Intoxicated workers: findings from a national Australian survey

Heavy Drinking by Occupation in Spain: Differences Between Weekdays and the Weekend

Estimating occupational disparity in heavy drinking jointly for weekdays and the weekend may be misleading for prevention purposes, because reasons for disparity in both periods may differ. The main objective was to assess occupational disparity in heavy average drinking (HAD) by week period and sex. 42,108 employees aged 16-64 were recruited from national surveys in Spain between 2011 and 2020. The outcome was HAD, defined as daily alcohol intake over 20 g (men) or 10 g (women). Occupation was classified in 15 categories. HAD adjusted prevalence ratios (HAD-aPRs) taking all occupations as reference, and relative adjusted excess prevalences (HAD-aEPs) comparing the weekend to weekdays in each occupation, were estimated using Poisson regression models with robust variance adjusted for sociodemographic and health covariates. The HAD-aPRs comparing each occupation with all occupations ranged 0.63-1.92 on weekdays and 0.65-1.45 on the weekend, with the highest aPRs on weekdays in construction, hospitality and primary-sector workers (1.92-1.62). The weekend-weekdays HAD-aEPs by occupation ranged 2.60-8.33, with the highest values in technicians/administrators, other professionals, teachers and health professionals (8.33-6.44). The global aEP was higher in women (6.04) than in men (3.92), especially in occupations just mentioned (8.70-11.73 in women vs. 3.64-6.32 in men). There was a considerable relative disparity in HAD risk between occupations on weekdays, with the highest risks in certain low-skilled occupations. Such disparity decreased on the weekend. The relative weekend increase in HAD risk was greater in women and in certain high-skilled occupations. This should be considered when designing prevention interventions on harmful drinking.

Cannabis use and workplace cannabis availability, perceptions and policies among Canadian workers: a comparison before and after the legalisation of non-medical cannabis

OBJECTIVES

Little data exist examining the impact of non-medical (recreational) cannabis legalisation among a working population. The objective was to compare cannabis use patterns and workplace risk perceptions, cannabis availability and workplace use policies before and almost 1 year after legalisation in Canadian workers.

METHODS

Two overlapping cross-sectional samples of Canadian workers were surveyed 4 months before legalisation (time 1 (T1), n=2011) and 9-11 months after legalisation (time 2 (T2), n=4032), gathering information on cannabis use (overall and workplace use), workers' perceptions regarding risks of workplace use, availability of cannabis at work and awareness of workplace substance use policies. The marginal distributions of these variables at T1 and T2 were compared, adjusting for sociodemographic, work and health and lifestyle factors.

RESULTS

Cannabis use status changed from prelegalisation to postlegalisation (p<0.0001), with fewer respondents reporting former use (ie, more than 1 year ago; 40.4% at T1, 33.0% at T2) and a greater proportion of workers reporting past-year use (30.4% at T1, 39.3% at T2). Never use remained stable (29.2% at T1, 27.6% at T2). Workplace cannabis use also remained stable (9.4% at T1, 9.1% at T2; p=0.4580). At T1, 62.7% of respondents reported being aware of their workplace having a substance use policy, increasing to 79.0% at T2 (p<0.0001). Small magnitude changes occurred in perceptions of risk and workplace availability.

CONCLUSIONS

Results point to a lack of substantive changes in the short-term from prelegalisation to postlegalisation. Longer-term data among workers are needed given the evolving nature of this legislative policy.

"We're supposed to be a family here": An ethnography of preserving, achieving, and performing normality within methamphetamine recovery

The perception of being abnormal, and a visceral desire to ‘feel normal again’, is a common feature of the literature on drug use and recovery. Normality is constructed, however, in response to context-dependent values and priorities, thereby legitimating certain behaviours as normative and therefore the assumed goal of people in recovery. In this paper we draw on an ethnographic study with twelve people attempting to reduce harmful methamphetamine use to explore how they engaged with ‘normality’. Semi-structured interviews and ethnographic observations were conducted across a range of settings related to participants’ recovery, including private residences, withdrawal services, doctor’s offices, counselling rooms, and court houses. We used a relational lens to conduct thematic analysis on interview transcripts and fieldnotes collected over six months, following the steps of Iterative Categorisation. Our analysis explores the central organising theme of normality as something that can be ‘preserved’, ‘achieved’, or ‘performed’ by people using methamphetamine. Findings are understood through the original concept of ‘ambient paternalism’, where neoliberal norms and values shape recovery trajectories even outside of engagement with services. Exhibiting normality enabled participants to work against the stigmatisation and moralisation of methamphetamine use by demonstrating their socio-political acceptability. Methamphetamine use could also be strategically used to enable participants to keep up with neoliberal normative standards of independent self-management. Increasing awareness of these complex repertoires of normality, and a more critical understanding of how this ideal is constructed and can impact service interactions, can support a less homogenising or coercive approach towards treatment and policy for people in methamphetamine recovery.

