The aim of this study was to collect data regarding managers’ views on the need to introduce drug testing at work and on the employment prospects of illicit drug users by means of a self administered questionnaire. A slight majority of managers (258, 56.5%) favoured the introduction of pre-employment drug testing with a smaller proportion (219, 47.9%) in favour of testing during employment. Practically none of the respondents (1.1%) was willing to employ a current illicit drug user and less than half (41.6%) were willing to employ a person with a past history of drug use. An increased willingness was noted among managers of younger age groups and in larger companies to employ past drug users. These results indicate that there is the possibility that work place drug testing may be used as a tool to discriminate against workers suffering from drug abuse rather than to offer opportunities for rehabilitation of the individual. The findings highlight the urgent need for the establishment of guidelines to be followed during drug testing in Malta by the appropriate statutory authority, since suitable legislation is absent.peer-reviewe

Gauci, Mark

Vella, Noel

English

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27 Maltese Medical Journal, 1998; 10(1):27 All rights reserved Managers' attitudes to Illicit drug testing in the workplace Noel Vella* and Mark Gauci* ABSTRACT: The aim of this study was to collect data regarding managers' views on the need to introduce drug testing at work and on the employment prospects of illicit drug users by means of a self administered questionnaire. A slight majority of managers (258, 56.5%) favoured the --, 	 introduction of pre-employment drug testing with a smaller proportion (219, 47.9%) in favour of testing during employment. Practically none of the respondents (1.1 %) was willing to employ a current illicit drug user and less than half (41.6%) were willing to employ a person with a past history of drug use. An increased willingness was noted among managers of younger age groups and in larger companies to employ past drug users. These results indicate that there is the possibility that work place drug testing may be used as a tool to discriminate against workers suffering from drug abuse rather than to offer opportunities for rehabilitation of the individual. The findings highlight the urgent need for the establishment of guidelines to be followed during drug testing in Malta by the appropriate statutory authority, since suitable legislation is absent. *Occupational Health and Safety Unit, Department of Labour, Valletta, Malta. Correspondence: Dr. N. Vella, 272 Old Railway Road, Balzan, BZN 07, Malta. Introduction The negative effects which drug abuse has on workers' health and on their efficiency in the workplace have been well documented 1-4. The increasing awareness of problems related to drug abuse in Malta may make companies and other organisations more likely to consider introducing programmes such as drug testing in an attempt to identify drug abusers amongst their employees. This paper presents the results obtained from a survey which, amongst other issues, investigated managerial attitudes toward the introduction of drug testing at work, and the willingness of managers to employ drug users. Method The data was collected by means of a questionnaire conducted in April and May 1996 to investigate managerial attitudes towards illicit drug and alcohol abuse in the Maltese workplace. Two hundred and fifty companies were randomly chosen from the 666 companies included in the publication "Made in Malta ­1996 - Manufacturers and Exporters"S The activities of these companies were various and included the manufacture of textiles, furniture, metal, machinery, as well as printing, paper, rubber, chemical, transport, construction, food and beverage industries, and business services. The questionnaire required 'yes', 'no' or 'uncertain' replies to a total of 27 questions covering demographic information, drugs use, alcohol use and policy. This questionnaire was sent to persons occupying managerial grades in the companies whose general manager showed interest in taking part. In view of the fact that some of the information being requested was personal and involved an admission of indulgence in an illegal activity, the questionnaire was designed so as to guarantee the respondents' anonymity. An attempt was made to minimise the number of non-responders by sending a second letter addressed to all participants urging them to return the questionnaire. Results were analysed using BMDP statistical software. Managerial responses were compared using Pearson chi square test; statistically significant differences were accepted atp < 0.05. Results Of the 250 general managers invited to participate in this survey, 190 (76%) agreed to take part and sent details of their managerial staff to be included in this study. A total of 764 managers were sent a copy of the questionnaire, and responses were obtained from 457 of them giving a final response rate of 59.8%. The majority of participants consisted of male managers (89.5%). The age of the respondents was normally distributed, with about 15% and 17% in the younger (<30) and older «50) age groups respectively and about 34% in each of the two middle age groups(30-39, 40-49). The distribution of participants by company size appears in Figure 1. The majority (56.4%) of managers felt that there was a need for the introduction of pre-employment drug testing, though