title: Prevalence of drug abuse among workers: strengths and pitfalls of the recent Italian Workplace Drug Testing (WDT) legislation.
abstract: BACKGROUND
  In 2008 a Workplace Drug Testing (WDT) law became effective in Italy for workers involved in public/private transportation, oil/gas companies, and explosives/fireworks industry with the aim to ensure public safety for the community.
  
  
  OBJECTIVE
  To examine and elaborate WDT data collected on a large group of workers (over 43,500) during March 2009-February 2010 in order to highlight pros and cons and to draw suggestions for policies in the field.
  
  
  METHODS
  Northern Italy.
  
  
  METHODS
  After ≤ 24 h notification, workers provided a urine sample screened for opiates, methadone, buprenorphine, cocaine, amphetamines, ecstasy, and cannabinoids (THC) by immunoassay. Positives were confirmed by GC-MS.
  
  
  RESULTS
  The positive rate was 2.0%, THC being most frequent drug (1.3%; cocaine, 0.4%; opioids, 0.3%). 6.9% of the positive workers tested positive for ≥ 2 classes (most often THC+cocaine). Gender ratio and mean age were significantly lower in positives (F/M=0.007; 35.5 ± 8.3 years) than negatives (0.016 and 40.7 ± 9.5, respectively). No decline in rates of positives and an increase of diluted samples over time were observed. The highest rates of positives were detected when sampling was performed just before/after week-end and during morning hours. Possible correlation between job type and drugs used were observed (e.g. more cocaine positives among road vehicle-drivers than among lift truck-drivers). Declared use of medicine/illicit drugs during the preceding week showed that illicit drug use was likely not always detected in urine and that almost 4% workers declared use of medicine drugs possibly affecting performance.
  
  
  CONCLUSIONS
  This survey enabled to evidence relevant pitfalls of the law and to define strategies to improve the outcomes of WDT policies.
authors.affiliation: Erasmus Mundus Master in Sustainable Regional Health Systems, Department of Public Health & Community Medicine, University of Verona, Italy.
authors.forename: Isabel
authors.initials: I
authors.lastname: Kazanga
authors.forename: Silvia
authors.initials: S
authors.lastname: Tameni
authors.forename: Alberto
authors.initials: A
authors.lastname: Piccinotti
authors.forename: Ivan
authors.initials: I
authors.lastname: Floris
authors.forename: Gabriele
authors.initials: G
authors.lastname: Zanchetti
authors.forename: Aldo
authors.initials: A
authors.lastname: Polettini
mesh_terms: D000328:Adult; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000652:urine*; D009790:Occupations / Q000706:statistics & numerical data; D015995:Prevalence; D011640:Public Policy; D015813:Substance Abuse Detection / Q000331:legislation & jurisprudence*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D017132:Workplace / Q000331:legislation & jurisprudence*
chemical_list: D009294:Narcotics