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People using drugs can experience normality as aspirational and burdensome.

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Demonstrating normality in recovery can be a form of social capital.

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Normality can be a form of paternalism enacted by social services.

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Performing normality helped participants reduce their marginalisation.

Alcohol intoxication incidence differences at companies in Lithuania

INTRODUCTION

Employee alcohol consumption is a major challenge to both the health of the employee and productivity of the company. Our study investigates the overall alcohol intoxication rates of employees at companies in Lithuania, alcohol intoxication incidence rates during the work week and associations between company variables and employee alcohol intoxication at work.

METHODS

Data for our study were collected at 153 different companies in Lithuania during the year 2018. Overall 2 455 997 alcohol breath tests were analysed. Data were analysed using descriptive statistics and Poisson regression analysis.

RESULTS

Descriptive statistics showed that the alcohol intoxication (blood alcohol concentration ≥ 0.01%) incidence rate was 0.31% (n = 7535). Average alcohol intoxication was 0.04%. Furthermore, higher alcohol intoxication incidence rates were found on Mondays and in the morning than at any other day or time. The results of Poisson regression analysis showed that the alcohol intoxication incidence rate ratios were highest among small companies, companies from the farming sector and companies from rural areas.

DISCUSSION AND CONCLUSIONS

We found a relationship between company variables, testing time and incidence rates of alcohol intoxication. The increased alcohol intoxication at work throughout the weekend and on Monday is consistent with the alcohol consumption patterns in the Lithuanian population. Relatively low alcohol intoxication rate for the majority of the positively tested cases may indicate consumption of small amounts of alcohol just before starting work or excessive alcohol consumption the day before. Our findings could be an indicator of an underlying problem and have implications for alcohol prevention strategies.

Socio-demographic differences in alcohol-related work impairment

BACKGROUND AND AIMS

The costs of alcohol-related presenteeism (being at work in an impaired state due to alcohol use) have been estimated as substantially larger than the costs of alcohol-related absenteeism. Past studies indicate that employees with lower socio-economic status experience more alcohol-attributable problems than employees in higher socio-economic strata. We aimed to estimate the prevalence of alcohol-related presenteeism among Norwegian adults and its association with sex, age, income and education.

DESIGN AND SETTING

Annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2016-19) among Norwegian adults.

PARTICIPANTS

A total of 5430 full- and part-time employees aged 16-79 years; 53% were men.

MEASUREMENTS

The main outcome was self-reported 12-month occurrence of work impairment due to alcohol use the previous day. Main predictors were income and education obtained from national registries, age and gender. A secondary outcome variable was self-reported alcohol-related absenteeism.

FINDINGS

The 12-month prevalence of alcohol-related work impairment was 8.7%, 95% confidence interval (CI) = 7.9, 9.4. Adjusted risk ratios (RR) indicated a higher risk for men compared with women (RR = 1.26, 95% CI = 1.06, 1.50) and higher risk for young employees (e.g. less than 26 years compared with 55+, RR = 7.64, 95% CI = 4.88, 11.95). The risk increased as a function of higher education (in order of increasing education, RR = 1.12, 95% CI = 0.87, 1.45; RR = 1.64, 95% CI = 1.26, 2.12; RR = 2.19, 95% CI = 1.63, 2.95). The risk was estimated as lower in the middle-income categories compared with the lowest (RR = 0.76, 95% CI = 0.58, 1.00, RR = 0.89, 95% CI = 0.66, 1.20, RR = 0.94, 95% CI = 0.68, 1.29) and higher for employees with the highest income (RR = 1.04, 95% CI = 0.73, 1.48; RR = 1.47, 95% CI = 1.09, 2.00).

CONCLUSIONS

In Norway, the risk of alcohol-related work impairment for employees in the highest education category is approximately twice that of employees with secondary education or less. Except for employees in the lowest income category, who had a higher risk than those in the middle-income categories, higher income is associated with increased risk of work impairment. Being younger and male are also associated with increased risk of alcohol-related work impairment.