the figure dropped slightly to 47.9% in favour of testing during employment (n=457). Managers overwhelmingly agreed that they should be included in any such programme if drug testing was introduced (n=457,93.2%). A perceived need to introduce pre-employment drug testing was associated with a readiness to introduce testing during employment, (x21=19.69, p<O.OOl). There was a significant gender difference in the attitude 28 	 N. Vella, M. GauciI Type of industry was significantly associated with a perceived need to introduce drug testing both before (x2,=13.44, p<O.OOI), and during employment (x2,=19.09, p<O.OOI) (Figure 2). There was a strongly posItive association between the perceived need to introduce drug testing both before (x2,=6.96, p<O.OOl) and during employment (x21=5.89, p<O.OOI) with the size of the manager's company (Figure 3). <10 10 to 49 50-99 100-499 >500 Managers who felt the need to Company size 	 introduce pre-employment drug testing at their place of work also agreed that Figure 1 - Distribution of managers and size of employing company (n-4S7) they themselves should undergo drug 100 testing if this was introduced • Before (n=169) 89 (x21=14.36, p<O.OOI). This was also the case for managers who felt the need to introduce drug testing during employment, (x21=1O.89, p<O.OOI). Inclusion of managers in drug testing was not significantly affected by type or size of industry, or managerial age. Practically none of the respondents (n=457, 1.1 %) was willing to employ a person who was currently using drugs. However, the proportion of managers oa en t:i: Cl J!l oa who would employ a person with a ~ u 	 " Q,E :! g"; o " 	 J3 .~ ~ ~ .a en en 	 C U history of drug use increasedQ, 	 "'0.a .. 	 ::J "c_C .- " > ::E e.. ::J.,. 	 E ... ~ ~~a: 	 m " Q, o " en substantially (n=457, 41.6%). The ... " 	 E m::J willingness to employ past drug users Figure 2 - Proportion of managers in different industries and percieved needs also significantly related to age of to introduce drug testing before and during employment 	 responders (x21=8.02, p<0.05) (Figure 4), (willingness to employ decreasing with increasing managerial age), and to company size (Figure 5) (x21=14.61, p<0.05), with more managers from companies employing more than 50 workers being in favour of employing such persons. However no association between age or company size, and attitudes towards the employment of current drug users could be found. The employment of past or current drug users was not shown to be significantly affected by the attitudes of managers from different types of industry, size of company, or by gender. • U Discussion Company size The introduction of drug testing in the Figure 3 - Proportion of managers reporting a need to introduce drug testing workplace is a controversial issue6• and company size Drug testing of certain workers is already taking place in Malta, albeit not on a widespread towards the introduction of both pre-employment drug scale. The results from this study show that there is a testing and testing during employment. Female managers small majority of managers who favour the routine use were more in favour of pre-employment drug testing of this procedure as a pre-employment selection tool. than their male colleague's (females 91 %, males 67%), This may reflect the difficulty in identifying a substance (x2 1=4.30, p<0.05) but not in the case of testing during abuser, particularly in the case of occasional drug users employment (males 57%, females 40%), (x21=4·50, or those not showing overt signs of dependence. p<0.05). However no demonstrable association was This study strongly suggests that the employment found between managerial age and the introduction of opportunities of known drug users are bleak. Whilst the drug testing. 	 fact that practically none of the respondents would 30 25 20 % 15 10 5 0 IiJ During (n=164) 80 60 % 40 20 0 100 80 60 % 40 20 o • preemployment (n=414) IZI during employment (n=400) <10 10 to 49 60-99 85 100-499 >600 29 100 Managers' attitudes to illict drug testing in the workplace such as low prevalence or lack of sJ 	 awareness of such problems, financial considerations or by a managerial76 71 	 conviction (which is often expressed privately) that despite not actually being 60 able to recognise the effects per se of % drug use on a worker, a manager may 40 nevertheless learn about such a problem due to the small size and close 20 	 proximity of workers in the Maltese workplace. The willingness of managers to include 0 	 themselves in such testing was a <30 30-39 40-49 >&0 positive finding in that it reveals an Age group understanding that all categories of workers may be affected by such Figure 4 - Proportion of mamangers in different age groups willing to emply problems and that all workers, past drug users (n=291) irrespective of grade should be subject 100 to the same company policy. The difference in attitude demonstrated by 84 managers employed by different types 80 of industry towards the need for the introduction of drug testing may be explained by various factors amongst60 which are different rates of prevalence% of such problems in these workplaces, 40 increased tolerance of drug use, or reduced awareness of the effects of drug use. 20 A limitation of the study was that larger companies may have a larger complement of managers, which could 0 have possibly resulted in over­<10 10 to 49 50-99 100-499 >500 representation of this sector. A possible Company size source of bias on which little control