Work-related Alcohol and Drug use - A National Forum.
29th June 2006.
Keynote speaker Bob Hawke
Adelaide was host to this important Forum on 29-30 June, in which the National Centre for Education and Training on Addiction (NCETA) and the Alcohol and other Drugs Council of Australia (ADCA) brought together workers, employers, researchers and alcohol and other drugs (AOD) professionals to look at the role of work - and the workplace - in how we use alcohol and other drugs, and the workplace's role in prevention of AOD related problems. The AOD field has probably never seen a gathering of such diverse parties and interests.
This series of four summaries covers most of the sessions of the Forum. While every attempt has been made to be accurate and objective, these summaries reflect necessarily the impressions (and possibly some misunderstandings) of one audience member. The present tense is generally used for reported speech. [Some comments of the writer are noted in brackets RH].
After the official opening by Christopher Pyne MP (Parliamentary Secretary to the Minister for Health and Ageing), three keynote speakers gave a social commentator's, then workers', and employers' perspectives on the issues involved.
Professor Barbara Pocock, of the University of South Australia, spoke on the impact of work in our lives. Her thesis is that Australian workers are on a work/life collision course. Australians have an apparent increasing appetite for work. Along with increased traveling time and work intensity, common family time is being squeezed or lost. Most new jobs are part time and casual, with lack of tenure, respect, predictability of earnings and hours, retirement savings, and limited job security. With this has come a contraction in those at home caring. We rank 17th out of 20 OECD countries in terms of the generosity of public support for childcare, paid leave for parents and child benefits.
There is no going back to the male breadwinner, yet a gendered distribution of domestic work and care persists. With a shift of community from home and street to workplace, there is erosion of relationships and intimacy, and an increasing tendency to commodify domestic responsibility, with care and love becoming the invisible sacrifice. What happens when women's need to work, and the increasing stress of the workplace, collide with the culture of motherhood: that mother is ever-loving, and always there? While kids understand parents' need to work, most prefer more parental time to more money in the household. One parent at home doesn't make up for the absence of the other.
Professor Pocock asks: will we adapt as a society or leave the individual privately to juggle? She put the case for reforms to accommodate the new worker and family , including an improved leave regime, decasualisation of ��permanent casual�� jobs; quality, accessible, affordable childcare, reduced hours of work and overtime, shared domestic work and unpaid care, and improved family payments system.
Richard Marles, Assistant Secretary of the Australian Council of Trade Unions (ACTU) told us that Australians are the second hardest working people (in job hours, paid and unpaid) in the OECD. At a time of low unemployment the reality is underemployment: with a third of the workforce working part-time, and increasing numbers in precarious and "atypical" employment; as casuals or independent contractors, getting no sick pay, holiday pay or paid parental leave - and this by virtue of workforce trends, rather than legislation or any particular policy decisions.
Work intensification is caused not only by globalisation, but by the trend to the 24-hour day economy - the benefits of both of which Mr Marles lauded. However workers are required to show more and more 'flexibility' and work is being pushed to its limits. This process leads to both long and short hours workers, and tips the scales in favour of employers. He described the unpredictability and precariousness of modern employment (only increased by the "Workchoices" legislation) as amounting to disempowerment, and listed possible health implications: less time spent with partner and children leading to relationship breakdown; less volunteering work in the community; stress being associated with heart disease, decreasing fertility, increased rate of accidents, increased use of drug and alcohol and increased anxiety and depression.
Mr Marles made the critical proposition that stress leads to increased use and abuse of drugs and alcohol, and identified stress, fatigue and bullying as the greatest problems in the workplace.
Chris Harris representing the Australian Chamber of Commerce and Industry (ACCI), reckoned the costs of drug and alcohol misuse as $13.7 billion per year, through absenteeism, decreased output, increased staff turnover, and as a trigger for claims such as sexual harassment, especially alcohol playing a role in the latter .
He outlined the forms of employer's responsibilities, whether statutory (eg laws covering aviation, or rail transport; or more broadly state Occupational Health and Safety (OH+S) legislation; through the need for liability management; or a broader commitment to corporate citizenship. These obligations are tempered by unfair dismissal and privacy laws - for example, it is unusual for summary dismissal to stand up in the courts.
He noted that employers are not drug and alcohol professionals, and have limited knowledge of unfamiliar drugs, including prescription drugs, but also other drugs whose use may reflect changing mores in the community.
An ACCI survey of enterprise agreements showed 70% addressed health and safety issues; 38% drug and alcohol issues (especially in building and construction); and only 2% provided for employee assistance in this respect. Of strategies in evidence in these agreements, behavioural standards were common (eg "must be fit and alert at work") as were provisions for serious misconduct (eg "intoxicated with alcohol or under the influence of illicit drugs"). Workplace drug testing was not widespread, being very industry specific (especially transport and mining). Nor were provisions for counselling, disciplinary measures, or rehabilitation. Few agreements had comprehensive strategies involving all these elements.
Mr Harris stressed that the greatest challenge lies with small and medium sized businesses [incidentally, more likely to be exempted from the restraining provisions of unfair dismissal laws. Although the ACCI does not share the ACTU's gloomy vision of "Workchoices" legislation, enterprise agreements will be a thing of the past for many employees under "Workchoices" and Australian Workplace Agreements. comment RH]
Previous ACTU secretary, and Australian Prime Minister, Bob Hawke was introduced as an authority on workers issues and also architect of the enlightened drug and alcohol policies which have existed in Australia since the middle 1980s. Mr Hawke promptly gave credit to Dr Neal Blewett as a great Health Minister who had championed such initiatives as the National Drug Summits and Strategies. He referred also to his own personal expertise both as a drinker, and an alcohol abstainer for the term of his prime ministership.
