Expert Commentary

Substance Abuse

Drug use is a pervasive problem in America, particularly in the construction industry. The economic and human costs are high, and the benefits to be gained through prevention are both tangible and significant. Learn about detection, testing, prevention, and employee assisted programs in this informative article.


Construction Safety
October 2000

Drug and alcohol abuse cuts across all categories of the U.S. population. It occurs within all ethnic groups, professions, trades, age groups, educational backgrounds, and salary ranges in all geographical areas of our nation. There are no specific traits to determine at-risk categories, nor applicable measures to predict usage with any accuracy. In short, substance abuse is a pervasive problem that affects all elements of the economy.

This article examines substance abuse, its costs and effects for business. Detection, testing, prevention, and employee assisted programs are also discussed. Particular attention is paid to the substance abuse problem in the construction industry.

Research Data

The high cost of accidents and lost productivity for business due to substance abuse has been researched in detail. The data shows substance abusers have accidents at a rate 3.6 times normal. This leads to higher indirect costs through damaged equipment, rework, material replacement, and medical costs. In addition, substance abusers strain the benefit system. Research has shown that drug users are 5 times more likely to file workers compensation claims, 3 times more likely to file health claims, and use sick leave at a rate 3 times higher than the average worker. The indirect effects of these costs on the ability of companies to be able to continue to operate competitively can only be estimated.

Studies have also been conducted to attempt to quantify the lost productivity due to substance abuse on the workplace. Research shows that substance abusers are 2.5 times more likely to be absent from work, with absences extending 8 days or more. They are also more likely to seek early dismissals or time off from work, up to 2.5 times that of the average worker, and they arrive late for work more than 3 times the average. Companies must either absorb these costs or pass them on in the form of higher prices for products or services.

Substance Abuse in the Construction Industry

The substance abuse problem for the construction industry is magnified due to the nature of construction work. The construction industry involves more potential hazards for its workers than any other occupation in the United States. Due to the wide range of activities performed on a construction site by employees from a variety of firms, there is significant exposure to harm from the actions of others as well as from the worker's own unsafe behavior.

The average construction worker must place great faith in the level of skill, competence, and fitness for duty of those working on the site. Workers rely on each other to do their jobs in a safe manner and to protect both themselves and their fellow workers. Not only does substance abuse cause accidents, it certainly reduces the effectiveness of the individual worker. Thus, the use of illegal substances or the abuse of prescribed medications, which might impair the ability of a worker to perform normally, poses a significant risk for the site management and workers.

Unfortunately, there is a large problem with substance abuse in the construction workplace. According to a 1988 National Institute on Drug Abuse (NIDA) survey, 28.1 percent of construction workers admitted to using illegal drugs. This figure is probably low since, even in a confidential survey, some people would be reluctant to admit to the use of illegal drugs. This was the highest percentage of drug use found in any industry surveyed--a dubious achievement.

This widespread usage of illegal substances is very likely a contributing factor to the construction industry's unacceptably high injury rate. Numerous companies that have implemented 100 percent drug testing validated this data. It is not uncommon to find initial drug test results in the range of 25-35 percent testing positive for drug use. In fact, even when workers know they are going to be tested, 3-5 percent test positive for drug usage. Research has also indicated that illegal substance use is highest in the 17- to 30-year age group, the population that makes up the majority of the construction workforce.

An additional consideration is that the Occupational Safety and Health Act (OSHA) requires, under the General Duty Clause, that employers provide "a place of employment which is free from recognized hazards that are causing or likely to cause death or serious physical harm." Clearly, a workplace tainted by the presence of workers impaired by substance abuse would have to be seen as a violation of this clause, given the level of knowledge about the hazards of construction work.

There is no denying that substance abuse is a very real problem for the construction industry, as it is for the rest of the economy. More than 95 percent of all U.S. companies report having problems with substance abuse in the workplace. Still, the problem is most visible in the construction industry--over 81 percent of the public believes construction workers ought to be tested for drug use.

Detection

Substance abuse in the workplace is a difficult problem from both the high risk potential for accidents that it causes as well as reduced worker productivity. Detection is a crucial element in any loss prevention program. This requires additional vigilance on the part of site supervision, since drug testing only indicates past usage and does not actually measure impairment.