Employee work status, mental health, substance use, and career turnover intentions: An examination of restaurant employees during COVID-19

The COVID-19 pandemic has negatively impacted the restaurant industry and employees in the worst possible way. This empirical study aims to examine the relationships between employees' work status (working, furloughed, or laid-off), mental health (psychological well-being and psychological distress), substance use (drug and alcohol use), and career turnover intentions during the pandemic. Analyzing the responses of 585 restaurant employees using structural equation modelling (SEM), findings revealed that working employees experienced higher levels of psychological distress, drug and alcohol use than furloughed employees. Moreover, psychological distress increased drug and alcohol use, as well as career turnover intentions. Lastly, all employees, regardless of their mental health, increased their substance use and indicated a desire to seek future employment in alternate industries during the pandemic. Practical and theoretical implications are discussed in detail.

Patterns and correlates of workplace and non-workplace cannabis use among Canadian workers before the legalization of non-medical cannabis

BACKGROUND

Little information exists about cannabis use and its correlates among workers, particularly use before or at work, which may impact occupational safety. This study explores overall and workplace cannabis use patterns before legalization among Canadian workers and estimates the associations of personal and work-related characteristics with workplace and non-workplace cannabis use.

METHODS

Cross-sectional data were collected from 1651 Canadian workers in June 2018. The primary outcome was past-year cannabis use pattern: use, including before/at work (past-year workplace use); use, but not before/at work (past-year non-workplace use); no past-year use (non-past-year use). The associations of personal (sociodemographic, health) and work-related factors with workplace and non-workplace cannabis use were estimated using multinomial logistic regression.

RESULTS

A quarter of respondents reporting past-year cannabis use used cannabis before and/or at work. Respondents reporting workplace use were more likely to report more frequent cannabis use, use for medical or mixed purposes, and high THC cannabis use than workers reporting non-workplace use. Several personal factors were positively associated with workplace and non-workplace use (e.g., younger age, lower education). A safety-sensitive job, drug testing, supervisor role, less job visibility, lower perceived ability of supervisors to identify use/impairment, and less restrictive workplace smoking policies were positively associated with workplace use only.

CONCLUSIONS

A non-trivial proportion of workers reported workplace use, but the nature of this use is complex. Work-related factors addressing the likelihood of detection and being in a safety-sensitive job were associated with workplace use. Worker education on lower risk use appears warranted.

Flying below the Radar: Psychoactive Drug Use among Young Male Construction Workers in Sydney, Australia

Background: Globally, there is growing concern regarding workers' illicit drug use and its implications for health and workplace safety. Young workers in male-dominated industries, such as construction, may be more susceptible to illicit drug use, risky drinking and its associated harms.Purpose/objectives: To investigate drug use and perceptions of risk among male construction workers, drawing comparisons between workers under 25 years with older age groups.Methods: Workers in Sydney, Australia (N = 511) completed a survey measuring past year illicit drug and alcohol use, psychological distress and perceptions of drug-related risks to health and safety. Prevalence in the total sample was compared with national estimates, and differences between younger and older survey respondents were examined using logistic regression models.Results: Survey respondents' cocaine, meth/amphetamine and cannabis use was significantly higher than estimates of male employees nationally (OR = 6.60, 3.58, 1.61, respectively). Young workers ≤24 were more likely to frequently use illicit drugs, drink heavily, and report psychological distress than those aged 35+. Workers ≤24 were least likely to perceive that drug use posed high risks to health or safety when compared with 25-34 and 35+ age groups.Conclusions/importance: The findings highlight the high prevalence of illicit drug use amongst young construction workers, representing threats to workplace safety even if used outside work hours. Greater emphasis on potential adverse effects of alcohol and drug use and closer examination of contributory workplace factors are required. These findings have practical implications to inform occupational health and safety programs and interventions in high-risk workplaces.

Gender-Specific Drinking Contexts Are Associated With Social Harms Resulting From Drinking Among Australian Young Adults at 30 Years

Aims

Understanding contexts in which social harms from drinking occur can help develop context-based harm reduction efforts. However, there is little knowledge of specific drinking contexts where such harms occur and whether these are gender or age specific. We aimed to investigate associations of a range of drinking contexts and social harms from drinking among young adults at age 30.

