 Cassandra A Okechukwu , assistant professor 1Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA cokechuk{at}hsph.harvard.edu 
 
 Policy makers should think carefully before exempting more workers from restrictions on working hours 
 
 In a linked paper, Virtanen and colleagues (doi:10.1136/bmj.g7772) present a meta-analysis combining published studies (34 cross sectional, n=139 112; two longitudinal, n=6873) with unpublished data (27 cross sectional, n=194 581; 18 longitudinal, n=93 729) to explore associations between long working hours and use of alcohol.1 They found that exposure to long working hours was associated with higher odds of alcohol use in cross sectional studies. 9 Another work related factor—long working hours—has been associated with several adverse health outcomes that are linked to alcohol use, including cardiovascular diseases, 10 11 12 13 14 depression and anxiety, 11 13 14 15 16 sleep deprivation, 11 12 16 and occupational injuries. 1 2 3 4 Risky alcohol use, defined for example, as more than 14 drinks/week among women and more than 21 drinks/week among men, 5 6 7 refers to the level of alcohol consumption at which there might be an increased risk of adverse health consequences, such as liver diseases, cancer, coronary heart disease, stroke, mental disorders, and injuries, as well as considerable social costs because of family disruption, violence, traffic incidents, healthcare costs, reduced work productivity, and permanent exclusion from the labour market. Participants were classified as follows: non-use or moderate use (up to 14 drinks/week for women and up to 21 drinks/week for men), and risky alcohol use (>14 drinks/week and >21 drinks/week, respectively). Outcome search terms were: “alcohol or alcohols or ethanol or wine or beer or liquor or spirit or alcoholism or (alcohol and dependence) or (alcohol and abuse) or (substance) or (drinking and behaviour) or (alcohol and drinking) or (alcoholic and beverages) or (alcohol and consumption) or (alcohol and misuse) or (heavy and drinking) or lifestyle or (life and style) or (health and behaviours) or (health and behaviour)”. The associations were not dependent on age or socioeconomic group, region, sample type, or the level of risky drinking in the cohort (all P>0.09 for heterogeneity). In the 12 remaining studies, working hours were treated as a continuous variable. 28 30 Of all published studies, 13 were from Japan, 31 32 33 34 35 36 37 38 39 40 41 42 43 seven from the United States, 44 45 46 47 48 49 50 four from Canada, 28 29 51 52 three from Australia 53 54 55 two from the UK, 56 57 and one each from New Zealand, 58 Denmark, 59 Taiwan, 60 France, 61 Spain, 62 and Sweden. Long working hours were associated with 1.11-fold likelihood of higher levels of alcohol use in the cross sectional analysis of 333 693 participants from 14 countries. Our results are also in accordance with global reports of alcohol use, which have shown large differences in alcohol consumption between countries.1 We found, for example, that the prevalence of risky alcohol use was lower in the US than in Europe. People who worked 49-54 hours a week ran a 13% higher risk of developing a “risky alcohol use” habit compared to counterparts who worked a 35-40-hour work week.
– Working more than a standard 40-hour workweek (if that "standard" still even exists) won't only shave away at your R&R time: It may also cause you to drink more, the Guardian reports. Researchers found that individuals who put in 49 to 54 hours a week were 13% more likely to suck down "risky" amounts of alcohol than those who work 35 to 40 hours, while the poor dears who toiled away for 55 hours or more had a 12% higher risk, according to a study in the British Medical Journal. For the purposes of this study, "risky" alcohol use was considered to be more than 14 drinks a week for women or 21 drinks a week for men, the Los Angeles Times reports. The study used cross-sectional analysis of 61 studies with nearly 334,000 subjects from 14 countries, as well as additional "prospective" analysis of 20 more studies that looked at 100,000 people from nine countries. So why do those who put in so many hours put in more appearances at happy hour? A few theories: They may be decompressing from work stresses; it's built into their personalities (the same folks who work hard can't help but play hard); or those who suffer from insomnia or depression may take longer to work and be more apt to pick up the bottle, notes the Times. Although work-health expert Cassandra Okechukwu wrote in the study's accompanying editorial that those who have jobs experience lower rates of "problem alcohol consumption" and better recovery rates from alcohol abuse than the unemployed, these results warrant further examination: They indicate about 2 million people are adopting risky alcohol habits across labor forces in the participating nations. "Long working hours is an exposure that we cannot afford to ignore," Okechukwu writes. (Binge drinking could mess up your immune system.)