Effectiveness and benefit-cost of peer-based workplace substance abuse prevention coupled with random testing

• Published in: Accident analysis and prevention Vol. 39; no. 3; pp. 565 - 573
• Main Authors: Miller, Ted R., Zaloshnja, Eduard, Spicer, Rebecca S.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2007
• Subjects: Accidents, Occupational - economics; Accidents, Occupational - prevention & control; Accidents, Occupational - statistics & numerical data; Adult; Benefit-cost; Cost-Benefit Analysis; Employer Health Costs; Humans; Injury; Middle Aged; Occupational; Occupational Health Services - economics; Peer Group; Program Evaluation; Retrospective Studies; Substance abuse; Substance Abuse Detection - economics; Substance-Related Disorders - economics; Substance-Related Disorders - prevention & control; Testing; Workplace; Wounds and Injuries - economics; Wounds and Injuries - epidemiology; Wounds and Injuries - prevention & control; USA; Occupational; Substance abuse; Benefit-cost; Injury; Testing
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2006.10.001

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.