RESUMO
BACKGROUND: While research in high-income countries (HICs) has established high costs associated with alcohol's harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower- or middle-income countries (LMICs). AIM: To compare estimates and predictors of alcohol's impacts upon coworkers among workers in 12 countries. METHODS: Cross-sectional surveys from 9,693 men and 8,606 women employed in Switzerland, Australia, the United States, Ireland, New Zealand, Chile, Nigeria, Lao PDR, Thailand, Vietnam, India, and Sri Lanka. Five questions were asked about harms in the past year because of coworkers' drinking: Had they (i) covered for another worker; (ii) worked extra hours; (iii) been involved in an accident or close call; or had their (iv) own productivity been reduced; or (v) ability to do their job been affected? Logistic regression and meta-analyses were estimated with 1 or more harms (vs. none) as the dependent variable, adjusting for age, sex, rurality of location, and the respondent worker's own drinking. RESULTS: Between 1% (New Zealand) and 16% (Thailand) of workers reported that they had been adversely affected by a coworker's drinking in the previous year (with most countries in the 6 to 13% range). Smaller percentages (<1% to 12%) reported being in an accident or close call due to others' drinking. Employed men were more likely to report harm from coworkers' drinking than employed women in all countries apart from the United States, New Zealand, and Vietnam, and own drinking pattern was associated with increased harm in 5 countries. Harms were distributed fairly equally across age and geographic regions. Harm from coworkers' drinking was less prevalent among men in HICs compared with LMICs. CONCLUSIONS: Workforce impairment because of drinking extends beyond the drinker in a range of countries and impacts productivity and economic development, particularly affecting men in LMICs.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Redução do Dano , Saúde Ocupacional/tendências , Local de Trabalho/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/prevenção & controle , Sudeste Asiático/epidemiologia , Austrália/epidemiologia , Chile/epidemiologia , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Nova Zelândia/epidemiologia , Nigéria/epidemiologia , Saúde Ocupacional/legislação & jurisprudência , Estados Unidos/epidemiologia , Local de Trabalho/legislação & jurisprudência , Adulto JovemRESUMO
AIMS: Survey data from 10 diverse countries were used to analyse the social location of harms from others' drinking: which segments of the population are more likely to be adversely affected by such harm, and how does this differ between societies? METHODS: General-population surveys in Australia, Chile, India, Laos, New Zealand, Nigeria, Sri Lanka, Thailand, United States and Vietnam, with a primary focus on the social location of the harmed person by gender, age groups, rural/urban residence and drinking status. Harms from known drinkers were analysed separately from harms from strangers. RESULTS: In all sites, risky or moderate drinkers were more likely than abstainers to report harm from the drinking of known drinkers, with risky drinkers the most likely to report harm. This was also generally true for harm from strangers' drinking, although the patterns were more mixed in Vietnam and Thailand. Harm from strangers' drinking was more often reported by males, while gender disparity in harm from known drinkers varied between sites. Younger adults were more likely to experience harm both from known drinkers and from strangers in some, but not all, societies. Only a few sites showed significant urban/rural differences, with disparities varying in direction. In multivariate analyses, most relationships remained, although some were no longer significant. CONCLUSION: The social location of harms from others' drinking, whether known or a stranger, varies considerably between societies. One near-commonality among the societies is that those who are themselves risky drinkers are more likely to suffer harm from others' drinking.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Intoxicação Alcoólica/epidemiologia , Relações Interpessoais , Violência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Chile/epidemiologia , Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Laos/epidemiologia , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Nigéria/epidemiologia , Fatores Sexuais , Sri Lanka/epidemiologia , Inquéritos e Questionários , Tailândia/epidemiologia , Estados Unidos/epidemiologia , Vietnã/epidemiologia , Ferimentos e Lesões/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Life expectancy has been increasing steadily over the past century in most countries, with only a few exceptions such as during wartimes. DISCUSSION: Marked reversal of life expectancy has been linked to substance use and related policies. Three such examples are discussed herein, namely the double reversal of life expectancy trends (first to positive, then to negative) associated with reducing alcohol supply in the then Union of Soviet Socialist Republics (USSR), followed by a rapid increase in availability; the impact of the rapid increase of prescription opioids on white non-Hispanics in the US; and the systemic impact of the violence accompanying the drug war in Mexico on the life expectancy of men. Alcohol policies were crucial to initiate the positive reversal in the USSR, and different substance use policies could have avoided the negative impacts on life expectancy of the described large groups or nations. Substance use policies can be responsible for abrupt negative changes in life expectancies. An orientation of such policies towards the goals of public health and societal well-being can help avoid such changes.
Assuntos
Expectativa de Vida/tendências , Mortalidade/tendências , Dinâmica Populacional/tendências , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adulto , Causas de Morte/tendências , Feminino , Humanos , Masculino , México/epidemiologia , U.R.S.S./epidemiologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/mortalidade , Adulto JovemRESUMO
Colorado, Washington state and Uruguay are currently designing legal non-medical markets for cannabis. These clearly contravene the 1961 and 1988 drug conventions; options for what may happen next are discussed. The current provisions in the three regulatory schemes are summarized. From a public health perspective, the emphasis should be on holding down consumption with regulatory measures, but the public health agenda does not seem to be a strong consideration in the implementation of the US schemes, and they are paying little attention to what can be learned from the history of alcohol and tobacco regulation. While alternative paths to a cannabis market under the conventions are noted, the legalization initiatives underline the need to revise the drug conventions, making prohibition of domestic markets an optional matter. Such changes would also ease the path for including alcohol under the conventions, which would be an important step forward in global health.
Assuntos
Cannabis , Comércio/legislação & jurisprudência , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Cooperação Internacional/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Colorado , Humanos , Uruguai , WashingtonRESUMO
Almost all countries are parties to the international drug conventions of 1961, 1971 and 1988. These strongly bind parties with respect to their domestic regulation of controlled substances, including requirements that possession, growing or use be a criminal offense and that any regulated market in the substances be limited to use only for medical or scientific purposes. Even where countries have argued they have "wiggle room", reform within the bounds of the conventions has often resulted in "net-widening" which nullifies the intent of the reform. Among the options for effective reform, probably the most immediately viable is the route of denunciation and reaccession with reservations--the route which Bolivia has now taken in order to legalise a regulated domestic market in coca leaves for chewing. The paper considers the existing record of reservations (by more than 30 parties to each of the conventions). Also discussed are the options for response to the reservations by other parties, which vary between the treaties, and how pursuing the option of denunciation and reaccession with reservation might potentially play out.
Assuntos
Substâncias Controladas/efeitos adversos , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Cooperação Internacional , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Bolívia , Coca/química , Humanos , Folhas de PlantaRESUMO
Esta publicación reúne el estado actual del conocimiento sobre la investigación, la práctica y la política temas de la asociación del alcohol con las lesiones. Se sintetiza los resultados de los estudios a partir de un número de los servicios de urgencias hospitalarios realizados en diferentes entornos culturales, incluyendo el MundialEstudio Colaborativo de la Salud sobre alcohol y lesiones. El libro ofrece una introducción a la epidemiología de las lesiones relacionadas con el alcohol y se refiere a cuestiones metodológicas de los estudios llevados a cabo en los servicios de urgencias. Asimismo, aborda las implicaciones de política pública y equipa al lector información práctica sobre las intervenciones que se pueden implementar en situaciones de emergencia departamentos, como el cribado y las intervenciones breves para el consumo de riesgo y perjudicial.