Globally, alcohol is the world’s number one risk factor for ill-health and premature death amongst the 25-59 year old age group, the core of the working age population. It is unsurprising, therefore that lost productivity costs feature as the dominant element in social costs studies arising from the harm done by alcohol (contributing to one half or more of the total social costs). Becoming unemployed worsens alcohol-related harm, and heavy drinking, itself, leads to unemployment. Alcohol is a significant risk factor for absenteeism and presenteeism at work, largely in a dose response manner, with a relationship between societal and individual level of alcohol consumption and sickness absence. Although some studies have reported a positive impact of alcohol consumption on earnings, a proxy measure of productivity, a meta-analysis of relevant studies suggested that the relationship was an artefact. Often forgotten is the impact of drinkers on the productivity of people other than the drinker. An Australian study found this to be comparable in cost size as the lost productivity costs of the drinkers themselves. The work place itself also impacts on alcohol-related harm. Certain occupations (in particular bar staff and sea workers) are at particular risk, and, in general, stressful working environments increase the risk of alcohol-related harm.
Despite the extensive evidence base for the potential negative impact of alcohol consumption on productivity, the evidence base for effective responses is rather poor. It is not known if changing work structures can reduce workplace alcohol-related harm. Whilst there is some limited evidence from systematic reviews for an impact of counselling based interventions at the work place, peer support programmes and web based programmes, most of the evidence is based on self-report, with few outcomes that are objective. Mandatory screening programmes seem to have an impact and can be appropriate for those employees in high risk situations, such as in the transport sector. Although systematic reviews find in general that health promotion programmes at the workplace have little impact, with, perhaps the exception of programmes that promote physical activity, well-being at work programmes seem to bring a productivity return on investment of 2.73 financial units for every financial unit spent. Finally, policies outside the workplace seem to have an impact. Investing in social welfare programmes and active labour programmes to keep and reintegrate workers in jobs can mitigate the negative effective of economic downturns on alcohol-related deaths. Alcohol polices themselves, such as increases in the price of alcohol, can reduce sickness absence and overall unemployment and improve overall productivity.
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