Evidence Summaries There is insufficient evidence to support alcohol and drug screening of occupational drivers for preventing injury, but alcohol screening possibly reduces injury rate immediately following the intervention.
A Cochrane review 1 included two interrupted time-series studies conducted a) in the companies in USA and b) on federal injury data. In these studies two interventions of interest were evaluated: mandatory random drug testing and mandatory random and for-cause alcohol testing programmes.
In reanalysis of the data in one study mandatory random and for-cause alcohol testing was associated with a significant decrease in the level of injuries immediately following the intervention (-1.25 injuries/100 person years, 95% CI -2.29 to -0.21) but the intervention did not significantly affect the existing long-term downward trend (-0.28 injuries/100 person years/year, 95% CI -0.78 to 0.21).
Mandatory random drug testing was significantly associated with an immediate change in injury level following the intervention (1.26 injuries/100 person years, 95% CI 0.36 to 2.16) in one study, but in the second study there was no significant effect (-1.36/injuries/100 person years, 95% CI -1.69 to 0.41). In the long term, mandatory random drug testing was associated with a significant increase in the downward trend of injuries in one study (-0.19 injuries/100 person years/year, 95% CI -0.30 to -0.07) and in the downward trend in fatal accidents in another study (-0.83 fatal accidents/100 million vehicle miles/year, 95% CI -1.08 to -0.58).
Comment: High quality interrupted time-series is a feasible study design but a cluster-randomised trial would be the ideal one. The study was downgraded for quality and design (no control).
. Cashman CM, Ruotsalainen JH, Greiner BA, Beirne PV, Verbeek JH. Alcohol and drug screening of occupational drivers for preventing injury. Cochrane Database Syst Rev 2009 Apr 15;(2):CD006566. [PMID:19370641]
Copyright © 2023 Duodecim Medical Publications Limited.
"Alcohol and Drug Screening of Occupational Drivers for Preventing Injury." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/454033/all/Alcohol_and_drug_screening_of_occupational_drivers_for_preventing_injury.
Alcohol and drug screening of occupational drivers for preventing injury. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/454033/all/Alcohol_and_drug_screening_of_occupational_drivers_for_preventing_injury. Accessed December 4, 2023.
Alcohol and drug screening of occupational drivers for preventing injury. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. https://evidence.unboundmedicine.com/evidence/view/EBMG/454033/all/Alcohol_and_drug_screening_of_occupational_drivers_for_preventing_injury
Alcohol and Drug Screening of Occupational Drivers for Preventing Injury [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2023 December 04]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/454033/all/Alcohol_and_drug_screening_of_occupational_drivers_for_preventing_injury.
TY - ELEC
T1 - Alcohol and drug screening of occupational drivers for preventing injury
ID - 454033
BT - Evidence-Based Medicine Guidelines
UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/454033/all/Alcohol_and_drug_screening_of_occupational_drivers_for_preventing_injury
PB - Duodecim Medical Publications Limited
DB - Evidence Central
DP - Unbound Medicine