Figure 5 - Percentage of managers willing to employ a past drug user and could be exerted was that there was a company size (n=291) reliance on the companies' General Managers to submit all the names of employ a current drug user may be understandable given their managers who would be asked to participate in this the nature of the illness, and in certain occupations, such survey. There was no way of ascertaining whether all the as those where there may be a high risk of injury to self managers were included in this list or not. The and to others, is definitely commendable, the relatively classification of industry by codes was the one adopted small proportion of managers willing to employ a past by the Departments of Social Security and Labour in drug user (41.6%) is particularly worrying. This data 1968, as well as the Employment and Trainingindicates that there is a certain amount of prejudice Corporation. This code obviously has great limitations, against these persons and that in certain situations such not only because of its age but also because a wide persons may be discriminated against. This finding is spectrum of work activities are grouped together under obviously not encouraging for a person who is each heading. In view of the fact that certain industries undergoing rehabilitation. Even worse is the implication remained under-represented in this survey, and due to that very few workers will admit to having a substance problems with regards to statistical analysis, it was abuse problem and agree to self-referral if they know decided to limit analysis to those industries represented that such an action may result in their being victimised. by more than 20 managers. The reduced willingness of managers from smaller  Whilst it may be argued that the company's health and companies «50 workers) to employ past users may be safety responsibilities can only be upheld by drugpartly explained by the frequently encountered issue of testing, citing amongst other reasons, the possible danger reduced flexibility in the allocation of workers to cover which a person with substance abuse problems may have for any absenteeism in an attempt to meet production on both co-workers as well as the public, issues such as deadlines with the result that managers may be unwilling the violation of the person, invasion of privacy,to risk having an employee who is seen as more likely to assumption of guilt, possibility of error, need for have such problems at work. reasonable cause, due process and assumption of guiltThe findings of this study highlight a difference in are strong arguments against7.8. The introduction of pre­attitude between managers from small companies and employment testing on its own has gross limitations and those from large ones with regards to the perceived need it was therefore surprising to note a reduced willingness for drug testing during employment. This reduced need to introduce drug testing during employment. This may in smaller companies may be due to a number of factors, indicate a lack of information about the rational use, and 30 N. Vella, M. Gauci limitations associated with drug testing, particularly because a negative drug test before employment has little bearing on whether a worker has taken drugs in the past or whether a person will start taking drugs after commencing work. One must also stress that care is needed in interpreting the results of such testing since the fact that a positive drug result to urine testing merely indicates exposure to the drug and not necessarily intoxication, habituation or addiction9. Drug testing per se does not measure performance or ensure safety, and care must be taken to ascertain that any testing for a just cause, which should only be introduced by joint agreement of management and workers, is not used simply to pick on an employee or as a means to obtain objective criteria to facilitate a punitive response, even more so in the absence of any legal framework7. However, there is a growing tendency abroad to introduce drug testing in safety sensitive occupations6.1O. Whilst being a complex issue drug testing may be of benefit in certain situations but it is important to carry out a cost-benefit analysis prior to its introduction since any potential benefit will be greatly affected by the prevalence of drug use in the population under consideration 11. The interest shown by managers in the introduction of drug testing at work, as well as the fact that drug testing has been introduced in some Maltese workplaces increase the urgency for legislation or at least the establishment of guidelines to be followed by medical practitioners involved in drug testing in Malta by the appropriate statutory authority, particularly with regards to ethical issues and procedures for ample collection and analysis. No drug testing should be introduced at a workplace until the burning question of what action will be taken in the case of persons testing positive has been carefully examined and a suitable policy has been formulated after consultation between the employer and the workers' representatives. Drug testing should be viewed as an opportunity to identify a sick worker and offer suitable support and rehabilitation. Employee Assistance Programmes (EAPs) have been developed as a strategy to combat workplace substance abuse, and have recently been introduced in a small number of selected workplaces in Malta during 1997. The aim of EA Ps is to aid management to identify a potential problem at an