Acute alcohol-related dysfunction as a predictor of employment status in a longitudinal study of working-age men in Izhevsk, Russia

AimsTo investigate longitudinally the effect of alcohol consumption and related acute alcohol-related dysfunction on employment status. Design, setting and participantsA total of 1143 men aged 25-55 years in regular paid employment and resident in the city of Izhevsk, Russia were interviewed between 2003-06 and then re-interviewed (2008-09) and their employment status ascertained. MeasurementsExposures of interest were baseline alcohol intake (yearly total volume of ethanol consumed and non-beverage alcohols) and alcohol-related dysfunction, measured by a latent variable defined in terms of frequency of alcohol-related dysfunctional behaviours and by one or more episodes of zapoi (a period of continuous drunkenness lasting 2 or more days). The outcome of interest was whether or not men were still in regular paid employment at follow-up. The inter-relationship between these variables was investigated using structural equation modelling. FindingsTotal volume of ethanol consumed had no substantive effect on future employment status; however, taking into account education and other socio-demographic factors, there was strong evidence that loss of regular paid employment at follow-up was influenced by non-beverage alcohol consumption [odds ratio=2.30 for non-beverage drinkers compared with beverage-only drinkers, 95% confidence interval (CI)=1.21, 4.40)], latent acute alcohol-related dysfunction (odds ratio=1.50 per standard deviation increase in dysfunction score, 95% CI=1.20, 1.88) and zapoi (odds ratio=3.08, 95% CI=1.71, 5.55). Acute alcohol-related dysfunction was an important mediator of the relationship between non-beverage alcohol use and employment status. ConclusionsAcute alcohol-related dysfunction is an important factor in determining whether men remain in employment and an important mediator of the effects of alcohol intake.