Directly alcohol-attributable mortality by industry and occupation in a Spanish Census cohort of economically active population

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• dc.contributor.author Pulido, Joséca
• dc.contributor.author Vallejo, Fernandoca
• dc.contributor.author Alonso-López, Ignacioca
• dc.contributor.author Regidor, Enriqueca
• dc.contributor.author Villar, Fernandoca
• dc.contributor.author Domingo-Salvany, Antòniaca
• dc.contributor.author Barrio, Gregorioca
• dc.date.accessioned 2018-05-11T07:28:02Z
• dc.date.issued 2017
• dc.description.abstract AIMS: To assess disparities in directly alcohol-attributable (DAA) mortality by industry/occupation in Spain during 2002-2011 and the contribution of different socio-demographic factors, including socioeconomic position, to explain such disparity. METHODS: Nationwide cohort study covering 16 million economically active people living in Spain in 2001. Deaths at age 25-64 were analyzed. Subjects were classified by employment status, industry and occupation at baseline. Poisson regression models were built, calculating rate ratios (RRs) compared to all employees or those in the education sector. RESULTS: DAA mortality was much higher in the unemployed than in employees (Crude RR: 2.4; 95% CI: 2.3-2.6) and varied widely across industries/occupations. Crude RRs>3.0 (p<0.05) compared to teachers were found in employees in extractive industries/fishing, agriculture/livestock, construction, catering/accommodation and protective services. Socio-demographic factors, especially age, gender and educational attainment contributed more to explain risk disparities than other factors or potential selection bias. However, after exhaustive sociodemographic adjustment, including education attainment and material wealth, a RR>1.33 (p<0.05) remained in unemployed, catering/accommodation employees and unskilled construction workers. RRs were significantly larger in women than men (p<0.05) among mineworkers/fishworkers/sailors (RR=8.6 vs. 1.2) and drivers (RR=3.7 vs. 1.0). CONCLUSIONS: The results could be extrapolated to all alcohol-attributable mortality since disparities for other strongly alcohol-related deaths, although smaller, were in the same direction. Given the wide occupational disparities in alcohol-attributable mortality, implementation of special measures to reduce this mortality in the highest risk groups is fully justified. Future research should better characterize the explanatory factors of disparities and their role in the causal chain.
• dc.format.mimetype application/pdf
• dc.identifier.citation Pulido J, Vallejo F, Alonso-López I, Regidor E, Villar F, de la Fuente L. et al. Directly alcohol-attributable mortality by industry and occupation in a Spanish Census cohort of economically active population. Drug Alcohol Depend. 2017 Nov 1;180:93-102. DOI: 10.1016/j.drugalcdep.2017.07.028
• dc.identifier.doi http://dx.doi.org/10.1016/j.drugalcdep.2017.07.028
• dc.identifier.issn 0376-8716
• dc.identifier.uri http://hdl.handle.net/10230/34611
• dc.language.iso eng
• dc.publisher Elsevierca
• dc.relation.ispartof Drug and Alcohol Dependence. 2017 Nov 1;180:93-102
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.drugalcdep.2017.07.028
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Alcohol-attributable mortality
• dc.subject.keyword Industry
• dc.subject.keyword Occupation
• dc.subject.keyword Population cohort
• dc.subject.keyword Sociodemographic factors
• dc.subject.other Alcoholisme -- Aspectes socials
• dc.subject.other Mortalitat -- Espanya -- Aspectes socials
• dc.title Directly alcohol-attributable mortality by industry and occupation in a Spanish Census cohort of economically active populationca
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion