The costs of alcohol hangover for the Dutch economy: impact of absenteeism and presenteeism

A. Merlo, N.R. Severeijns, A.S.M. Sips, J. Garssen, G. Bruce, J.C. Verster

Research output: Contribution to journalMeeting Abstractpeer-review


Background: The alcohol hangover is defined as the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero [1]. While performance impairment during hangover has been consistently demonstrated [2], research on the impact on work performance, absenteeism, and presenteeism is scarce. A recent investigation estimated the combined annual costs of being hungover or under the influence of alcohol at work for the UK economy at 1.61 billion euro [3]. In 2013, the National Institute of Public Health and the Environment of the Netherlands (RIVM) estimated the annual costs of alcohol-related absenteeism and presenteeism for The Netherlands at 1.3 billion euro (hangover and under the influence of alcohol at work combined), including and 0.22 absenteeism days, and 2.5 presenteeism days with a 27% reduction of performance on presenteeism days[4].

Objective: The purpose of this study was to investigate hangover-related absenteeism and presenteeism, and estimate the annual costs for the Dutch economy.

Methods: An online survey was conducted among Dutch adults [5]. Participants indicated whether in 2019 (i.e., pre-COVID-19) they consumed alcohol and were employed. Absenteeism and presenteeism due to alcohol hangover were assessed, using questions adapted from Bhattacharya [3], including the number of days that participants (a) did not work because they experienced a hangover and (b) worked while having a hangover. Performance on presenteeism days was rated on a scale ranging from 0% (compared to a regular day I achieved nothing/did not work) to 100% (my work was absolutely not influenced by experiencing reduced immune fitness). Statistics Netherlands provided information on the average Dutch income. Using the method by Bhattacharya [3], the economic costs of absenteeism and presenteeism due to reduced immune fitness were calculated.

Results: Data of N=351 participants (63.5% female) with a mean (SD) age of 34.6 (14.5) years old was evaluated. About one third (33.6%) of all employees had been hungover at work at least once in 2019, and 8.3% reported absenteeism due to hangover. The mean (SD) number of absenteeism and presenteeism days were 0.2 (0.9) and 2.4 (7.0) days, respectively. On average, employees reported a 26% reduction in performance when being at work while having a hangover. The estimated economic cost of the alcohol hangover due to absenteeism (€306 million euro) and presenteeism (€986 million euro) sum up to a total of €1.29 billion euro. Presenteeism and absenteeism were most commonly reported by younger, male, and higher educated individuals.

Conclusions: These findings suggest that alcohol hangover has a significant impact on the Dutch economy. The 2019 data are comparable to those obtained in 2013, although for the current analysis only hangover was considered and not being under the influence of alcohol at work. However, it should be noted the data were obtained from a relatively small convenience sample. To obtain a more accurate estimate of the costs of hangover-related absenteeism and presenteeism, the study should be replicated in a larger and national representative sample.
Original languageEnglish
Article numberP.0012
Pages (from-to)S9-S10
Number of pages2
JournalEuropean Neuropsychopharmacology
Issue numberSupplement 1
Early online date30 Dec 2021
Publication statusPublished - 31 Dec 2021


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