title: Effectiveness and benefit-cost of peer-based workplace substance abuse prevention coupled with random testing.
abstract: 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.
authors.affiliation: Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 125 Calverton, MD 20705, USA. miller@pire.org <miller@pire.org>
authors.forename: Ted R
authors.initials: TR
authors.lastname: Miller
authors.forename: Eduard
authors.initials: E
authors.lastname: Zaloshnja
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Spicer
mesh_terms: D000062:Accidents, Occupational / Q000191:economics / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D003362:Cost-Benefit Analysis; D017049:Employer Health Costs; D006801:Humans; D008875:Middle Aged; D009786:Occupational Health Services / Q000191:economics*; D010379:Peer Group; D015397:Program Evaluation; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000191:economics*; D019966:Substance-Related Disorders / Q000191:economics / Q000517:prevention & control*; D017132:Workplace; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control