Imagine having a bad day at work. Would that include up to several hours of traffic delays? What about rude and/or difficult passengers, a lack of rest breaks, the absence of restrooms, problems with supervisors, equipment malfunction, job interference with family life, and disruption of eating and sleeping patterns? A study in the July issue of Alcoholism: Clinical & Experimental Research reports that such is the job reality for many bus drivers, and some are using after-hours alcohol to cope with stress generated during the day.
"It’s very important to consider the context in which stress reactions are taking place," explained David R. Ragland, professor of epidemiology in the school of public health at the University of California - Berkeley and lead author of the study. "Many situations that are stressful are incompatible with alcohol consumption." For example, he said, giving a speech may be stressful but consuming alcohol would be counter-productive as it might interfere with performance. Similarly, driving a bus is a very public occupation that requires a high level of concentration. On-the-job alcohol consumption would likely interfere with job performance. In fact, research indicates that drinking during work hours occurs very infrequently among bus drivers. Still, as Ragland’s study shows, it appears that some bus drivers are using alcohol to help "wind down" from the day’s stress.
"Everyone has some level of stress on the job," said Genevieve Ames, senior research scientist at the Prevention Research Center, Pacific Institute for Research and Evaluation. "However, this study shows that employees who experience high levels of job stress, and who have the belief that their stress is severe, are more likely to be drinkers, and are more likely to be heavy drinkers." In addition, noted Ames, people who reported having high work stress also reported drinking to deal with that work stress, drinking more alcohol since beginning employment as a bus driver, and having more negative social and health consequences due to their drinking behavior.
"Interestingly," she added, "there was virtually no association between the stress-related measures and alcohol dependency or alcoholism." Which means that even though work-related stress may have led to greater alcohol consumption, it hadn’t necessarily led anyone to become alcohol dependent. Nonetheless, Ragland’s study noted that with reinforcement, such a pattern of consumption might lead to excessive alcohol intake or alcohol abuse.
"The collection of interview responses from employees of specific occupations is a difficult task," Ames also noted. "Refusals to cooperate, underreporting, outright falsehoods, and fear of repercussions from the employers," she said, are all issues that researchers face when asking questions about sensitive topics such as alcohol use and abuse. In this particular case, Ragland and his co-authors were approached by both the transit company and the union when medical-exam results suggested that bus drivers had higher rates of high blood pressure than other workers. Union and company officials felt that this might be related to the high levels of stress bus drivers experience on the job.
"We’ve done several epidemiological studies related to driver health status and occupational stress," said Ragland. "This study is an outcome of one of our original studies related to hypertension and work stress." He added that numerous other studies have shown that bus drivers have poorer health than workers in other occupations; conditions include heart disease, hypertension, and musculoskeletal disorders. Yet, he noted, "a number of other studies, mostly not about bus drivers, have shown relationships between job stress and job strain (defined as having high levels of responsibility with limited resources) and health outcomes."
Such relationships, including those found by this study, are part of what Ames called "a growing body of evidence that environmental factors of the workplace have a role in heavier and problematic drinking for U.S. workers. Until recently," she explained, "research has failed to show statistically significant evidence of relationships between work stress and drinking. This study shows what others have been suggesting for some time: that work stress and drinking behavior have to be considered within a specific occupational type, rather than across a range of occupations."
Nonetheless, added Ragland, "we think our findings may have applicability to other occupations. While much research on the health effects of employment focuses on just the time between starting and ending work, in fact, conditions of work such as strain, stress, and conflict may ‘spill over’ to non-work time and affect social or family life. We have demonstrated this with respect to alcohol consumption; there are probably other ways in which this happens too."
Ragland said that more research is needed on the process of ‘winding down’ or recovering from a day of highly stressful work and, perhaps more importantly, on how to reduce occupational stress conditions in the first place.
The second point was strongly echoed by Ames. "The importance of this study is that it shows a relationship between work stress and heavier drinking after work, thereby identifying a possible risk factor at work, and one that can be modified. This study and others like it provide guidelines for prevention intervention in the workplace, rather than with the individual. I believe this work will have direct application to prevention intervention programs for transit drivers nation-wide."
For those who routinely ‘self-medicate’ their work-related stress with an after-hours beverage or two, Ames had several words of caution. "Ragland’s findings suggest that work stress and after-hours drinking is a dangerous combination. If you have high stress at work - and if you drink after work alone or with others to placate that stress - you may be at risk for serious alcohol-related problems."
Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.
Articles were written based on the following published research:
Ragland, D.R., Greiner, B.A., Yen, I.H., & Fisher, J.M. (2000, July). Occupational stress factors and alcohol-related behavior in urban transit operators. Alcoholism: Clinical and Experimental Research, 24(7), 1011-1019.
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