TY - JOUR

T1 - The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations

T2 - A meta-analysis and meta-regression

AU - Irizar, P

AU - Puddephatt, JA

AU - Gage, SH

AU - Fallon, V

AU - Goodwin, L

PY - 2021/9/1

Y1 - 2021/9/1

N2 - BackgroundTrauma 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.MethodLiterature 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.Results1882 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.ConclusionsMale-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.

AB - BackgroundTrauma 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.MethodLiterature 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.Results1882 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.ConclusionsMale-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.

KW - Hazardous alcohol use

KW - Harmful alcohol use

KW - Occupational health

KW - Mental health

KW - Meta-analytic methods

U2 - 10.1016/j.drugalcdep.2021.108858

DO - 10.1016/j.drugalcdep.2021.108858

M3 - Journal article

C2 - 34214883

VL - 226

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

M1 - 108858

ER -