Alcohol consumption and physical activity among healthcare workers
Francesca Montali , Giovanna Campaniello , Simona Fontechiari , Mariangela Ferrari , Pietro Vitali
About the authors:
Clinical Governance, Risk Management, Quality and Accreditation - General Directorate - Academic Hospital of Parma
Nursing Directorate, Academic Hospital of Parma
Preventive Medicine, Hospital Hygiene and Hygienic Healthcare Safety Unit - General Directorate, Academic Hospital of Parma
Aims The study analysed the relation between consumption of wine/beer/hard liquor and the practice of physical activity in everyday life for healthcare professionals.
Methods A descriptive survey design was used. A representative sample (n=914) of healthcare practitioners who work in a teaching hospital have participated. Data were collected through the distribution of self-reported questionnaires.
Results 47.4% drank wine/beer occasionally. 16% consumed approximately half a litre daily, while 1.3% had a daily consumption of one litre or more. Fewer consumed hard liquor occasionally and only 1% on a regular basis. 26.1% declared to not practise physical activity, while 71.2% affirmed to do it occasionally and 2.1% regularly. Reporting no performed physical activity were associated to wine/beer consumption but not to hard liquor consumption.
Conclusion Health promotion programs should not only target the general population, but also target the health care personnel.
The international literature has provided evidence that excessive consumption of alcohol leads to an increase in diseases and an aggravation on injury outcomes (1). Also sedentary behaviour and physical inactivity as well as alcohol consumption are associated with adverse health outcomes (2). The word “sedentary” is applied to people who spend most of their day either sitting or lying down without doing any kind of physical activity (3). Physical inactivity is defined as “doing no or very little physical activity at work, at home, for transport, or in discretionary time” (4). Knowing the epidemiological data related to healthcare professionals’ lifestyles is a critical step towards supporting a culture of health promotion. For both staff and patients in the last two decades a lot of researchers have dedicated themselves to the study of alcohol consumption among physicians and medical students (5-11) and among healthcare professionals (12-15). Despite evidence showing the impacts of alcohol consumption on global health, studies have documented the existence of different attitudes and habits among physicians, and a relation to the risk of alcohol consumption (16-18).
Unsurprisingly, also among doctors, men have a higher alcohol consumption than women; they drink more frequently, consume a higher amount of alcohol per occasion and at a more hazardous or harmful level (6;11;19).
The research on healthcare workers’ physical activity, however, is much rarer (20-22). The few studies that have been carried out have highlighted that despite the significant education of healthcare workers on health promotion and healthy lifestyles, this knowledge is not always transferred to their own behaviour.
The aim of the study was to explore the relation between consumption of alcohol and the practice of physical activity in everyday life for healthcare professionals.
Materials and Methods
The survey was anonymous. Each of 3150 staff members were contacted through the intranet with an invitation to participate in the study. No financial or material incentives were offered in exchange for participation. The questionnaire was administered by the Parma University Hospital from January to April 2013.
The results were distributed to all professionals, managers/coordinators, and other involved services.
The Academic Hospital of Parma is a teaching general hospital with 1250 beds, located in the Parma Province (which has about 447.000 inhabitants). The sample of n=914 respondents was considered representative (CI=99%) compared to the reference population (n=3.150).
A brief self-report questionnaire was administered to investigate the alcohol consumption behaviours and physical activity. The questionnaire was distributed in 2013 in order to explore the phenomenon for the first time in the Parma University Hospital, and the survey has not been repeated since then.
The questionnaire consisted of two parts: Part A collected demographic information: gender, age, profession (physicians, nurses, health technicians, health workers, other employees), marital status (married/cohabitant, single, separated/divorced, widower), instruction degree (primary school, secondary school, high school diploma, bachelor degree) and workplace (clinical unit/service, office, other/vehicle). Part B reported the frequency of alcohol consumption and physical activity through the following questions:
1.“Do you do any physical activity?”
(1 = No, 2 = Yes, occasionally, 3 = Yes, I play sport at a competitive level),
2. “Can you indicate your habits with respect to the assumption of wine/beer?”
(1 = I don’t consume neither wine nor beer, 2 = I consume them only occasionally, 3 = I consume them with an approximately ½ litre daily dose, 4 = I consume a wine/beer daily dose equivalent or higher than 1 litre)
3. “Can you indicate your habits with respect to the assumption of hard liquor?”
(1 = No, 2 = Yes, occasionally, 3 = Yes, regularly).
The demographic information of the respondents (gender, age, marital status, instruction degree, profession, and workplace) was descriptively expressed as numbers and percentages (Table 1). The association of demographic variables as gender and age with the drinking behaviours and physical activity was analysed through Mann-Whitney’s test and χ test in order to obtain the risk estimate and the crude Odd Ratios values (OR with 95% CI).
A multinomial logistic regression method was used for verifying which of the respondents’ demographic characteristics were found to be significant predictors for the dependent variables (wine/beer consumption, hard liquor consumption, and physical activity). All dependent variables (wine/beer consumption, hard liquor consumption, and physical activity) have been recoded into dichotomous (presence/absence of consumption or activity) and the adjusted OR values have been reported. The relation between healthcare workers’ drinking behaviours and their physical activity has been evaluated according to the Pearson χ test. All statistical analyses were performed through SPSS 17.0 software. 95% CI not including the value one and p-value <0.05 where considered statistically significant.
Overall, 28.2% declared that they were not consuming beer or wine, while 71.3% declared that they did not consume hard liquor at all. Furthermore, 26.1% declared that they were not physical active (Table 2).
Table 3 shows that wine/beer consumption was significant more frequent among women (OR 1.272; 95% CI 1.186-1.363) More women also declared an occasional consumption of hard liquor (OR 1.339; 95% CI 1.182-1.517). A subanalysis on the physicians reported contrary results, however, with men consuming more alcohol both in relation to hard liquor (p<0.014) and to wine/beer ( p<0.022). Age was not related to wine/beer consumption, but staff members of 31 years and older seemed more likely to consume hard liquor than their younger colleagues ((OR 1.112; 95% CI 1.038–1.190). Marital status was not a significant predictor of wine/beer consumption, but showed higher risk of consuming hard liquor (OR 1.405; 95% CI 1.185–1.665). Furthermore, single healthcare workers seem more likely not to consume hard liquor compared to the other groups (OR 0.540; 95% CI 0.435-0.671). Living alone was associated to no consumption of hard liquor.