Send email for updates


About updates
Review analysis

This entry is our analysis of a review or synthesis of research findings added to the Effectiveness Bank. The original review was not published by Findings; click Title to order a copy. Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text The Summary conveys the findings and views expressed in the review.

Title and link for copying Comment/query to editor

Alcohol and drug screening of occupational drivers for preventing injury.

Cashman C.M., Ruotsalainen J., Greiner B.A. et al.
Cochrane Database of Systematic Reviews: 2009, 2, Art. No.: CD006566.

Exhaustive search finds just two rigorous studies of workplace testing for alcohol and/or drug use of people employed as drivers. For drugs there was some evidence of a long-term effect in averting injuries and deaths but in respect of both drugs and alcohol the evidence was too thin to support any particular policy.

Summary Testing employees in the workplace for alcohol and drug use is commonplace in some countries but its effect in reducing occupational injuries remains unclear. This review for the Cochrane collaboration aimed to assess the effects of testing for alcohol and drug use among people whose job involves driving a motor vehicle, in particular whether this helps prevent injury or work-related effects such as sickness absence related to injury.

The analysts searched for studies which compared testing interventions with another intervention or no intervention and collected relevant outcome data. In principle included were studies which randomly allocated drivers or workplaces to testing or not, and those which assessed the effects of testing by before and after measures.

Only two such studies were found, both from the USA, and both were variants of a before versus after research design. One was conducted in five large US transportation companies that carried passengers and/or cargo to examine the association between occupational injuries and the introduction of federally required alcohol and (separately) drug testing. In this study two interventions were evaluated: mandatory random drug testing, and mandatory random and 'for-cause' (ie, when there was reason to believe the employee had been drinking) alcohol testing programmes. Another study focused only on mandatory random drug testing and based on federal injury data that covered all lorry drivers working for interstate carriers.

Main findings

The analysts recalculated the results from raw data provided by the study authors. In one study, mandatory random and for-cause alcohol testing was associated with a significant decrease in the frequency of injuries immediately following the intervention, but there was no significant change in the existing long-term downward trend.

Mandatory random drug testing was significantly associated with an immediate increase in the frequency of injuries following the intervention in one study, and in the second study there was no significant link. However, in both studies random drug testing was associated with a significant further dip in the long-term downward trend in the frequency of injuries or fatal accidents.

The authors' conclusions

There was some limited evidence that in the long term, mandatory drug testing can be more effective than no intervention in reducing injuries in occupational drivers. For mandatory alcohol testing, there was evidence of an immediate effect only. The state of the evidence is insufficient to be able to advise for or against drug and alcohol testing of occupational drivers as the sole long-term solution to preventing injuries in the context of workplace culture, peer interaction and other local factors.

Last revised 04 March 2014. First uploaded 05 November 2012

Comment/query to editor
Give us your feedback on the site (one-minute survey)
Open Effectiveness Bank home page
Add your name to the mailing list to be alerted to new studies and other site updates


Top 10 most closely related documents on this site. For more try a subject or free text search

HOT TOPIC 2016 Can testing and sanctions displace addiction treatment?

REVIEW 2011 A new paradigm for long-term recovery

DOCUMENT 2012 Will intensive testing and sanctions displace treatment?

REVIEW 2010 Testing for cannabis in the work-place: a review of the evidence

STUDY 2005 Communities can reduce drink-driving deaths

STUDY 2010 South Dakota 24/7 Sobriety program evaluation findings report

STUDY 2010 Is 24/7 Sobriety a good goal for repeat driving under the influence (DUI) offenders?

STUDY 2009 The 24/7 Sobriety Project

STUDY 2006 Drink-driving cut by 30-minute talk with hospital patients

STUDY 2000 Injuries reduced even when interventions do not stop problem drinkers drinking