Mr Hawke commended to the forum three principles which he had laid down for the nation to work together in the difficult economic times in which he took over the prime ministership, in the national summit of governments, churches, businesses, and unions:
- complete sharing of information, to provide a common factual basis for understanding and action;
- an understanding of the identity of interests (what is in all our interests); and
- the universality of obligation - not just employers telling workers to behave themselves (or vice versa, presumably).
In the discussion that followed, several contentions emerged:
- workplace drug and alcohol issues can be seen as an individual responsibility or being caused by structural problems in the economy and workplaces.
- an unhealthy impetus for developments may come from 'push-back', a kind of tit-for-tat between unions and employers.
- stress and overwork have consequences (mistake rates increasing after working 40-50 hours/week), having healthy workers is better for all, and therefore a need to prioritise keeping workers healthy, for employees to 'own' this issue.
- there is evidence that it is appropriate to average overtime over 1-2 month periods (but not longer), and that workers are often their own worst enemies when it comes to overtime - also, one in two overtime hours is unpaid.
- substances may be used in response to stress (especially sedative-hypnotics) but also to improve workplace performance (eg stimulants).
- Workchoices may lead to a 'race to the bottom' in workers' conditions (ACTU) - but OH+S is protected because enshrined in state law (ACCI).
- The second session of the day dealt with employees' and employers' obligations.
Tony Beech, Chief Commissioner of the Western Australian Industrial Relations Commission spoke on "Drug Testing at Work - Getting it Right". He described cases where workplace drug testing was tested in the courts - either challenged upon its introduction, or in claim for unfair dismissal.
The first case involved BHP in the mining industry in 1998. The testing programme was upheld by the Commission because BHP had consulted widely, and explained the programme, which was holistic and comprehensive and included education and opportunities for rehabilitation. It set higher levels for cannabinoids in urine on the basis that these might better represent impairment than the lower levels usually used - one implication is that such levels may be challenged in the courts.
The BHP case provided a precedent for workplace drug testing for that particular setting and context, but not necessarily for others. It illustrates the principle that 'fairness' is a test at law, in this case weighing a "demonstrable need" against civil liberties, and the right to privacy.
Some further issues were the distinction between random and targeted urine testing, the need for employees to examine the reasons for an employee refusing to do a urine test (eg religious, modesty, on principle), the lack of current accepted standards for saliva testing, and the fact that extension of workplace testing will depend on acceptance of the need for it by the wider community, as was the case with random breath testing of motorists.
Ms Lyn Barnett, of Safework South Australia, gave a perspective from an OH+S inspectorate - noting that all Australian states had similar provisions. Obligations on employers fall into 3 types: Acts and Regulations, which are law and must be followed; Approved Codes of Practice, which must be followed unless a better alternative exists; and Guidelines, designed to help employers meet their obligations.
In general employers must
- provide a safe workplace environment and consult with employees
- carry out risk management
- implement and document policies
Employees are obliged to
- look after themselves and others in the workplace
- not endanger these by using alcohol and other drugs
- obey reasonable orders
Risk assessment must always consider how likely harms were to occur, and the degree of those harms. Policies should take account of workplace culture, stress, relationships and the availability of substances.
An medical perspective came from senior occupational physician Dr Ian Gardner, currently Senior Consultant to the Australian Defence Force, under the title: "To Pee or Not to Pee - That is the question". Dr Gardner stressed that the views he expressed were his own, not necessarily those of the ADF.
While there was no debate anymore about the place of alcohol testing, the same could not be said for other drug testing. There is, in his view, little evidence of the relationship between other drugs and workplace harms, and minimal evidence of a relationship between available drug tests and impairment.
There are important concerns regarding privacy, interpretation of tests, chain of custody and punishment resulting from positive tests. Existing tests may miss current intoxication (eg very recent use of amphetamines) and do not detect impairment from fatigue, ill-health, and medications (eg chemotherapy).
Dr Gardner reviewed the limitations of the available evidence for the relationship between other drugs than alcohol and workplace harms. He stressed the importance of "root cause analysis" of industrial accidents, rather than blaming substance use merely by association. In the absence of good evidence, Dr Gardner's position is that there is "a limited place for drug testing in safety critical areas".
Currently available tests of fitness for duty, for example computer based tests of reaction or cognition, are unvalidated, though they are already in use in some industries like mining.
In the discussion that followed, it was pointed out that Blood Alcohol Level BAL of 0.05 though often used as a benchmark or reference point, does not actually define safety or impairment, but is a legal definition reflecting what is socially acceptable at this time. Although it does not prove impairment, it implies it, based on good research evidence. A comment from the floor was that the pharmaceutical industry has considerable expertise from testing its products for causing possible impairment - coming as it were from the opposite direction, of establishing the safety or safe use of these substances.
Many of these issues were taken up in more detail on Day 2 of the Forum.
The transcripts of these presentations will be available from NCETA in the Proceedings of the Forum. For more details contact NCETA on 08 8201 7535 or nceta@flinders.edu.au or www.nceta.flinders.edu.au.
The forum presentations can be viewed at: www.nceta.flinders.edu.au/events/twenty_four_seven.html#Presentations
