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Bar Staff have Doubled Risk of Death from Alcohol Consumption

A new report from the Office of National Statistics reveals that bar staff and publicans are approximately twice as likely to die from alcohol consumption as the general population. Other people working in catering, hospitality and entertainment also have an increased risk, as do hairdressers and barbers. Amongst male workers, seafarers, butchers and labourers (building, woodworking, flooring and tiling) have a similarly increased risk. Men with the lowest rates of death from alcohol are farmers, managers, and professional drivers, whilst women who work with children, as well as managers have the lowest risk of dying from alcohol consumption. Overall, those in full-time employment have a lower risk of alcohol-related death.

Doctors have traditionally had high rates of heavy drinking and alcohol-related death, but according to the new report, they are now amongst the professions with the lowest rates of alcohol-related death. The authors of the report comment on two factors that may be important here. The first is that doctors are more aware of the health implications of heavy drinking, and so have reduced their drinking before the rest of the population. A similar trend was previously observed with smoking. A second factor is that many doctors may have cultural reasons for not drinking, as a relatively high proportion of doctors are Asian (21% of doctors, relative to 4% of the general population). Professor Martin Plant (quoted on the BBC news website) suggests a third possibility, that it is the increased number of women in the profession that has had “a civilising effect.” 

The figures for one occupation have been widely misreported; a number of newspapers and magazines have reported that “female office juniors” are twice as likely to die from alcohol as the rest of the population. In fact, it would be more accurate to say they are half as likely to die. The reason for this dramatic error is that the report gives two measures, the Population Mortality Ratio (PMR) and the Standardized Mortality Ratio (SMR). Neither is perfect, which is why both are reported. PMR is based on the proportion of deaths (before the age of 64) within each occupation, so is affected by how many people die of other things. SMR looks at the number of people in each occupation who died, relative to the number that would be expected to die if the alcohol-related mortality rate was the same for all occupations.

The PMR indicates that, of those “elementary office occupations” who’d died, the proportion who had died of alcohol related problems was twice that found in the general population. However, this figure is misleading, as we can see when we look at the actual numbers who died. Based on the rate of alcohol-related deaths in the general population, we would expect 36 deaths from alcohol amongst female office staff. In fact, there were only 17, less than half as many as would be expected (SMR). The reason for the high proportion of alcohol related deaths (PMR) is that whilst secretaries are only half as likely to die from alcohol related problems as other people, they are even less likely to die from anything else.

The full report is published in Health Statistics Quarterly 35, Autumn 2007, pp 6-12.