early stage and to take steps aimed at full rehabilitation of a productive worker rather than his or her dismissaP2. Such programmes stress the importance of prevention in the form of worker education to increase awareness about the effects of these substances, to use alcohol responsibly and to provide them with information about the available treatment and rehabilitation facilities . Both supervisors and workers representatives should be trained to enable them to recognise signs suggestive of substance abuse and to encourage the use of the company substance abuse programme when necessaryl3. Such initiatives should be undertaken in partnership with the workers' representatives, whose support for these programmes will be vital to ensure that they will have a reasonable chance of success. The ultimate key to success in addressing the problem of substance abuse is prevention and the commitment of employees 14. Further studies are needed to obtain a better indication of the prevalence of substance abuse at different workplaces, including Government Departments, and the types of drugs most commonly abused. The study strongly suggests that a substantial effort is required to counter managerial perceptions if any EAPs introduced are to have a reasonable chance of success. There is also a need for the authorities concerned to undertake an exercise aimed at identifying those occupations in which a worker suffering from such problems may cause serious accidents as in the case of transport workers, and take steps, if necessary through appropriate legislation, for the routine testing of these workers as part of employee assistance programmes. Acknowledgements We would like to acknowledge SEDQA's contribution in encouraging this project, both as regards its funding as well as through the valid comments made on the design of the questionnaire by members of its staff, namely Dr. Julian Mamo and Dr. Richard Muscat. We are also grateful to Prof. Anton Buhagiar for his contribution in statistical analysis of the results. References 1. 	 Atwell C. Drug and alcohol screening in the workplace. Occ Health 1995 Vo147. No.2, 51-54. 2. 	 Bertera RL. The· effects of behavioural risks on absenteeism and health-care costs in the workplace. J Occ Med 1991. Vol. 33, No 11, 1119-1124. 3. 	 Terrell A .. Screening for drug abuse. J Occ. Health and Safety Australia and New Zealand 1988. Vol. 4, No. 5, 441-445. 4. 	 Moll-V an- Charanta A W, Mulder PGH. Perceptual acuity and the risk of industrial accidents. Am J Epid. 1990. Vol. 131, No. 4, 652-663. 5. 	 Made in Malta - 1996 - Manufacturers and Exporters. Malta Export Trade Corporation 1996. 6. 	 Sheridan PJ. Expert advice on drug screening. Occ Hazards 1987 Vol. 49, No. 10,44-47. 7. 	 Anon. Workshop on drug testing in the workplace. Canadian Centre for Occupational Health and Safety, 1987 Report No. P87-1lE. 8. 	 Schubert R. Drugs in the workplace. Testing without a cause? Occ Health and Safety Canada. 1990. Vol. 6, No. 2, 142-146. 9. 	 McCunney RJ. Drug testing: technical complications of a complex social issue. Am J Ind Med 1989 Vol. 15, No. 5, 589-600. 10. 	 Anon. New drink and drug laws proposed for Railway Staff. Occ Health review 1991 No. 34,2. 11. 	 Zwerling C, Ryan J. Pre-employment drug screening -­The epidemiologic issues. J Occ Med 1982 Vol. 34, No. 6,595-599. 12. 	 Fantauzzo FC, Smith S. Employee Assistance Programmes: What they are, how they benefit employees and coinpanies. Mining Engineering Vol. 39, No. 11, 995-998. 1987. 13 . Masi D. Combating alcoholism in the workplace. Health and Social Work 1979 Vol. 4, No. 4, 41-59. 14. 	 Butler B. Altered States: dealing with workplace substance abuse. Accident Prevention 1992 Vol. 39, No. 6, 10-14. The copyright of this article belongs to the Editorial Board of the Malta Medical Journal. The Malta Medical Journal’s rights in respect of this work are as defined by the Copyright Act (Chapter 415) of the Laws of Malta or as modified by any successive legislation. Users may access this full-text article and can make use of the information contained in accordance with the Copyright Act provided that the author must be properly acknowledged.  Further distribution or reproduction in any format is prohibited without the prior permission of the copyright holder. This article has been reproduced with the authorization of the editor of the Malta Medical Journal (Ref. No 000001)  

Altered States: dealing with workplace substance abuse. Accident Prevention

Drug and alcohol screening in the workplace. Occ Health

Drug testing: technical complications of a complex social issue.

Drugs in the workplace. Testing without a cause? Occ Health and Safety Canada.

Employee Assistance Programmes: What they are, how they benefit employees and coinpanies.

Expert advice on drug screening. Occ Hazards

Manufacturers and Exporters. Malta Export Trade Corporation

New drink and drug laws proposed for Railway Staff. Occ Health review

Perceptual acuity and the risk of industrial accidents.

Pre-employment drug screening - The epidemiologic issues.

Screening for drug abuse.

The· effects of behavioural risks on absenteeism and health-care costs in the workplace.

Workshop on drug testing in the workplace. Canadian Centre for Occupational Health and Safety,

Managers’ attitudes to illicit drug testing in the workplace

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Managers’ attitudes to illicit drug testing in the workplace

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