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Job strain, hazardous drinking, and alcohol-related disorders among Brazilian bank workers
Carlos Tadeu Lima1, Michael Farrell, Martin Prince
1State University of Feira de Santana, Departamento de Saúde, Área de Medicina, Feira de Santana, Bahia, Brazil. carlostadeu.lima@gmail.com
Objective:
To assess the association between high job strain and drinking behaviors among bank workers.
Method:
A crosssectional study was performed in 1,080 Brazilian bank employees. Participants completed a self-reported questionnaire, including the Alcohol Use Disorders Identification Test to assess hazardous drinking (HZD). Alcohol-related disorders (ARDs) were assessed using the Composite International Diagnostic Interview. Associations between job strain and drinking behaviors were tested by fitting the main effects of high job demands and low job control, with the interaction between them, and by comparing high demands and low-control jobs with other jobs, using Poisson regression.
Results:
Prevalences of HZD and ARDs were 25.5% and 13.5%, respectively. For the association with HZD, there was a significant interaction between high demands and low control (prevalence ratio [PR] = 1.56, 95% CI [1.03, 2.35]). For low-demand jobs, low control was negatively associated with HZD (PR = 0.69, 95% CI [0.50, 0.97]). High demands only conferred increased risk for HZD in the context of low control. Patterns of association with ARDs were similar but did not reach statistical significance. Furthermore, multivariate analyses supported the associations between the four-quadrant jobstrain model and HZD. However, passive jobs were associated with a low prevalence of HZD, and post hoc analysis suggested that increased risk of HZD was concentrated in the highest quarter of job strain (PR = 1.55, 95% CI [1.10, 2.21]).
Conclusions:
High job strain was associated with HZD; the association with ARDs was equivocal. For HZD, an interaction between high demands and low control, as posited by Karasek, was observed.
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