Effectiveness and benefit-cost of peer-based workplace substance abuse prevention

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Accident Analysis & Prevention (Impact Factor: 1.87). 06/2007; 39(3):565-73. DOI: 10.1016/j.aap.2006.10.001
Source: PubMed


Few studies have evaluated the impact of workplace substance abuse prevention programs on occupational injury, despite this being a justification for these programs. This paper estimates the effectiveness and benefit-cost ratio of a peer-based substance abuse prevention program at a U.S. transportation company, implemented in phases from 1988 to 1990. The program focuses on changing workplace attitudes toward on-the-job substance use in addition to training workers to recognize and intervene with coworkers who have a problem. The program was strengthened by federally mandated random drug and alcohol testing (implemented, respectively, in 1990 and 1994). With time-series analysis, we analyzed the association of monthly injury rates and costs with phased program implementation, controlling for industry injury trend. The combination of the peer-based program and testing was associated with an approximate one-third reduction in injury rate, avoiding an estimated $48 million in employer costs in 1999. That year, the peer-based program cost the company $35 and testing cost another $35 per employee. The program avoided an estimated $1850 in employer injury costs per employee in 1999, corresponding to a benefit-cost ratio of 26:1. The findings suggest that peer-based programs buttressed by random testing can be cost-effective in the workplace.

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    • "The one study assessed as demonstrating strong methodological rigour found random alcohol testing reduced alcohol involved road fatalities among heavy truck drivers (Brady et al., 2009). Similarly, some of the studies that demonstrated moderate methodological rigour (Miller et al., 2007; Snowden et al., 2007; Spicer and Miller, 2005) also found random alcohol testing to be associated with reductions in accidents in the transport industry. "
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    ABSTRACT: 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.
    Accident Analysis & Prevention 10/2014; 71:154–165. DOI:10.1016/j.aap.2014.05.012 · 1.87 Impact Factor
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    • "Their evidence also suggested that random drug and alcohol testing might have further reduced this risk of injury. In a later publication (Miller et al., 2007), the same authors confirmed that a peer-based program and drug testing was associated with an approximate one-third reduction in injury rate, while alcohol testing reduced the injury rate by one sixth. It is worth mentioning that even in the organisations already applying A&D tests, many of them do it solely within the scope of Occupational Medicine exams, i.e., meaning that the worker knows in advance when the test sample will be collected. "
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    ABSTRACT: Programmes for testing Alcohol and Drugs (A&D) at the workplace, at random and by surprise, are believed to have a positive impact on safety and to reduce individual’s accident risk. Despite this perception, there is limited scientific evidence and poor statistical support of this assumption. This study aims at testing whether there is such a cause-effect relationship between A&D testing and post-accident reduction, and how to quantify it. The methodology applied data-mining techniques together with classical statistics hypothesis testing. It covers a wide range of data concerning accidents, alcohol and drug tests, biographical and occupational records of a large railway transportation company in Portugal, for a period of 5½ years. Results give sound statistical evidence of individual’s accident risk decrease after being tested, by quantifying the relations between A&D testing and post-testing accidents. Results also estimate the optimal testing frequency that balances testing costs and accident reduction. Optimum rates of tests per year per worker are in the ranges ]0.5–1.0] in white-collars and professions at large, and ]0.0–0.5] in operations/technical personnel. The fraction of accident victims that are prevented by the application of optimal frequencies are around 59% for workers onboard trains, 72% for those working near trains, and 85% for white-collars. Testing at the optimal frequency generates net savings of at least 15:1, in onboard personnel. In conclusion, testing for alcohol and drugs at workplace, at random and by surprise, has a statistically significant preventive effect in overall professions, but is stronger within white-collars.
    Safety Science 10/2014; 68(Oct 2014):108–120. DOI:10.1016/j.ssci.2014.03.007 · 1.83 Impact Factor
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    • "By comparing worksites, companies, and the like, over time, factors are controlled for that simultaneously affect all cross-sections and confound the relationship between the variable of interest and outcome. If no pre-intervention data are available, one can model the outcome based on variation of an independent variable that measures program activity or usage that changes over time (Miller et al., 2003; Spicer, Miller, Durkin, & Barlow, in press). In addition, one can compare groups that vary in level of exposure to the intervention. "
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    ABSTRACT: Corporate data fall under the general category of administrative data and provide varied information on the worker and workplace. Studies of worker health, including evaluations of workplace programs, are often based on corporate data. With the exception of health care claims data, which are usually administered by a third party, the corporation collects these data and grants permission to use them. In light of new federal regulations, gaining access to corporate data is more complicated and intimidating than ever before. This paper discusses the impact of federal regulations on the use of corporate data in research, the potential of corporate data in evaluation studies, the challenges to obtaining and using these data, and finally, study designs that make use of corporate data.
    American Journal of Evaluation 01/2004; 25(1):109-119. · 2.02 Impact Factor
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