Methods

We used data from 2187 30-year-old adults. Latent constructs of gender-specific drinking contexts were created using factor analysis. We performed multivariate logistic regression between drinking contexts and a range of social harms from drinking, separately by gender.

Results

After accounting for social roles and binge drinking, gender-specific solitary drinking contexts (‘home drinking’ for men and ‘daytime drinking’ for women) were positively associated with marital problems and problems with other family members and friends. Conversely, ‘social drinking’ was not. Work-related drinking among men was associated with marital/intimate relationship problems and friendship problems. After accounting for mental health symptoms, women’s home drinking was associated with marital problems.

Conclusion

We found that experiences of social harms from drinking at 30 years differ depending on the drinker’s gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults.

A National survey on substance use among Iranian industrial workers

Background: Recent evidence shows that the prevalence of substance abuse is 2.1% in Iranians aged 15-64 years, while reported rates are higher in studies that target industrial workplaces. Our study intends to provide a national picture of substance use among industrial workers in Iran.

Methods: This survey was designed to collect data through interviews and dipstick urine tests. Using a multi-stage sampling approach, we recruited our study subjects from a representative sample of industrial workers from all provinces in 2015. Data were weighted to estimate the prevalence rate of substance use. Odds ratios were calculated through adapting logistic regression to test the strength of association between substance use (based on self-report and urine test) and sociodemographic factors including sex, age group, education level, marital status and worker’s professional training status. All statistical analyses were conducted using SPSS Version 22. P <0.05 was considered significant.

Results: We analyzed the data collected from 13,128 participants; both self-reported use and urine test results. Majority of the respondents were male (n=12077, 92%), aged 21-40 years old (n=9491, 72.3%), had finished middle/secondary school (n=8353, 63.6%) and were married (n=11012, 83.9%). Opium was the most popular abused substance (n=352, 2.7%) followed by alcohol (304, 2.3%), based on self-reports. Urine tests showed that 23.8% (n=3105) of the participants had a positive result for the use of opiates/opioids, crystal meth and/or cannabis. The highest rate of substance use reported from a province was 60.50%; the lowest provincial rate was 9.0%.

Conclusion: Nearly a one-fourth of Iranian industrial employees are engaged in use of substances with significant geographical distribution. Urine test is the recommended method to assess the prevalence of drug use among industrial workers in Iran.

Risk Factors for the Number of Sustained Injuries in Artisanal and Small-Scale Mining Operation

Background

The relationship between risk factors and likelihood of occupational injury has been studied. However, what has been published has only provided a limited explanation of why some of the employees working in the same environment as other employees suffered a single-injury event, while other employees experienced multiple-injury events. This article reports on an investigation of whether artisanal and small-scale miners in Migori County of Kenya are susceptible to a single-injury or multiple-injury incidences, and if so, what underpinning parameters explain the differences between the single incident injured and the multiple incident injured group. Mine management commitment to safety in artisanal and small-scale mining (ASM) operations is also considered.

Materials and methods

The research objectives were achieved by surveying 162 uninjured and 74 injured miners. A structured, closed-end questionnaire was administered to participants after the stratification of the study population and systematic selection of the representative samples.

Results

The results showed that most injured miners suffer a single-injury incident rather than experiencing multiple-injury events, and laceration (28.40%) was the common injury suffered by the miners. The analysis showed that the risk factors for the single incident injured group were not similar to those in the multiple incident injured group. The research also found mine workers have low opinion about mine management/owners commitment to safety.

Conclusion

The study concluded that mine management and miners need to be educated and sensitized on the dangers of this operation. Provision of safety gears and positive safety culture must be a top priority for management.

Cross-National Comparisons and Correlates of Harms From the Drinking of People With Whom You Work

BACKGROUND

While research in high-income countries (HICs) has established high costs associated with alcohol's harm to others (AHTO) in the workplace, scant attention has been paid to AHTO in the workplace in lower- or middle-income countries (LMICs).

AIM

To compare estimates and predictors of alcohol's impacts upon coworkers among workers in 12 countries.

METHODS

Cross-sectional surveys from 9,693 men and 8,606 women employed in Switzerland, Australia, the United States, Ireland, New Zealand, Chile, Nigeria, Lao PDR, Thailand, Vietnam, India, and Sri Lanka. Five questions were asked about harms in the past year because of coworkers' drinking: Had they (i) covered for another worker; (ii) worked extra hours; (iii) been involved in an accident or close call; or had their (iv) own productivity been reduced; or (v) ability to do their job been affected? Logistic regression and meta-analyses were estimated with 1 or more harms (vs. none) as the dependent variable, adjusting for age, sex, rurality of location, and the respondent worker's own drinking.

