Evidence map›Paper›PMID 25587065›Full record

SynthesisBMJ (Clinical research ed.)2015

Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data.

Marianna Virtanen, Markus Jokela, Solja T Nyberg, Ida E H Madsen, Tea Lallukka, Kirsi Ahola, Lars Alfredsson, G David Batty, Jakob B Bjorner, Marianne Borritz and 34 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

90 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. The consequences of a compressed workweek: a systematic literature review.International archives of occupational and environmental health · 2025
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  17. Work demands, self-care, and mental health in lawyers.Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law · 2026
    Article
  18. Working hours and depression in the HEAF cohort.Occupational medicine (Oxford, England) · 2025
    Article
  19. Article
  20. Article

30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

44 authors.

Marianna VirtanenFinnish Institute of Occupational Health, 00250 Helsinki, Finland marianna.virtanen@ttl.fi.
Markus JokelaInstitute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
Solja T NybergFinnish Institute of Occupational Health, 00250 Helsinki, Finland.
Ida E H MadsenNational Research Centre for the Working Environment, Copenhagen, Denmark.
Tea LallukkaFinnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
Kirsi AholaFinnish Institute of Occupational Health, 00250 Helsinki, Finland.
Lars AlfredssonInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
G David BattyDepartment of Epidemiology and Public Health, University College London, London, UK Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
Jakob B BjornerNational Research Centre for the Working Environment, Copenhagen, Denmark.
Marianne BorritzDepartment of Occupational Medicine, Koge Hospital, Koge, Denmark.
Hermann BurrFederal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
Annalisa CasiniSchool of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Els ClaysDepartment of Public Health, Ghent University, Ghent, Belgium.
Dirk De BacquerDepartment of Public Health, Ghent University, Ghent, Belgium.
Nico DraganoInstitute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Raimund ErbelDepartment of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
Jane E FerrieDepartment of Epidemiology and Public Health, University College London, London, UK School of Social and Community Medicine, University of Bristol, Bristol, UK.
Eleonor I FranssonInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Stress Research Institute, Stockholm University, Stockholm, Sweden School of Health Sciences, Jönköping University, Jönköping, Sweden.
Mark HamerDepartment of Epidemiology and Public Health, University College London, London, UK.
Katriina HeikkiläSchool of Medicine, University of Tampere, Tampere, Finland.
Karl-Heinz JöckelInstitute for Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
France KittelSchool of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Anders KnutssonDepartment of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Markku KoskenvuoDepartment of Public Health, Faculty of Medicine, University of Helsinki, Finland.
Karl-Heinz LadwigHelmholtz Zentrum München (German Research Center for Environmental Health (GmbH)), 85764 Oberschleißheim, Germany.
Thorsten LunauInstitute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Martin L NielsenUnit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark.
Maria NordinStress Research Institute, Stockholm University, Stockholm, Sweden Department of Psychology, Umeå University, Umeå, Sweden.
Tuula OksanenFinnish Institute of Occupational Health, 00250 Helsinki, Finland.
Jan H PejtersenDanish National Centre for Social Research, Copenhagen, Denmark.
Jaana PenttiFinnish Institute of Occupational Health, 00250 Helsinki, Finland.
Reiner RuguliesNational Research Centre for the Working Environment, Copenhagen, Denmark Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Paula SaloFinnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Psychology, University of Turku, Turku, Finland.
Jürgen SchuppGerman Institute for Economic Research, Berlin, Germany Free University of Berlin, Berlin, Germany.
Johannes SiegristInstitute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Archana Singh-ManouxDepartment of Epidemiology and Public Health, University College London, London, UK Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
Andrew SteptoeDepartment of Epidemiology and Public Health, University College London, London, UK.
Sakari B SuominenDepartment of Public Health, University of Turku, Turku, Finland Nordic School of Public Health, Gothenburg, Sweden Folkhälsan Research Center, Helsinki, Finland.
Töres TheorellStress Research Institute, Stockholm University, Stockholm, Sweden.
Jussi VahteraFinnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, University of Turku, Turku, Finland Turku University Hospital, Turku, Finland.
Gert G WagnerGerman Institute for Economic Research, Berlin, Germany Max Planck Institute for Human Development, Berlin, Germany Berlin University of Technology, Berlin, Germany.
Peter J M WesterholmOccupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Hugo WesterlundStress Research Institute, Stockholm University, Stockholm, Sweden.
Mika KivimäkiFinnish Institute of Occupational Health, 00250 Helsinki, Finland Department of Public Health, Faculty of Medicine, University of Helsinki, Finland Department of Epidemiology and Public Health, University College London, London, UK.

Funding

U19 MIDlife in the United States-Diversity Supplement-WellsU19AG051426 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI CAROL D. RYFF · 2016 to 2026
$74.8M
STATISTICS COREP01AG020166 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI RYFF, CAROL D. · 2002 to 2015
$50.6M
Socioeconomic gradient in CHD in early old ageR01HL036310 · NHLBI · UNIVERSITY OF LONDON · PI KIVIMAKI, MIKA J, MARMOT, MICHAEL G · 1986 to 2012
$3.1M
Health behaviors over the adult lifecourse and cognitive agingR01AG034454 · NIA · UNIVERSITY COLLEGE LONDON · PI KIVIMAKI, MIKA J, SINGH-MANOUX, ARCHANA · 2009 to 2013
$1.5M
Medical Research Council G0100222Medical Research Council K013351Medical Research Council MR/K013351/1NHLBI NIH HHS R01HL036310NIA NIH HHS P01 AG020166NIA NIH HHS R01AG034454NIA NIH HHS U19 AG051426
6 · The paper itself

Abstract

objectiveTo quantify the association between long working hours and alcohol use.

designSystematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW

methodsThe search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.

resultsCross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥ 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.

conclusionsIndividuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.

Indexed as

Age FactorsAlcohol DrinkingCross-Sectional StudiesHumansOdds RatioPrevalenceProspective StudiesSex FactorsSocioeconomic FactorsWorkload

Identifiers

PMID25587065
PMCPMC4293546

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.