Article Text

Download PDFPDF

Association between alcohol consumption and impaired work performance (presenteeism): a systematic review
  1. Mikkel Magnus Thørrisen1,
  2. Tore Bonsaksen1,2,
  3. Neda Hashemi3,
  4. Ingvild Kjeken1,4,
  5. Willem van Mechelen5,6,7,8,9,
  6. Randi Wågø Aas1,3,10
  1. 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
  2. 2Faculty of Health Sciences, VID Specialized University, Sandnes, Norway
  3. 3Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
  4. 4National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  5. 5Amsterdam University Medical Centers, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Vrije University Medical Center, Amsterdam, The Netherlands
  6. 6Center of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  7. 7School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
  8. 8Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  9. 9School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
  10. 10Presenter - Making Sense of Science, Stavanger, Norway
  1. Correspondence to Mikkel Magnus Thørrisen; mikkel-magnus.thorrisen{at}


Objectives The aim of this review was to explore the notion of alcohol-related presenteeism; that is, whether evidence in the research literature supports an association between employee alcohol consumption and impaired work performance.

Design Systematic review of observational studies.

Data sources MEDLINE, Web of Science, PsycINFO, CINAHL, AMED, Embase and Swemed+ were searched through October 2018. Reference lists in included studies were hand searched for potential relevant studies.

Eligibility criteria We included observational studies, published 1990 or later as full-text empirical articles in peer-reviewed journals in English or a Scandinavian language, containing one or more statistical tests regarding a relationship between a measure of alcohol consumption and a measure of work performance.

Data extraction and synthesis Two independent reviewers extracted data. Tested associations between alcohol consumption and work performance within the included studies were quality assessed and analysed with frequency tables, cross-tabulations and χ2 tests of independence.

Results Twenty-six studies were included, containing 132 tested associations. The vast majority of associations (77%) indicated that higher levels of alcohol consumption were associated with higher levels of impaired work performance, and these positive associations were considerably more likely than negative associations to be statistically significant (OR=14.00, phi=0.37, p<0.001). Alcohol exposure measured by hangover episodes and composite instruments were over-represented among significant positive associations of moderate and high quality (15 of 17 associations). Overall, 61% of the associations were characterised by low quality.

Conclusions Evidence does provide some support for the notion of alcohol-related presenteeism. However, due to low research quality and lack of longitudinal designs, evidence should be characterised as somewhat inconclusive. More robust and less heterogeneous research is warranted. This review, however, does provide support for targeting alcohol consumption within the frame of workplace interventions aimed at improving employee health and productivity.

PROSPERO registration number CRD42017059620.

  • alcohol consumption
  • presenteeism
  • work performance
  • sick leave
  • employees
  • workplace interventions
  • workplace health promotion

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors RWA is the principal investigator and project manager of the WIRUS project (Workplace Interventions preventing Risky Use of alcohol and Sick leave). This review study was designed by MMT and RWA. MMT analysed the data and drafted the manuscript. Data selection was performed by MMT, NH and RWA; data extraction by MMT and TB; and quality assessment by MMT and IK. TB, NH, IK, WvM and RWA provided scientific input to the different drafts and provided data interpretation. All authors made critical revisions and provided intellectual content to the manuscript, approved the final version to be published and agreed to be accountable for all aspects of this work.

  • Funding The review study is funded by the Norwegian Directorate of Health and the Research Council of Norway.

  • Disclaimer The funding bodies had no role in the design of the review or in data analysis or interpretation.

  • Competing interests For the avoidance of doubt, WVM wishes to declare that he is director-shareholder of Vrije University Medical Center (VUmc) spin-off company Evalua Nederland B.V. and non-executive board member of Arbo Unie B.V. Both companies operate in the Dutch occupational healthcare market.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on reasonable request.

  • Patient consent for publication Not required.