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Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study

Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study
Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study
BACKGROUND:
The direct cost of excessive alcohol consumption to health services is substantial but dwarfed by the cost borne by the workplace as a result of lost productivity. The workplace is also a promising setting for health interventions. The Preventing Alcohol Harm in Liverpool and Knowsley (PrevAIL) project aimed to evaluate a mechanism for detecting the prevalence of alcohol related liver disease using fibrosis biomarkers. Secondary aims were to identify the additive effect of obesity as a risk factor for early liver disease; to assess other impacts of alcohol on work, using a cross-sectional survey.

METHODS:

Participants (aged 36-55 y) from 13 workplaces participated (March 2011-April 2012). BMI, waist circumference, blood pressure and self-reported alcohol consumption in the previous week was recorded. Those consuming more than the accepted UK threshold (men: >21 units; female: >14 units alcohol) provided a 20 ml venous blood sample for a biomarker test (Southampton Traffic Light Test) and completed an alcohol questionnaire (incorporating the Severity of Alcohol Dependence Questionnaire).

RESULTS:

The screening mechanism enrolled 363 individuals (52 % women), 39 % of whom drank above the threshold and participated in the liver screen (n = 141, complete data = 124 persons). Workplaces with successful participation were those where employers actively promoted, encouraged and facilitated attendance. Biomarkers detected that 30 % had liver disease (25 %, intermediate; 5 % probable). Liver disease was associated with the frequency of visits to the family physician (P = 0.036) and obesity (P = 0.052).

CONCLUSIONS:

The workplace is an important setting for addressing alcohol harm, but there are barriers to voluntary screening that need to be addressed. Early detection and support of cases in the community could avert deaths and save health and social costs. Alcohol and obesity should be addressed simultaneously, because of their known multiplicative effect on liver disease risk, and because employers preferred a general health intervention to one that focused solely on alcohol consumption.
1471-2458
532
Cook, P.A.
7a504967-66a6-4297-aa6c-998d8a5f6613
Morleo, M.
28a29c4b-e795-4834-bd0b-b424e737cca0
Billington, D.
31bbbb74-d7ad-45ff-9429-a7ab6bf06eaf
Sanderson-Shortt, K.
e9d9c9f0-45d2-4317-a43f-85608f94d3b7
Jones, C.
efc76da3-efd7-43ed-89c3-bf4c9a7951a7
Gabbay, M.
2368972c-3306-471f-bf13-42f70fd9833e
Sheron, N.
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Bellis, M.A.
fd953e31-b150-4a65-bdd1-0a57d6f8092a
Phillips-Howard, P.A.
86b6778f-001f-435b-ba2e-eb6d76921751
Gilmore, I.T.
32561296-7d10-406b-b5f5-b8345392029c
Cook, P.A.
7a504967-66a6-4297-aa6c-998d8a5f6613
Morleo, M.
28a29c4b-e795-4834-bd0b-b424e737cca0
Billington, D.
31bbbb74-d7ad-45ff-9429-a7ab6bf06eaf
Sanderson-Shortt, K.
e9d9c9f0-45d2-4317-a43f-85608f94d3b7
Jones, C.
efc76da3-efd7-43ed-89c3-bf4c9a7951a7
Gabbay, M.
2368972c-3306-471f-bf13-42f70fd9833e
Sheron, N.
cbf852e3-cfaa-43b2-ab99-a954d96069f1
Bellis, M.A.
fd953e31-b150-4a65-bdd1-0a57d6f8092a
Phillips-Howard, P.A.
86b6778f-001f-435b-ba2e-eb6d76921751
Gilmore, I.T.
32561296-7d10-406b-b5f5-b8345392029c

Cook, P.A., Morleo, M., Billington, D., Sanderson-Shortt, K., Jones, C., Gabbay, M., Sheron, N., Bellis, M.A., Phillips-Howard, P.A. and Gilmore, I.T. (2015) Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study. BMC Public Health, 15, 532. (doi:10.1186/s12889-015-1860-9). (PMID:26041363)

Record type: Article

Abstract

BACKGROUND:
The direct cost of excessive alcohol consumption to health services is substantial but dwarfed by the cost borne by the workplace as a result of lost productivity. The workplace is also a promising setting for health interventions. The Preventing Alcohol Harm in Liverpool and Knowsley (PrevAIL) project aimed to evaluate a mechanism for detecting the prevalence of alcohol related liver disease using fibrosis biomarkers. Secondary aims were to identify the additive effect of obesity as a risk factor for early liver disease; to assess other impacts of alcohol on work, using a cross-sectional survey.

METHODS:

Participants (aged 36-55 y) from 13 workplaces participated (March 2011-April 2012). BMI, waist circumference, blood pressure and self-reported alcohol consumption in the previous week was recorded. Those consuming more than the accepted UK threshold (men: >21 units; female: >14 units alcohol) provided a 20 ml venous blood sample for a biomarker test (Southampton Traffic Light Test) and completed an alcohol questionnaire (incorporating the Severity of Alcohol Dependence Questionnaire).

RESULTS:

The screening mechanism enrolled 363 individuals (52 % women), 39 % of whom drank above the threshold and participated in the liver screen (n = 141, complete data = 124 persons). Workplaces with successful participation were those where employers actively promoted, encouraged and facilitated attendance. Biomarkers detected that 30 % had liver disease (25 %, intermediate; 5 % probable). Liver disease was associated with the frequency of visits to the family physician (P = 0.036) and obesity (P = 0.052).

CONCLUSIONS:

The workplace is an important setting for addressing alcohol harm, but there are barriers to voluntary screening that need to be addressed. Early detection and support of cases in the community could avert deaths and save health and social costs. Alcohol and obesity should be addressed simultaneously, because of their known multiplicative effect on liver disease risk, and because employers preferred a general health intervention to one that focused solely on alcohol consumption.

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More information

Published date: 4 June 2015
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 383284
URI: https://eprints.soton.ac.uk/id/eprint/383284
ISSN: 1471-2458
PURE UUID: 7455c466-5ca6-4a19-a98f-7f8b9f573de5
ORCID for N. Sheron: ORCID iD orcid.org/0000-0001-5232-8292

Catalogue record

Date deposited: 12 Nov 2015 11:30
Last modified: 06 Jun 2018 13:07

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Contributors

Author: P.A. Cook
Author: M. Morleo
Author: D. Billington
Author: K. Sanderson-Shortt
Author: C. Jones
Author: M. Gabbay
Author: N. Sheron ORCID iD
Author: M.A. Bellis
Author: P.A. Phillips-Howard
Author: I.T. Gilmore

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