RESULTS

Between 1% (New Zealand) and 16% (Thailand) of workers reported that they had been adversely affected by a coworker's drinking in the previous year (with most countries in the 6 to 13% range). Smaller percentages (<1% to 12%) reported being in an accident or close call due to others' drinking. Employed men were more likely to report harm from coworkers' drinking than employed women in all countries apart from the United States, New Zealand, and Vietnam, and own drinking pattern was associated with increased harm in 5 countries. Harms were distributed fairly equally across age and geographic regions. Harm from coworkers' drinking was less prevalent among men in HICs compared with LMICs.

CONCLUSIONS

Workforce impairment because of drinking extends beyond the drinker in a range of countries and impacts productivity and economic development, particularly affecting men in LMICs.

Social Drinking Contexts and Their Influence on Problematic Drinking at Age 30

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.

Illicit Drugs in the Nightlife Setting: Changes in Employee Perceptions and Drug Use over a Fifteen-Year Period

Illicit drug use is common in nightlife settings and associated with various public health-related problems, making this an important arena for prevention. Purpose/objectives: To assess perceived prevalence of illicit drug use in the Stockholm nightlife setting, use of and attitudes toward illicit drugs among employees at licensed premises. Also, to make comparisons with two identical measurements from 2001 and 2007/08, and to explore potential differences related to own drug use, type of licensed premise, age or gender. Methods: Cross-sectional surveys were conducted at three time-points: 2001, 2007/08, and 2016/17, comprising employees at licensed premises in Stockholm participating in STAD's Responsible Beverage Service training program. A total of 665 persons (mean age 28 years, 53% women) were included in the 2016/2017 measurement. Results: A majority of the respondents reported having observed patrons intoxicated by illicit drugs in the last six months, and agreed that patrons intoxicated by illicit drugs should be asked to leave licensed premises. The belief that one had observed patrons intoxicated by illicit drugs was more common among respondents who had themselves been using illicit drugs during the last year, and also among employees at nightclubs. Furthermore, comparisons with previous time-points showed a significant increase in the proportion of employees using illicit drugs. Almost half of the respondents in the youngest age group (18-24 years) reported illicit drug use during the last year. Conclusions/importance: Observation and use of illicit drugs are common among employees in the Stockholm nightlife setting and has increased significantly during the past decade.

Social and public health implications of the legalisation of recreational cannabis: A literature review

BACKGROUND

After many years of legal struggles for the legalisation of recreational use of cannabis, the Constitutional Court of South Africa ruled in favour of the applicants in September 2018. Although the ruling issued caution regarding the social challenges accompanying this legalisation, it did not address how the country would deal with the societal consequences of this ruling.

AIM

The aim of this article was to discuss the social and public health implications of the legalisation of recreational cannabis on South Africa.

METHODS

Literature review on the social, health and legal impacts of legalisation of cannabis, considering experiences of other countries that have legalised cannabis.

RESULTS

The legalisation brings a range of significant negative consequences, which include an expected increase in the number of users and the subsequent undesirable effects on the physical, mental and social health of communities.

CONCLUSION

In terms of financial, infrastructural and human resources, South Africa cannot afford the consequences of the legalisation of recreational cannabis. Poor communities, children and the youth will carry the brunt of the scourge of cannabis use.

The hidden costs of employee drinking: A quantitative analysis

INTRODUCTION AND AIMS

Alcohol use impacts workplace productivity in terms of absence and reduced performance by employees. This study's aims were to estimate the cost of lost productivity associated with alcohol use in New Zealand and to describe and quantify its impact on employers.

DESIGN AND METHODS

An online survey was completed by 800 New Zealand employees and 227 employers across a range of industries. The costs of lost productivity directly attributable to alcohol use were estimated using days off work (absenteeism), lost hours of productive time while at work (presenteeism) and hours spent by employers dealing with alcohol-related issues. Ordinal logistic regression was used to explore the association between employee characteristics and reduced workplace productivity associated with alcohol consumption.

RESULTS

The estimated annual average cost of lost productivity per employee was NZ$1097.71 (NZ$209.62 absenteeism, NZ$888.09 presenteeism) and NZ$134.62 per employer. At a population level this equates to approximately NZ$1.65 billion per year. The significant predictors of reduced workplace performance were being younger (less than 25 years), male, having a stressful job and drinking more than the recommended standard number of drinks per session.

