Is the Time Right for Impairment Testing
Ever since Ronald Reagan urged the creation of drug-free workplaces in 1986, the number of companies using urine tests to screen workers' drug use has escalated. But that growth may have peaked. After reaching a high of 81 percent in 1996, the percentage of employers using drug testing fell to 70 percent in 1999, according to a survey by the American Management Association, which is based in New York. And that number is likely far lower among small companies, which were not included in the survey.
As a practical matter, firms short of workers are lowering their standards, which can mean avoiding drug testing during the hiring process. "The decline is a reflection of a rather dramatic short supply of qualified workers," says Eric Greenberg, director of management studies for the AMA. "In the crunch for skilled workers, with positions needing to be filled, employers forgo reasons to not hire, and they take people they might have given a pass on previously."
A desire not to pry
Other concerns reflect a growing discomfort with the process of prying into employees' private behavior, especially if it has no impact on job performance. "Safety is the primary reason employers use drug testing, and the government encourages or requires it," says Lewis Maltby, president of the National Workrights Institute in Princeton, New Jersey. "But it's a pathetic excuse for a safety program. It misses 90 percent of the problem. Most people who have accidents on the job are not drug users, and drugs have nothing to do with [most] accidents. Most accidents are caused by fatigue or alcohol."
Stephen Heischman, a senior investigator at the National Institute on Drug Abuse, agrees. "Testing for drugs in urine doesn't tell anything about their performance on the job," he says.
In addition, because urine tests measure metabolites, inactive by-products, they do not necessarily identify someone currently under the influence of a drug. "A pilot who snorts cocaine on his way to the airport will pass a drug test," says Maltby. "But a few days later he will fail it."
In a white paper published in September 1999, the American Civil Liberties Union labeled drug testing a bad investment, an expensive effort that does not deter drug use, that harms workplace morale, that lowers company productivity, and that, in short, is unnecessary. It encourages alternatives such as impairment testing.
Also called fitness-for-duty or performance-based testing, impairment testing measures whether or not an employee is alert enough for work. From early tests that required participants to keep a cursor on track during a video game-like simulation, the industry has evolved toward a focus on evaluation through eye movements. In the impairment testing equipment from Eye Dynamics of Torrance, California, which should be released in about a year, the employee looks into a dark viewport, then follows a light with his or her eyes. "What the light does mimics a sobriety test for probable cause," says board chairman Ron Waldorf.
The equipment then analyzes a person's response in comparison to his or her normal baseline response, compiled from an average of three previous tests taken by the worker. Once their baselines have been established and stored in the equipment, employees might be asked to complete the test before each workday or less frequently to be sure that they are not impaired. "In 90 seconds, you know if a person shouldn't be driving a school bus," says Waldorf.
One advantage of impairment testing is that it focuses on workplace rather than leisure behavior. Another advantage is that it provides immediate results. And because impairment tests measure involuntary responses, cheating is less a concern than it is with urine tests, which unsupervised employees have been known to dilute or substitute.
Fatigue, stress, and alcohol
Another advantage is that it catches employees who are impaired because of problems that a drug test can't spot: fatigue, stress, and alcohol use. "Typical workplace testing really only covers a small fraction of the reasons why people are impaired," says Larry Rouvelas, executive vice president of PMI, a Rockville, Maryland-based firm that sells impairment tests. He cites an informal study in which employees undergoing his firm's impairment test took a follow-up drug test and also answered questions posed by a staff nurse. For those who failed the impairment test, these were the causes: 1 percent illegal drugs, 8 percent alcohol/hangover, 23 percent illness/medications, 30 percent fatigue, 38 percent multiple factors.
Most would agree that impairment testing is less invasive than the typical drug test. "There are no bodily fluids, nothing of a demeaning nature," says Waldorf.
But Bob Stephenson isn't so sure that impairment tests shield workers. The acting director of the Division of Workplace Programs at the Substance Abuse and Mental Health Services Administration in Rockville, Maryland, doesn't see how impairment tests are substantially different from urine tests. "There's an individual gauge of what's invasive," he says. "If you have to demonstrate a performance baseline every day, I'd consider that very invasive." And he worries that if an employee shows a slight impairment due to a prescription medication, for example, the necessity of disclosing such information also infringes on privacy. "With impairment testing, you have to rule out other things. The only way to do that is to have the person admit" the nature of the impairment, he says.
Despite such objections, impairment testing obviously offers some benefits. But why, if the technology has been on the market for 30 years and if it has proven successful for the transportation and aviation industries, has it failed to find widespread acceptance? "Not too many companies use impairment testing, which is a real mystery," says Maltby. "From everything we know, for the employers who used it, it was a very positive experience. But it has not achieved commercial success." Waldorf agrees, adding that "95 percent of companies have not heard of or used impairment testing."
The problem of cost
The biggest obstacle has been cost. While long-term drug testing-at about $15 per test-can add up, impairment testing has traditionally required a very large initial investment. Though PMI never charges for individual tests, its clients must first buy a piece of equipment that costs $30,000. While Rouvelas emphasizes that "one accident takes out more than the $30,000 cost" of the equipment, he adds that PMI also offers a more moderate leasing option.
Waldorf is convinced that this steep price, along with poor follow-up, has been the reason for all the "dead bodies" of defunct impairment testing companies along the HR highway. So his firm has decided to make its system free and instead charge $5 per test, with discounts available for high-volume use, "like a copy machine." Says Waldorf: "It takes away a big barrier to marketing."
Another reason for the lack of interest in impairment testing has been that employers are leery of drastic change. Despite the shortcomings of drug tests, they do have a history. That may be why today's impairment testing is being touted as a complement to rather than a substitute for drug testing, a quick way to make sure that workers can perform and an alert to the occasional need for closer investigation of workers with problems.
Interest in impairment testing is growing. A few scientific studies-including one in 1996 by the National Academy of Sciences - have touted its benefits. And although the American Management Association's survey of workplace testing didn't mention impairment testing until 1997, it placed the use of what it calls fitness-for-duty testing at 55 percent of companies in 1999. The word might finally out that drug testing is not the only - and perhaps not the best - tool for making workplaces safer.
- National Institute on Drug Abuse
- Substance Abuse and Mental Health Services Administration
- American Management Association
Workforce, February 2001, Vol 80, No 2, pp. 69-71 Subscribe Now!