Surveillance for drugs in the workplace
- a solution looking for a problem

A CBI study revealed that almost one in every 20 member companies tested their employees for drug use. Another study found over half of all employers consider drug use as grounds for immediate dismissal. But evidence suggests that it is bad jobs that lead to bad habits, that drug testing is an intrusive and suspect science and that drug-related problems should be a matter for the sickness, not the disciplinary, procedure.

So far, Britons are not taking as many drug tests as some of their counterparts overseas. In Sweden about 28 per cent of companies use the tests 1 and in the US the great majority of major firms police their employees' drug use. 2

Even so, the Confederation of British Industry has estimated that eight per cent of member companies - one in 12 - test job applicants for drugs or alcohol, and getting the job is conditional on the result. For those already employed by CBI companies, 4.5 per cent could expect to be drug tested at work. 3

The US experience is a salutory one. Ten years ago, only one in five companies used the tests. By 1993, 85 per cent of major US companies tested workers and job applicants.

The UK might be a decade behind the US on workplace drug testing, but there are worrying parallels. A 1987 train crash in Maryland where sixteen people died, over 140 were injured and in which crew members tested drugs positive, led to the US Department of Transport introducing the first widespread drug screening programme, subsequently firmed up in law.

In the UK, the 1991 Cannon Street rail crash in similar circumstances led to the introduction of the Transport and Works Act 1992, which made it a criminal act for transport workers to be "unfit" because of drink and drugs.

Even before this act took effect, an estimated 250,000 workers in the UK were tested for alcohol and drug use. Testing is already routine for UK staff or job applicants at companies including London Transport, British Rail, Mobil, Shell, Sun Valley Foods and in the Armed Forces. After the Exxon-Valdez disaster, Exxon demanded all contractors have a drugs policy and submit to random drugs tests. For most UK workers, though, the drugs policy in their workplace remains a matter for negotiation, not legislation.

It's my job

While it is easy to blame the worker for their drug use, studies suggest bad job characteristics can drive a worker to drugs or drink.

In 1991, the Occupational Health and Safety Commission in the State of Victoria, Australia, set up an enquiry into the relationship between work, drugs and drink. The Commission noted: "We can see work-related alcohol and drug use as an outcome of bad job design and poor work environment, rather than viewing it simply as a causal factor in workplace accidents." 4

In their authorative reseach review, Healthy work, 5 Karasek and Theorell note that workers in high strain jobs - lots of work but little say in when and how that work is done - resort to drugs for temporary relief of the stress, but may find themselves relying on drugs to see them through the job: "It is in high-strain populations that drugs are most commonly used, to assuage society and induce some synthetic form of relaxation. But in a drugged society (whether by prescription or illegally) respite is never more than temporary; larger doses are always needed, and the side effects of reduced capacity to perform are almost unavoidable."

Production line workers at one Shropshire plastics factory interviewed by Hazards admitted relying on nightly doses of speed to see them through the tedium of a 12-hour shift, without breaks, in stifling heat. Last year ICFTU, the "world's TUC", revealed that women workers in Hondoras, accused of not working fast enough, were injected with amphetamines then forced to work 48-hour shifts. 6

Lessons abroad

When New Zealand's Minister of Health Jenny Shipley backed random drug testing late in 1994, she prompted a national scandal. National newspapers ran features over several days, alleging sample testing labs, supported by US equipment suppliers, were behind the move and stood to make millions. 7,8

In a national press release New Zealand Privacy Commissioner Bruce Slane urged the minister to think again 9: He said: "Random drug testing is a solution looking for a problem."

"It must be remembered that drug testing:
• can establish only that the person has used one of number of drugs over a period of some days or weeks previously
• does not establish workplace impairment
• does not establish whether the person was ever impaired
• does not establish whether the person will be impaired in the future
• does not establish whether the person will be impaired in the workplace in the future."

Ross Wilson, vice president of the NZ Council of Trade Unions warned that under New Zealand's 1993 Privacy Act "any employer who introduces random drug testing is likely to end up in court." 10

He added: "The notion that drug abuse in the workplace is a serious occupational health hazard is a diversion from the principal causes of workplace injuries, that of workers having to work in hazardous and unsafe workplaces."

An NZCTU briefing warns that "drug testing would be an ideal tool with which to harass disliked or unwanted workers. Unrestricted rights to drug test workers are an open invitation to discriminate on the grounds of appearance or perceived lifestyle." 11

Safety is used as a pretext for the introduction of drugs tests. But NZCTU claimed there is no evidence linking drug use to higher accident rates. And a report to the US government's Bureau of Labor Statistics conference in 1992 concluded that drugs were rarely implicated in workplace fatalities.

Out of work

Drugs testing would, seemingly, provide irrefutable evidence of sackable bad behaviour. However, as the New Zealand example shows, employers are making hire or fire decisions on the basis of dubious science and are policing their employees' behaviour - not their ability to do the job - inside and outside the workplace.

A joint smoked outside hours on a Friday evening, will test positive on Monday morning. Traces of amphetamines, opiates, cocaine and barbiturates linger in urine for two to three days. Cannabinoids hang around for up to five days for an infrequent user and up to a month for a regular user.

New hair tests provide an indelible drugs record slightly older than your last skinhead haircut and might identify 10 times as many positives.