Impairment is the operative term in dealing with substance abuse, since this can be the proximate cause of accidents. In fact, in those cases where there was post-accident testing for the presence of illegal substances, 50 percent of the accidents involved one or more parties testing positive for illegal substances.

In addition, it must be recognized that substance abuse extends beyond the use of illegal substances. Misuse of prescription medication and alcohol are often overlooked when attempting to detect substance abuse and in structuring a prevention program. While the construction culture has changed a great deal in the past decade, alcohol use is still a widely condoned activity among construction workers. The physical impairment problems brought on by the misuse of legal substances can be just as detrimental as those resulting from illegal substances. This reality must be considered in detecting problems and developing prevention programs. Additionally, there is a large portion of "travelers" in the construction workforce on many projects. Since the normal behaviors of these folks, who have come into a new region for work, are not known to their fellow workers or supervisors, impairment is more difficult to detect.

Testing and Prevention

Drug testing is part of the solution, but until recently, testing has not been very pervasive in the construction industry. As of 1990, less than 25 percent of the construction industry workforce was subject to testing of any sort. However, recognition of the extent of usage of illegal substances in the workplace and the impact on profitability has led to more widespread testing. By 1993, the level of testing of construction workers had risen to 57 percent of the workforce, with increases in each subsequent year.

There are several key elements for consideration in crafting a substance abuse prevention program. The first is to determine the components of testing. These included pre-employment, post-accident, for-cause, and random testing. While research has shown that the presence of the random test component increases the effectiveness of the program, many object to this aspect.

The substances to be tested for are normally based on the Department of Transportation (DOT) 10 panel program. This is a widely recognized test panel, and most labs are equipped to administer it. The next element is selection of a lab and implementation of the testing protocol. This protects the privacy of the individual while preserving the integrity of the sampling. A medical review officer must be chosen to validate the test result. Two final elements round-out a complete program: training and employee assistance.

Training, of both workers and supervisors, in detecting impairment is an often overlooked aspect of a prevention program, but can be most critical. The absence of people who can detect impaired workers on the job site leaves a gaping hole in the program. As a part of the training program, workers and supervisors must be taught how to approach and confront a suspected impaired worker, since most people are neither skilled in nor comfortable performing this function.

Employee assistance programs (EAPs) are a controversial aspect of substance abuse prevention. Some employers reject any type of EAP. These employers object to retaining any workers who have a problem on the basis that their behavior has marked them as dangerous, and it is a waste to invest additional resources on them. Other employers believe that good workers can make mistakes, and the EAP is an effective means to rehabilitate and return good craftsmen to the job site.

Substance Abuse Prevention and Safety

Substance abuse prevention programs must be a part on any comprehensive safety program. This notion has permeated the construction industry as well, including those who have long resisted the imposition of such programs as violations of privacy. The American National Standards Institute (ANSI) A10 Construction and Demolition Standards committee recently incorporated substance abuse prevention programs as an element in the A10.38 standard, Key Elements of Safety and Health Programs.

Studies have revealed some disturbing implications for companies that do not take any preventive actions to eradicate substance abuse from its workforce. More than 70 percent of all substance abusers are actively employed. In confidential questioning, more than 66 percent of new workers indicate that they have used illegal substances in the past. Given the transient nature and mobility of the construction workforce, this represents a high risk factor. What is more, 60 percent of all drug users sell drugs to help support their own use, and more than 25 percent of users steal to support their drug use. Thus, not only does the illegal substance usage affect the human aspects of an enterprise, the physical assets and workplace security are also at risk.

Conclusion

The substance abuse picture is quite bleak, and the benefits to be gained through prevention are both tangible and significant. What is even more important than the immediate human and cost factors when examining the implications of substance abuse in the construction industry is the potential for harm that goes far beyond the actual construction work itself. Improper or poor quality construction work can lead to potentially dangerous structures or completed operations problems.

Substance abuse is probably one of the most complicated issues that the construction industry is compelled to deal with. This makes it crucial that loss control personnel understand all the aspects of the problem so that they can help companies effectively deal with all the elements that must be addressed for a loss prevention program to deal with the problem in a comprehensive manner.

The public supports workplace testing, workers want to be protected, and owners are making it a contractual requirement. In time, such pressure should help reduce the high level of drug usage among construction workers and improve overall safety performance.


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