DISCUSSION AND CONCLUSIONS

Considering absenteeism costs alone will substantially underestimate the total productivity loss associated with alcohol use. Designing and effectively targeting a set of multifaceted policies to engineer change at both the workplace and societal levels will assist in reducing the costs of lost productivity.

Evaluation of a workshop to address drugs and alcohol in the workplace

Purpose

Risky alcohol and other drug (AOD) use is ubiquitous in some workplace cultures, and is associated with considerable risks to health, safety and productivity. A workplace drug and alcohol first aid program was developed to support supervisors and managers to recognize and respond appropriately to AOD problems, increase knowledge of AOD and reduce the stigma associated with AOD. The purpose of this paper is to undertake an evaluation to assess the program’s efficacy.

Design/methodology/approach

A self-report survey was administered to program participants before (T1), immediately after (T2) and three months following program completion (T3). Changes in alcohol/drug-related knowledge, role adequacy, motivation and personal views were examined using repeated measures ANOVA.

Findings

A total of 109 participants took part in the program, with only 26 completing scores at all three time points. Mean scores increased significantly (p<0.05) between T1 and T2 for knowledge (12.7–16.0), role adequacy (11.8–17.4), motivation (9.7–10.4) and personal views (9.0–9.6). Significant improvements were maintained at T3 for knowledge (15.1) and role adequacy (17.3).

Practical implications

Drug and alcohol first aid programs offer a potentially valuable initiative to improve the knowledge, skills and understanding of managers and supervisors in tackling workplace AOD risks, associated stigma and improving help seeking.

Originality/value

Workplace programs for managers can facilitate organization-wide responses to the reduction of AOD-related problems, increase implementation of appropriate policy and interventions, minimize associated harms and stigma and reduce negative imposts on productivity and profit.

Workplace alcohol harm reduction intervention in Australia: Cluster non-randomised controlled trial

INTRODUCTION AND AIMS

The workplace holds substantial potential as an alcohol harm reduction and prevention setting. Few studies have rigorously examined strategies to reduce workplace alcohol-related harm. Hence, an in-situ 3 year trial of a comprehensive alcohol harm reduction intervention in Australian manufacturing workplaces was undertaken.

DESIGN AND METHODS

Informed by a gap analysis, a multi-site trial was undertaken. Three manufacturing industry companies, located at four separate worksites, with a minimum of 100 employees were recruited through a local industry network. Based on worksite location, two worksites were allocated to the intervention group and two to the comparison group. The pre-specified primary outcome measure, risky drinking (Alcohol Use Disorders Identification Test, AUDIT-C) and other self-report measures were collected pre-intervention (T1), 12 months (T2) and 24 months post-intervention (T3).

RESULTS

No significant intervention effect was observed for the primary outcome measure, risky drinking. Significant intervention effects were observed for increased awareness of alcohol policy and employee assistance. At T3, the odds of intervention group participants being aware of the workplace policy and aware of employee assistance were 48.9% (95% confidence interval 29.3-88.9%) and 79.7% (11.5%, 91.8%), respectively, greater than comparison group participants.

DISCUSSION AND CONCLUSIONS

Comprehensive tailored workplace interventions can be effective in improving workplace alcohol policy awareness. This is one of few workplace alcohol trials undertaken to-date and the findings make an important contribution to the limited evidence base for workplace alcohol harm prevention initiatives.

Young construction workers: substance use, mental health, and workplace psychosocial factors

Purpose

Young Australian workers are at elevated risk of mental health and alcohol and other drug related problems. The purpose of this paper is to examine the relationship between alcohol and drug (AOD) use, psychological wellbeing, and the workplace psychosocial environment among young apprentices in the construction industry.

Design/methodology/approach

A cross-sectional survey of a cohort of 169 construction industry apprentices in their first year of training was undertaken. The survey included measures of psychological distress (K10), quantity/frequency measures of alcohol and illicit drug use, and workplace psychosocial factors.

Findings

Construction industry apprentices are at elevated risk of AOD related harm and poor mental health. Levels of psychological distress and substance use were substantially higher than age/gender equivalent Australian population norms. Job stress, workplace bullying, and general social support accounted for 38.2 per cent of the variance in psychological distress. General social support moderated the effects of job stress and bullying on psychological distress. Substance use was not associated with psychological distress. However, workplace social support accounted for 2.1 per cent of the variance in AUDIT-C scores, and 2.0 per cent of the variance in cannabis use. Workplace bullying explained 2.4 per cent of the variance in meth/amphetamine use.

