Prevalence of drug abuse among workers: Strengths and pitfalls of the recent Italian Workplace Drug Testing (WDT) legislation

BackgroundIn 2008 a Workplace Drug Testing (WDT) law became effective in Italy for workers involved in public/private transportation, oil/gas companies, and explosives/fireworks industry with the aim to ensure public safety for the community.AimsTo examine and elaborate WDT data collected on a large group of workers (over 43,500) during March 2009–February 2010 in order to highlight pros and cons and to draw suggestions for policies in the field.SettingNorthern Italy.MethodsAfter ≤24 h notification, workers provided a urine sample screened for opiates, methadone, buprenorphine, cocaine, amphetamines, ecstasy, and cannabinoids (THC) by immunoassay. Positives were confirmed by GC–MS.ResultsThe positive rate was 2.0%, THC being most frequent drug (1.3%; cocaine, 0.4%; opioids, 0.3%). 6.9% of the positive workers tested positive for ≥2 classes (most often THC + cocaine). Gender ratio and mean age were significantly lower in positives (F/M = 0.007; 35.5 ± 8.3 years) than negatives (0.016 and 40.7 ± 9.5, respectively). No decline in rates of positives and an increase of diluted samples over time were observed. The highest rates of positives were detected when sampling was performed just before/after week-end and during morning hours. Possible correlation between job type and drugs used were observed (e.g. more cocaine positives among road vehicle-drivers than among lift truck-drivers). Declared use of medicine/illicit drugs during the preceding week showed that illicit drug use was likely not always detected in urine and that almost 4% workers declared use of medicine drugs possibly affecting performance.ConclusionsThis survey enabled to evidence relevant pitfalls of the law and to define strategies to improve the outcomes of WDT policies.