The European Union’s Working Time Directive (EUWTD) states that individuals do not have to work more than 48 per week, unless they wish to.

ONS figures from 2011 suggest full-time workers in the EU work on average 41.6 hours per week. However, the true number of hours worked is difficult to estimate given the long hours frequently worked by individuals striving to gain a work-life balance, achieve promotion or improve their work status.

Long working hours have been linked to family conflict and stress-related health problems (APA, 2002). Several studies have shown an association between longer working hours and a range of negative health outcomes, including anxiety, depression, cardiovascular disease and sleep problems (Van der Hulst, 2003).

However, few studies have explored the relationship between long working hours and alcohol use. Of the current studies available, many are limited by small sample sizes and inconsistent findings. One potential difficulty in this type of research is variation in the definition of “heavy or risky alcohol use”. For example in the UK, government guidelines define hazardous alcohol as >14 units per week for females and >21 units per week for males. However, the measurement of units is rarely used in the rest of Europe.

In order to address the paucity of research in this area a recent study (Virtanen et al, 2015) performed the first systematic analysis of available research studies on the link between long working hours and alcohol use.

Methods

• The authors searched the PubMed and EMBASE databases for studies using search terms for work exposure including “work and hours or overtime and work etc.” and “alcohol and abuse or heavy and drinking etc.” for alcohol outcomes.

• Studies were deemed suitable for inclusion if they had empirical, peer reviewed data and examined the association between working hours and alcohol use.

• Assessment of working hours and alcohol use was variable across studies and high variation was seen in the definition of “risky alcohol use”.

• Data were analysed in two stages; a prospective meta-analysis (research question formulated before eligibility of studies is known) and analysis of individual participant data (summarises data from several studies that answer the same research question).

Results

• A cross sectional analysis of 333,693 workers from 61 studies and 14 countries indicated that longer working hours increased the likelihood of greater alcohol use by 11% (odds ratio 1.11).

• Data from the prospective meta-analysis of 100,602 workers from 20 studies and 9 countries showed a similar increase in risk of 12% (odds ratio 1.12).

• Individual participant data from 18 studies demonstrated an increased risk of 13% (odds ratio 1.13) for those who worked 49-54 hours per week and a 12% (odds ratio 1.12) increased risk in those who worked ≤ 55 hours per week for risky alcohol consumption, when compared to individuals who worked 35-40 hours per week.
• Interestingly, these associations were not influenced by age, sex, socioeconomic status or geographical location.

Conclusions

Findings indicate that individuals who work in excess of standard recommended hours (e.g. 48 hours per week) are more likely to increase their drinking to risky levels.

However, these data cannot determine why individuals who work longer hours are at increased risk for risky alcohol use.

The authors suggest that increased stress associated with working longer hours may lead to increased alcohol use as means of alleviating work-related strain.

Results also reveal that the association between long working hours and alcohol use was not influenced by factors such as socioeconomic status or geographical location.

In terms of socioeconomic status, the authors suggest that longer working hours may be more evenly distributed across socioeconomic groups than previously thought. Also despite previous reported cultural differences in drinking (WHO, 2014), the authors report no influence of geographic region on the association between long working hours and drinking. This discrepancy may reflect that data were obtained using a convenience sample collected from European, UK, US and Australian cohorts that may not be fully representative of geographical locations.

Strengths and limitations

• This study is the first to systematically analyse the association between long working hours and alcohol use.

• This work has a range of implications for workplace alcohol policy, alcohol intervention and more widely for public health.

• The authors account for publication bias by including unpublished data in their analysis.

• Many studies included in the analysis relied on self-reported data for estimates of number of hours worked per week and alcohol consumption.
• The authors reported searching only the PubMed and EMBASE databases. Searching a broader and greater number of databases, including for example PsycINFO and CINAHL, would potentially have returned a larger number of studies to include in their review.

• Number of hours worked may not reflect “work strain”. For example, hours of work do not give any information about productivity or work completed in this time.

Implications

A recent BMJ editorial (Okechukwu, 2015) highlighted the potential implications for this research:

• This work supports previous evidence indicating that long working hours are an important determinant of workers’ health.

• With increasing pressure to exclude workers from EU standards that limit working hours, number of hours worked is an important health exposure.

• Regulation of working hours is a potentially important target for public health interventions for reducing risky alcohol use.

Links

Virtanen, M (2015) Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data. BMJ; 350 doi: http://dx.doi.org/10.1136/bmj.g7772

Okechukwu, CA (2015) Long working hours are linked to risky alcohol consumption (editorial). BMJ; 350 doi: http://dx.doi.org/10.1136/bmj.g7800

Van der Hulst, M (2003) Long work hours and health. Scand J Work Environ Health, 29:171-88. [Abstract]

American Psychological Association (2002). Employees’ longer working hours linked to family conflict, stress-related health problems. June 2002, Vol 33, No. 6.

World Health Organization. Global status report on alcohol and health 2014. WHO, 2014.