Practical implications

Construction trades apprentices are a high-risk group for harmful substance use and poor mental health. Study results indicate that psychosocial wellbeing interventions are warranted as a harm reduction strategy.

Originality/value

This is the first study of its kind to describe a cohort of Australian construction trade apprentices in terms of their substance use and psychological wellbeing. The study shows workplace psychosocial factors may predict young workers psychological wellbeing.

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

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<0.05) compared to teachers were found in employees in extractive industries/fishing, agriculture/livestock, construction, catering/accommodation and protective services. Socio-demographic factors, especially age, gender and educational attainment contributed more to explain risk disparities than other factors or potential selection bias. However, after exhaustive sociodemographic adjustment, including education attainment and material wealth, a RR>1.33 (p<0.05) remained in unemployed, catering/accommodation employees and unskilled construction workers. RRs were significantly larger in women than men (p<0.05) among mineworkers/fishworkers/sailors (RR=8.6 vs. 1.2) and drivers (RR=3.7 vs. 1.0).

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.

Prefrontal electrical stimulation in non-depressed reduces levels of reported negative affects from daily stressors

Advances in neuroscience and pharmacology have led to improvements in the cognitive performance of people with neurological disease and other forms of cognitive decline. These same methods may also afford cognitive enhancement in people of otherwise normal cognitive abilities. “Cosmetic”, or supranormal, cognitive enhancement offers opportunities to enrich our social or financial status, our interactions with others, and the common wealth of our community. It is common to focus on the potential benefits of cognitive enhancement, while being less than clear about the possible drawbacks. Here I examine the harms or side-effects associated with a range of cognitive enhancement interventions. I propose a taxonomy of harms in cognitive enhancement, with harms classified as (neuro)biological, ethical, or societal. Biological harms are those that directly affect the person’s biological functioning, such as when a drug affects a person’s mood or autonomic function. Ethical harms are those that touch on issues such as fairness and cheating, or on erosion of autonomy and coercion. Societal harms are harms that affect whole populations, and which are normally the province of governments, such as the use of enhancement in military contexts. This taxonomy of harms will help to focus the debate around the use and regulation of cognitive enhancement. In particular it will help to clarify the appropriate network of stakeholders who should take an interest in each potential harm, and in minimizing the impact of these harms.

Use of alcohol and drugs by employees in selected business areas in Norway: a study using oral fluid testing and questionnaires

Background

Alcohol or drug use and associated hangover may reduce workplace safety and productivity and also cause sickness absence. The aims of this study were to examine (i) the use of alcohol and drugs, and (ii) reduced efficiency at work and absence due to such use among employees.

Methods

Forty-four companies were invited; half of them agreed to participate. Employees filled in a questionnaire and provided a sample of oral fluid, which was analysed for alcohol, 12 psychoactive medicinal drugs and 6 illicit drugs. Participation was voluntary and anonymous.

Results

Two thousand four hundred thirty-seven employees in eight business areas agreed to participate (92 % of those invited). By combining questionnaires and oral fluid testing, we found that 5.2 % had used psychoactive medication during the last couple of days, 1.4 % had used illicit drugs, 17.0 % had used alcohol during the last 24 h but only one person (0.04 %) was positive for alcohol in oral fluid. About 25 % reported reduced efficiency at work, and 5 % reported absence from work due to alcohol use during the past 12 months. The use of illicit drugs and binge drinking resulting in reduced efficiency and absence was most common among restaurant and bar workers and more common among men than women, whereas use of psychoactive medication was most common among healthcare, transportation and storage workers.

Conclusion

Impairment at work due to alcohol or drugs was rare, whereas reduced efficiency due to drinking was reported by a fairly large proportion. There were marked differences between some business areas, and across gender.

