GENEVA (ILO News) – Moderate drinkers who have had "one too many" actually cause more alcohol-related workplace problems than their less numerous, but heavier-drinking colleagues. Many heavy drinkers have developed "a physical tolerance and social mechanisms", that mask the impact of their drinking behaviour, says a new report prepared for the International Labour Office. ^{(Note 1)}

In addition, the economic "cost of illness" measuring treatment, prevention, research, law enforcement and lost productivity caused not only by abuse of alcohol, but use of other substances such as illicit drugs either alone or combined with alcohol, are high in a number of countries surveyed, the draft report says.

"The economic costs of lost productivity are difficult to gauge but they are clearly enormous," the report says, citing studies carried out in the United States, the United Kingdom, Japan, Australia, Germany and Canada. Other difficult to measure results of alcohol abuse include lowered educational levels, divorce, negative employee morale, poor performance, pilfering and vandalism.

These and other results of the study are to be discussed at an ILO meeting, in Geneva on 3-4 February. The meeting will bring together experts from the ILO, World Health Organization (WHO) and the United Nations International Drug Control Programme and public and private sector managers from the participating countries of the project ^{(Note 2)} - Egypt, Mexico, Namibia, Poland and Sri Lanka - to finalize a draft report on the results of the five-year programme.

Here are some of the issues to be discussed:

* Seventy to eighty per cent of alcohol-related incidents (accidents, quarrels, absenteeism, crime) occur among moderate drinkers and low consumers, simply because their number is so much greater.

* Costs-of-illness studies conducted in some countries have shown the high cost of alcohol and drug abuse. In the United States, the economic costs of alcohol abuse were estimated at US$ 70 billion (and costs of drug abuse $44 billion) in 1985; in the United Kingdom, GB 1.6 billion (US$ 2.6 billion) in 1987; in Japan, 664 billion yen (US$ 5.7 billion) in 1987 (1.9% of GDP in that year); in Australia Aus$ 4.5 billion ( US$ 3.38 billion) in 1988; in Germany nearly DM 6 billion (US$ 3.3 billion) in 1990; and in Canada Can$ 7.5 billion (US$ 5.5 billion) for alcohol and Can$ 1.37 billion (US$ 941 million) for illicit drug abuse in 1992. ^{(Note 3)}

* In all occupations, the highest rates of alcohol and drug use and misuse are among younger and male workers. Specific occupations at greater risk for the development of alcohol and drug problems include food and beverage service, transportation workers and maritime workers.

* Among men, the highest rates of alcohol, marijuana and cocaine use on the job are in the recreation, entertainment and construction industries. Among women, the highest rates of alcohol use are in agriculture, forestry and fishery industries.

* High rates of alcohol use were noted among lawyers, domestic servants, company directors, military personnel, the medical profession and even police officers, and high rates of drug abuse among doctors, nurses, military personnel, business executives, lorry drivers, pilots and workers on mass production assembly lines.

* The population at highest risk is the 20 to 30 year age bracket. Between the ages of 20 and 35, alcohol-related damage is mainly the result of intoxication resulting in accidents, disputes, absence from work. Between the ages of 35 and 55 alcohol-related damage includes health problems and psycho-neurological changes.

* Drug and alcohol abuse have a wide impact, spreading to families and co-workers who are affected in terms of lost earnings, stress, and low morale.

The meeting will also review a programme that promotes new approaches to addressing drug and alcohol problems with greater involvement of managers in the workplace in cooperation with unions. This programme also draws on the support of social partners and the networks that employers' and workers' organizations provide in reaching enterprises and their workforce.

"Moving away from the traditional predominant use of experts in treatment and rehabilitation, this is a management-led programme geared primarily towards prevention", said ILO's Senior Advisor on Drug and Alcohol Prevention, Behrouz Shahandeh. "One cannot address alcohol and drug prevention in the workplace in isolation from corporate attitudes, values and behaviour, as well as the working environment and conditions."

The programme was initiated prior to the adoption of the Code of Practice on the Management of Alcohol and Drug-related Issues in the Workplace ^{(Note 4)} by a tripartite meeting of experts in January 1995 and its subsequent endorsement by the ILO Governing Body. The Code represents an international consensus on how to manage drug and alcohol problems in the workplace.

The programme uses a "traffic light" system for classifying employees who need help: a green zone (staying free of substance abuse problems), amber zone (those requiring early intervention such as counselling) and red zone (those requiring treatment and rehabilitation).

Enterprises which have confronted the issue traditionally focus on assisting workers who already have a problem, providing them with counselling services or referral to treatment and rehabilitation programmes with the aim of returning to work. Such programmes are only directed at employees who are considered alcoholic or drug-dependent which may be around 3 per cent of the workforce (red zone), and those who are experiencing the early effects of alcohol and drug problems, another 8 to 10 per cent (amber zone).

"With this background", noted Mr. Shahandeh, "the major thrust of the project has been to make a paradigm shift from a problem-oriented approach (red and amber zones) to a primary prevention approach concentrating on the green zone," adding the objective is to prevent workers from sliding into the amber and the red zones.

A review conducted five years after the project's inception revealed that more than half of the thirty-eight participating enterprises experienced a net decrease in alcohol and drug related problems. Reduced absences from work, fewer discipline problems and less tardiness were the main improvements. The enterprises ^{(Note 5)} covered different sectors of economic activity: agriculture, manufacturing, trades, transport, government, banking and finance and together employed about 125,000 workers (84% male). For most, participating in this project was important to "improve the quality of work, increase enterprise productivity and profits, improve the well-being of workers and their families, learn about effects of substance abuse in the workplace and reduce conflicts among workers and supervisors."

The programme has led to the establishment of the Association of Resource Managers against Drug Abuse (ARMADA) in each country, the further development of which will be the subject of a meeting on 5 February at the ILO. The mechanism calls for collaboration among senior-level managers from enterprises that are developing programmes of prevention. "This networking arrangement has proven to be extremely useful in sharing information and experiences, pooling resources and doing things together at the community level", Mr. Shahandeh concluded. ARMADA activities have also facilitated the involvement of family members in the programmes.

Note 1:
Substance abuse and the workplace: Current state of research and future needs. Draft of a report prepared for the International Labour Office by the Canadian Centre on substance Abuse, December 1997.

Note 2:
The ILO, the World Health Organization (WHO) and the United Nations International Drug Control Programme (UNDCP) are the executing agencies for Model Programmes of Drug and Alcohol Abuse Prevention among workers and their Families, with ILO as the lead agency.

Note 3:
Exchange rates in January 1998. Not official and should be used as a reference only.

Note 4:
Code of Practice on the Management of Alcohol and Drug-related Issues in the Workplace, ILO 1996, ISBN 92-2-109455-3, 15 Swiss Francs.

Note 5:
Examples of some participating enterprises:

- the Petroleum Cooperative Company, the Cairo Transport Company and the Arab Gelatine Pharmaceutical Products in Egypt;
- the Ford Motor Company, KALTEX (textiles) and CELANESE (chemicals) in Mexico;
- Namibia Beverages (Coca Cola), Telecom Namibia and Model Supermarket Ltd. in Namibia;
- Rokita Chemicals, Power Engineering Technical Services and the Rolling Stock Company in Poland;
- Ministry of Labour and Vocational Training, Bata Ceylon Ltd. and Ever-ready Battery Ltd. in Sri Lanka.