Alcohol and the Workplace: Risk Factors, Support and Prevention

Overview

Alcohol related risk at work is often managed through policies, testing and disciplinary procedures. This literature review takes a broader view by examining which working conditions are associated with harmful alcohol use and which workplace interventions may help reduce risk.

The authors reviewed 33 papers published between 2020 and 2024. Twenty examined workplace factors linked with alcohol use, while 13 assessed interventions.

The evidence connects harmful alcohol consumption with job strain, work related stress, weak social support, insecure employment, poor organisational culture and shift work. Violence, harassment, trauma and major disruptive events also appeared in the literature.

These findings do not prove that working conditions directly cause harmful drinking in individual employees. However, they suggest that alcohol risk should not be treated solely as a private lifestyle issue when patterns are associated with occupation, work schedules and psychosocial conditions.

Harmful alcohol use was also associated with absence, reduced performance, accidents and injuries. Some studies involved large worker populations and identified differences between industries, although these patterns should not be used to stereotype particular groups.

Interventions included digital self help tools, brief online programmes, education, clinical support, management campaigns, organisational policies and financial incentives.

The authors consider approaches that work at several levels to have the greatest promise. These combine confidential individual support with action on workplace stressors, management practice and organisational policy.

Digital tools may improve access for employees who fear stigma or career consequences, but privacy is essential. Workers need to understand what information is collected and whether their employer can access it. Digital support should also connect people with occupational health, primary care or specialist treatment when more intensive help is required.

The review’s central message is that workplace alcohol prevention should combine clear safety expectations with confidential support and action on working conditions that may increase risk.

Aim and Methodology

The review had two main aims: to examine recent evidence on the relationship between working conditions and harmful alcohol use, and to assess workplace interventions designed to reduce consumption or related harm.

Searches covered papers published between 2020 and 2024. The full methods section lists ScienceDirect, MEDLINE through PubMed, Scopus and Google Scholar, while the abstract names PubMed, Scopus and Web of Science. This inconsistency makes the exact search process harder to reproduce.

The search produced 94 records. After screening and exclusions, 33 papers were included. Twenty examined workplace risk factors and 13 assessed interventions.

Two authors conducted the review independently, with disagreements resolved through joint assessment involving another author.

The findings were synthesised narratively because the included studies differed considerably in design, population and outcome measures.

The authors did not report a formal risk of bias assessment, registered review protocol or meta analysis, so the conclusions should be interpreted with some caution.

Key Findings

1. Psychosocial Working Conditions Matter

High job demands, low control, insecurity, poor social support and negative organisational culture were recurring factors associated with harmful alcohol use.

Stress may contribute to drinking as a coping response, although observational studies cannot always establish whether difficult working conditions increase alcohol use or whether harmful use contributes to workplace problems.

For employers, the implication is that alcohol prevention should include psychosocial risk assessment.

Workload, staffing, bullying, harassment, traumatic exposure, job control and support after difficult events may all need attention.

2. Shift Work and Sector May Influence Risk

Several studies associated shift work and irregular schedules with harmful drinking in some worker groups.

Possible influences include disrupted sleep, fatigue, social isolation and reduced recovery time.

Differences were also reported between industries. These may reflect workforce demographics, workplace culture, income, working patterns and social norms rather than the sector itself.

Employers should therefore rely on local evidence such as employee surveys, occupational health information, absence patterns and incident data rather than assumptions about particular occupations.

3. Harmful Use Is Linked With Safety and Attendance

The reviewed studies associated harmful alcohol use with workplace accidents, injuries, absence and reduced productivity. Some also reported relationships with depression and suicidal thoughts.

This makes early support relevant to both occupational safety and mental health.

However, employers should avoid making assumptions about individuals. Fitness for work decisions should consider actual behaviour, evidence of impairment, the nature of the job and appropriate professional advice.

Managers should respond to observable concerns and risk rather than attempting to diagnose alcohol dependence.

4. Digital Tools May Improve Access

Several interventions used websites, applications or online programmes offering self monitoring, feedback, education and goal setting.

Private or anonymous access may be useful for employees who fear stigma or disciplinary consequences.

However, digital delivery alone is not enough.

Employees should know who operates the service, what information is collected and whether the employer receives any personal data. People experiencing severe dependence, withdrawal risk or a mental health crisis require appropriate healthcare rather than self help alone.

5. Managers Can Help or Discourage Disclosure

Managers can communicate policy, respond to immediate safety concerns and signpost workers towards support.

Their involvement can also discourage employees from seeking help if workers fear blame, judgement or disciplinary action.

Training should therefore help managers recognise changes in behaviour, document objective concerns, address immediate risk and make appropriate referrals without attempting to diagnose a health condition.

6. Policy Should Link Safety With Support

A workplace alcohol policy should distinguish between immediate impairment, harmful use, dependence, voluntary disclosure and misconduct.

It should explain expectations around fitness for work, reporting, confidentiality, occupational health referral, investigation and return to work.

The review suggests that policy is most effective when combined with education, trusted support and action on organisational risk factors.

A written policy alone is unlikely to change behaviour if managers are inconsistent or employees do not trust the available support.

7. Combined Approaches Appear Most Promising

The authors regard programmes addressing both individual needs and organisational conditions as more promising than isolated interventions.

A combined approach might include confidential screening, brief intervention, clinical referral, manager education, review of stressful working conditions and clear safety expectations.

The evidence is varied, so this should not be read as proof that every combined programme will be effective.

Study Limitations

The review included different occupations, countries, intervention types and outcome measures.

No formal quality or bias assessment was reported, and no meta analysis was conducted. The restriction to English language studies from 2020 to 2024 may also have excluded relevant evidence.

Many studies relied on self reported alcohol consumption, which may underestimate use, especially where workers fear consequences.

The review therefore supports a broader approach to prevention but does not establish that any single intervention will reduce workplace accidents, absence or harmful drinking in every organisation.

Takeaways for Practice

• Assess workload, insecurity, bullying, trauma, shift patterns and social support as possible contributors to risk.
• Keep expectations around impairment and safety critical work clear.
• Train managers to respond to evidence and refer workers for help rather than diagnose.
• Provide confidential access to occupational health, employee assistance and specialist treatment.
• Explain clearly how personal information is collected and used.
• Combine individual support with action on work related causes and organisational culture.
• Evaluate whether interventions are reaching employees and producing lasting benefits.

Read the Full Research Study Here:

Giezek, M., Szpakow, A., Mintus, B., & Karakiewicz, B. (2026). Risk factors for harmful alcohol consumption among employees and intervention strategies used in the workplace: current state of knowledge based on a literature review. Frontiers in Public Health, 13, Article 1685325. Published 5 January 2026. https://doi.org/10.3389/fpubh.2025.1685325