Detecting impairment: sensitive cognitive measures of dose-related acute alcohol intoxication

The cognitive impairment that results from acute alcohol intoxication is associated with considerable safety risks. Other psychoactive substances, such as medications, pose a similar risk to road and workplace safety. However, there is currently no legal limit for operating vehicles or working while experiencing drug-related impairment. The current study sought to identify a brief cognitive task sensitive to a meaningful degree of impairment from acute alcohol intoxication to potentially stand as a reference from which to quantify impairment from other similar substances. A placebo-controlled single-blind crossover design was employed to determine the relative sensitivity of four commonly-administered cognitive tasks (Compensatory Tracking Task, Digit Symbol Substitution Test, Brief Stop Signal Task and Inspection Time Task) to alcohol-related impairment in male social drinkers at ~0.05% ascending breath alcohol concentration (BrAC), ~0.08% peak BrAC and 0.05% descending BrAC. The Inspection Time Task was identified as the most sensitive task, detecting a medium to large magnitude increase in impairment (g ≈ 0.60) at 0.05% ascending and descending BrAC, and a large magnitude effect size (g = 0.80) at 0.08% peak BrAC. The remaining tasks failed to demonstrate sensitivity to dose-dependent and limb-dependent changes in alcohol-induced impairment. The Inspection Time Task was deemed the most sensitive task for screening alcohol-related impairment based on the present results. Confirmation of equivalence with other drug-related impairment and sensitivity to alcohol-induced impairment in real-world settings should be established in future research.

How effective is drug testing as a workplace safety strategy? A systematic review of the evidence

The growing prevalence of workplace drug testing and the narrow scope of previous reviews of the evidence base necessitate a comprehensive review of research concerning the efficacy of drug testing as a workplace strategy. A systematic qualitative review of relevant research published between January 1990 and January 2013 was undertaken. Inclusion criteria were studies that evaluated the effectiveness of drug testing in deterring employee drug use or reducing workplace accident or injury rates. Methodological adequacy was assessed using a published assessment tool specifically designed to assess the quality of intervention studies. A total of 23 studies were reviewed and assessed, six of which reported on the effectiveness of testing in reducing employee drug use and 17 which reported on occupational accident or injury rates. No studies involved randomised control trials. Only one study was assessed as demonstrating strong methodological rigour. That study found random alcohol testing reduced fatal accidents in the transport industry. The majority of studies reviewed contained methodological weaknesses including; inappropriate study design, limited sample representativeness, the use of ecological data to evaluate individual behaviour change and failure to adequately control for potentially confounding variables. This latter finding is consistent with previous reviews and indicates the evidence base for the effectiveness of testing in improving workplace safety is at best tenuous. Better dissemination of the current evidence in relation to workplace drug testing is required to support evidence-informed policy and practice. There is also a pressing need for more methodologically rigorous research to evaluate the efficacy and utility of drug testing.

[Consumption of alcohol and other drugs by the active population in Spain]

OBJECTIVE

To describe consumption patterns of alcohol and other drugs in the active population in Spain by gender.

METHODS

Based on 15,082 active persons selected from the Domiciliary Survey of Alcohol and Drugs (Encuesta Domiciliaria de Alcohol y Drogas [EDADES]) 2007, we estimated prevalences for high-risk alcohol consumption (>50 g/day in males, >30 g/day in females), daily intake of tranquilizers, cannabis consumption in the last 30 days, and consumption of any other illegal drug in the last 12 months, by employment status, economic sector and occupational categories. Odds ratios (OR) and their confidence intervals (95% CI) were estimated by logistic regression models.

RESULTS

The following prevalences were found: high-risk alcohol consumption, 3.4%; daily use of tranquilizers, 2.3%; cannabis consumption in the last 30 days, 7.9%; and consumption of any illegal drug in the last 12 months, 11.9%. Except for tranquilizer use, prevalences were higher in men than in women. Consumption of tranquilizers (OR = 1.68; 95%CI: 1.04-2.73), cannabis and other illegal drugs were all higher in unemployed men than in employed men, while only tranquilizer consumption was higher in unemployed women (OR = 1.70; 95% CI: 1.23-2.34). High-risk alcohol consumption was greater among men engaged in the catering, primary production and construction sectors in comparison to manufacturing industries: OR = 1.63 (95% CI: 1.11-2.38), OR = 1.52 (95% CI: 1.04-2.20), and OR = 1.50 (95% CI: 1.10-2.04), respectively. For women, those in catering showed higher consumptions of cannabis (OR = 2.34; 95% CI: 1.28-4.27) and of other illegal drugs (OR = 2.85; 95% CI: 1.71-4.76); the latter were also higher in commerce, transport and administration sectors than in manufacturing industries.

CONCLUSIONS

These findings could serve as a useful reference for companies wanting to carry out preventive programs, and also for future studies assessing the impact of preventive measures.