High prevalence of alcohol use disorder & psychiatric comorbidity among coal mine workers: Observations from a cross-sectional study in West Bengal.

Background & objectives Tobacco (30%), alcohol (21.4%) and cannabis (3%) are the three most commonly abused substances in India. Tobacco and alcohol abuse have higher prevalence rates among different occupational groups as compared to that in general population in the country. Both tobacco and alcohol lead to significant occupational harm in terms of absenteeism, injuries, sickness and lost productivity. This study estimated the patterns of substance use and associated common psychiatric comorbidity in a sample of coal mine workers. Methods Coal mine workers at the age of 18 yr or above engaged in mining activities (skilled/semi-skilled/unskilled) were recruited from the Raniganj - Asansol coal mining areas of Eastern Coalfields Limited (ECL). Participants were screened to identify patterns of substance use and other common mental health problems. All participants were administered ASSIST (The Alcohol, Smoking and Substance Involvement Screening Test); GENACIS (Gender, Alcohol and Culture: An International Study) modified questionnaire; and Hospital Anxiety and Depression Scale (HADS) for primary screening for anxiety and depression. Results Out of 202 participants 69 per cent (n=140) were found with either 'hazardous and harmful' (moderate risk); or 'dependent' (high risk) patterns of use of either tobacco or alcohol or cannabis or of more than one substance. Only 31 per cent (n=62) were 'low-risk' for all substances. Almost 65 per cent (n=132) and 49 per cent (n=99) participants out of the whole sample (n=202) belonged to 'hazardous and harmful' (moderate risk) and 'dependent' (high risk) pattern of tobacco and alcohol consumption, respectively. About 28.8 per cent (n=38) and 23.7 per cent (n=31) of all participants had anxiety and depression, respectively. Combined moderate to high use of both alcohol and tobacco use was significantly associated with the risk of having anxiety [adjusted odds ratio (AOR)=4.896, P<0.015] and depression (AOR=5.335, P<0.012). Interpretation & conclusions Alcohol and tobacco are major substance abuse problems among coal mine workers. This population requires early community and primary care based brief intervention as well as additional community-based pharmacotherapy for substance dependence problems as well as intervention for common mental health issues.