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.