Directly alcohol-attributable mortality by industry and occupation in a Spanish Census cohort of economically active population

Abstract Aims To assess disparities in directly alcohol-attributable (DAA) mortality by industry/occupation in Spain during 2002–2011 and the contribution of different socio-demographic factors, including socioeconomic position, to explain such disparity. Methods Nationwide cohort study covering 16 million economically active people living in Spain in 2001. Deaths at age 25–64 were analyzed. Subjects were classified by employment status, industry and occupation at baseline. Poisson regression models were built, calculating rate ratios (RRs) compared to all employees or those in the education sector. Results DAA mortality was much higher in the unemployed than in employees (Crude RR: 2.4; 95% CI: 2.3–2.6) and varied widely across industries/occupations. Crude RRs > 3.0 (p   1.33 (p  Conclusions The results could be extrapolated to all alcohol-attributable mortality since disparities for other strongly alcohol-related deaths, although smaller, were in the same direction. Given the wide occupational disparities in alcohol-attributable mortality, implementation of special measures to reduce this mortality in the highest risk groups is fully justified. Future research should better characterize the explanatory factors of disparities and their role in the causal chain.