, Knutsson A, Brandt L, Huss A, Ronnberg S, Helander A (2002). Screening for risky and elevated alcohol consumption in day and shift workers by use of the AUDIT and CDT. [Submitted]

V. Hermansson U, Helander A, Huss A, Brandt L, Ronnberg S (2002). Brief intervention of risky alcohol consumption in the workplace: A one-year randomized, controlled study. [Submitted]