Job stressors and the incidence of alcohol-related outcomes: prospective findings from the national French ESPS survey.

BACKGROUND: Prospective studies are lacking on the associations between job stressors and alcohol-related outcomes in the working population. The objectives were to explore the prospective associations of these exposures, including changes in exposure, with three alcohol-related outcomes. METHODS: The study relied on the prospective data of the national French ESPS survey (Health, health care and insurance survey) collected among a sample of 2080 workers in 2010 and 2014. Ten job stressors, derived from the job strain and effort-reward imbalance models, in 2010 (baseline) and changes in these exposures between 2010 and 2014 were studied. The incidence of three alcohol-related outcomes in 2014 (follow-up) was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among the study sample of workers free of these outcomes at baseline: intermediate/heavy drinking, binge drinking, and alcohol misuse. Robust Poisson regression models were performed to study the exposure-outcome associations before and after adjustment for covariates. Gender-related interactions were tested. RESULTS: Job insecurity at baseline predicted the incidence of binge drinking at follow-up [incidence rate ratio (IRR) = 2.18; 95% confidence interval (CI): 1.33-3.58], and persistent job insecurity in both 2010 and 2014 displayed the strongest association with the incidence of binge drinking (IRR = 2.74; 95% CI: 1.36-5.54). Redundancy plan at baseline was borderline significant as a predictive factor of the incidence of binge drinking. Low freedom at work at baseline predicted the incidence of alcohol misuse among women. CONCLUSIONS: Job stressors, particularly those related to employment uncertainty, predicted the incidence of alcohol-related outcomes, especially binge drinking. Job stressors, including persistent exposures, may warrant more attention for preventing alcohol-related outcomes.