Alcohol Consumption at Work in Construction Workers Employed in Small Italian Companies

Background: Alcohol consumption is an important occupational risk factor, especially in safety-sensitive sectors such as construction. Alcohol-related psychomotor impairment may increase the risk of workplace injuries and may also affect the safety of third parties. However, data on alcohol-related behaviors, workers' risk perception, and alcohol-focused health surveillance among Italian construction workers are still limited. Methods: We conducted a cross-sectional survey between September 2023 and June 2024 in 315 construction workers employed in small Italian companies. All participants performed work activities for which local legislation mandates alcohol-use and alcohol-dependence checks as part of occupational health surveillance. Data were collected through an anonymous 27-item questionnaire exploring sociodemographic characteristics, alcohol consumption (AUDIT-C; cut-off >= 5 for men and >= 4 for women), alcohol use at work, knowledge of national regulations, alcohol-related risk perception, and accident/injury indicators. Nonparametric tests and multivariable linear regression were used to identify factors associated with AUDIT-C scores. Logistic regression analyses examined associations between perceived alcohol-related risks and awareness of, and exposure to, alcohol-dependence checks during health surveillance. Results: The sample was predominantly male (274/315; 86.98%), and 26.03% of workers were aged 46-55 years. The mean AUDIT-C score was 2.85 +/- 2.49 (3.13 +/- 2.47 in men; 0.95 +/- 1.75 in women); 32.7% of workers screened positive, mainly men. Alcohol consumption during the work shift was reported by 1.9% of participants (7.94% occasionally), and during breaks by 5.08% (19.37% occasionally). Most workers were aware of the workplace alcohol ban (90.48%), and 83.49% reported having undergone alcoholrelated checks. Higher AUDIT-C scores were associated with alcohol consumption during the work shift and occasional drinking during breaks. Conclusions: Although average AUDIT-C scores were not high, a relevant subgroup of workers showed risky drinking patterns and some alcohol consumption at work. These findings highlight the need to strengthen prevention strategies and ensure consistent alcohol-related health surveillance in construction settings.