Etelä-Savon Työterveys Oy, Maaherrankatu 13, 50100, Mikkeli, Finland.
Conmedic Oy, Antaksenkuja 3, 02330, Espoo, Finland.
BMC Public Health. 2022 Jan 11;22(1):67. doi: 10.1186/s12889-021-12473-2.
Overuse of alcohol is a significant risk factor for early retirement. This observational study investigated patient characteristics and work processes in occupational health care (OHC) affecting practices in tackling alcohol overuse.
The data were from 3089 patient contacts gathered for quality improvement purposes in fifteen OHC units during the years 2013-2019 in Finland. A two-proportion z-test was performed to find associations between reason for contact, and 17 other factors, and the probability of alcohol use being checked and overuse tackled.
OHC personnel checked alcohol use twice as often with male patients as with female patients. Employees at risk of needing sick leave were checked for alcohol use more often (55.4, 95% confidence interval 49.2-61.6%) than those on > 30-day sick leave or working with permanent work disability (p < 0.01). Alcohol use was checked in 64.1% (59.5-68.7%) of patients while making an individual health promotion plan compared to 36.9% of those without a plan (33.1-40.6%, p < 0.0001). Patients with depression were actively checked for alcohol use, especially in cases of major depression (72.7%, 64.0-81.0%). Work processes in which OHC should have been more active in checking and tackling alcohol use included assessing the need for rehabilitation (36.5%, 32.0-41.0%) and health check-ups (HCUs) for mental reasons (43.8%, 38.1-49.4%). HCUs where alcohol overuse was detected led to brief interventions to tackle the overuse in 58.1% (43.4-72.9%) of cases.
The study showed factors that increased OHC personnel's practices in checking and tackling alcohol use and work processes where the activity should be improved. Discussions about alcohol use took place more often with working-aged men than women, the younger the more. OHC personnel checked actively alcohol use with patients in danger of sick leave, patients treated for depression, while making an individual health promotion plan, and in planned HCUs with a confirmed protocol. More improvement is needed to conduct brief interventions in disability prevention processes, and especially when overuse is detected.
过度饮酒是提前退休的一个重要危险因素。本观察性研究调查了影响职业健康保健（OHC）中处理过度饮酒做法的患者特征和工作流程。
该数据来自于 2013 年至 2019 年期间芬兰 15 个 OHC 单位为提高质量收集的 3089 名患者就诊记录。采用两比例 z 检验，以确定就诊原因与 17 项其他因素之间的关联，以及检查和处理饮酒过度的概率。
OHC 人员对男性患者进行饮酒检查的频率是女性患者的两倍。有休病假风险的员工比休病假超过 30 天或患有永久性工作残疾的员工（p<0.01）更常接受酒精使用检查（55.4%，95%置信区间 49.2-61.6%）。在制定个人健康促进计划时，64.1%（59.5-68.7%）的患者接受了酒精使用检查，而没有计划的患者为 36.9%（33.1-40.6%，p<0.0001）。患有抑郁症的患者会主动接受酒精使用检查，尤其是患有重度抑郁症的患者（72.7%，64.0-81.0%）。OHC 应该更积极地检查和处理酒精使用的工作流程包括评估康复需求（36.5%，32.0-41.0%）和出于精神原因进行健康检查（HCUs）（43.8%，38.1-49.4%）。在发现酒精过度使用的 HCUs 中，58.1%（43.4-72.9%）的病例中进行了简短干预以处理过度使用。
该研究显示了增加 OHC 人员检查和处理酒精使用以及需要改进工作流程的因素。与女性相比，OHC 人员与工作年龄的男性、年轻人讨论酒精使用的次数更多。OHC 人员积极检查有休假风险、接受抑郁症治疗、制定个人健康促进计划和有明确方案的计划 HCUs 中的患者的酒精使用情况。在残疾预防流程中需要进一步改进进行简短干预，特别是在发现过度饮酒时。