According to New Zealand Privacy Commissioner Bruce Slane: "Finding that a substance has been used by someone (and some of the drugs detected will have been lawfully prescribed) does no more for safety than finding out that an employee had an alcoholic drink in the last couple of weeks."

False positives

The Swedish Work Environment Association noted in 1994 "that the occupational health services that carry out the tests are often careless about limit values and confidentiality." 1 A 1993 American Management Association survey found that nearly a quarter of companies did not follow verification guidelines and six per cent did not bother to verify results at all. 2

Being totally clean is not necessarily a guarantee of a negative test. One poppy seed bagel too many and you could be branded a hardened heroin user. Codeine headache pills have a similar side effect, showing up as morphine in tests. Anti-histamines hayfever treatments can give a false positive for amphetamines. And anti-inflammatory drugs including ibuprofen give a convincing cannabis reading. Companies testing for drugs usually include benzodiazepines, present in common medicines like Valium.

There's even evidence of "passive" drug use - picking up measurable, but not intoxicating, levels of drugs just by associating with users.

US workers have won six figure sums for defamation, emotional distress or victimisation after botched tests or false positive results.

However flawed, an established workplace drug testing industry is difficult to dislodge. By 1988 drug testing had already become a billion dollar industry in the US. It shows no signs of declining, despite a 1991 House of Representatives report showing that tests on 28,873 federal employees had cost the taxpayer $77,000 for each employee testing positive (about £50,000).

The law

A 1994 Labour Research Department (LRD) survey 12 found nearly six in every 10 employers define drink and drug use as gross misconduct justifying immediate dismissal.

The Health and Safety Executive's excellent pamphlet, Drug abuse at work, 13 spells out the law on drug abuse. The main law used by the police in drugs cases is the Misuse of Drugs Act 1971, it says, adding which makes it offence for an employer to knowingly allow drug use, possession or supply on the premises.

It adds that the general duties of employers and employees under the Health and Safety at Work Act 1974 will also apply is health and safety is likely to be compromised. Transport workers are covered by the Transport and Works Act 1992. The act requires employers to exercise "all due diligence" to prevent workplace substance use and makes it illegal for workers to be "unfit" through drink or drugs.

Drugs policy

HSE's Drug abuse at work gives useful guidance on negotiating a drugs policy: a written policy "should form part of an overall health and safety policy, should be designed to eliminate or reduce to a minimum the possible effects of drug abuse on the abuser, other employees, the public and the environment, and should apply to everyone in the organisation."

Among other recommendations, HSE says employers should:
• stress the confidentiality of any discussions and subsequent treatments
• make clear that absence for treatment and rehabilitation will be regarded as normal sickness
• enable an employee to return to the same job after treatment or, where this is not feasible or advisable, to try to provide suitable alternative employment
• seek the commitment of line managers and employees to the policy "by fully consulting workplace representatives, including any safety representatives appointed under the Safety Representatives and Safety Committees Regulations 1977, at all stages in developing the policy"; and
• agree with workplace representatives what action to take where an employee admits to needing help, is found abusing drugs or has a relapse after receiving treatment.

Before any drug testing is introduced, HSE says: "The agreement of the workforce to the principle of screening should be obtained, and in each case the written consent of the individual must also be obtained. Medical confidentiality must be assured: managers should only be told whether an employee is considered fit or unfit for work."

Advice
• National Drugs Helpline. Free and confidential advice and information 24 hours a day. Calls do not show up on the bill. Telephone: Freefone 0800 776600.
• Health Education Authority. Advice on health education materials on drug use. Tel: 0171 631 0930. Scotland: 0131 447 8044. Wales: 01222 823925.
• Release. Legal service for drug-related problems. 388 Old Street, London EC1V 9LT. Tel: 0171 729 5255.
Drug misuse and the workplace. 1989. Guide from Employment Department. Caxton House, Tothill Street, London SW1H 9NF.

References
1. Drug tests without principles: Occupational health services are careless about limit values and confidentiality. Working Environment in Sweden 1994. Arbetsmiljo. 1994
2. 85 per cent of major US firms now test workers for drugs. Workers' Health International Newseletter, No.36, Summer 1993. From Hazards, £3.00.
3. Workers' privacy: Part III: Testing in the workplace. ILO Conditions of work digest, vol.12, number 2, 1993.
4. Journal of Occupational Health and Safety, Australia and New Zealand, vol.8(1), 1992.
5. Karasek R and Theorell T. Healthy work: stress, productivity, and the reconstruction of working life. 1990. Basic Books. ISBN 0 465 02897 7. £9.95.
6. Trade unionists in danger as trade wars take hold. Workers' Health International Newsletter, No.44, Summer 1995. Available from Hazards, £3.00.
7. Drug-test plan flawed. Dominion. 6 Dec 1994. NZ.
8. Drug figures "exaggerated". Sunday Star Times. 27 Nov 1994. NZ.
9. Workplace drug testing. Media release, NZ Privacy Commissioner, 22 November 1994.
10. Claims on drug testing have no factual basis. NZCTU press notice. 24 November 1994.
11. Substance abuse (drug) testing in the New Zealand workplace: NZCTU response. NZCTU, PO Box 6645, Wellington, New Zealand.
12. Bargaining report. LRD. November 1994.
13. Drug abuse at work: a guide for employers. HSE. booklet. IND(G)91L (revised). From HSE Books, tel: 01787 881165.