The prevalence of hazardous and harmful alcohol use across trauma-exposed occupations: A meta-analysis and meta-regression

Patricia Irizar*, JO-ANNE PUDDEPHATT, S Gage, V Fallon, L Goodwin

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

12 Citations (Scopus)

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.
Original languageEnglish
Article number108858
JournalDrug and Alcohol Dependence
Volume226
DOIs
Publication statusPublished - 1 Sept 2021

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