Burnout and alcohol problems among urban transit operators in San Francisco

Although occupational burnout has been linked with numerous psychosomatic symptoms and mental health problems, few studies have examined the association between burnout and substance use. This study assessed the contribution of burnout (Emotional Exhaustion--Maslach Burnout Inventory) to the risk of alcohol dependence and alcohol-related harm among a sample of urban transit operators. The study population consisted of 993 current drinkers who participated in the 1993-1995 San Francisco Muni Health and Safety Study. A series of multivariate logistic regression models were developed to analyze the association between burnout and risk of alcohol problems after adjustment for seniority, sociodemographic factors, and mean daily ounces of ethanol. The results indicate that burnout is associated with elevated risk of alcohol dependence (odds ratio [OR] = 1.03; 95% confidence interval [CI] = 1.01, 1.06). The association between burnout and alcohol-related harm, however, was attenuated. These findings suggest that transit operators with higher levels of burnout may be at increased risk for alcohol problems, particularly alcohol dependence. The temporal relationship between the development of burnout and the onset of alcohol problems among occupational cohorts warrants further investigation.