Workplace impairment is a serious and sometimes confusing topic. The causes of impairment are varied, the effects mixed and remediation efforts, until now, have been difficult to implement.
This guide to Workplace Impairment is designed to answer your questions and get your organization on the right track.
You may find these additional resources beneficial to get started:
What are the Benefits of Cognitive Impairment Testing?
Recognizing Impairment in the Workplace
What's the Science Behind Impairment Testing?
Impairment in the Workplace - How Does Impairment Testing Compare to Drug Testing?
What Occupational Impairment Tests are Available Today?
When Deciding Whether Workplace Impairment Testing will be Successful at your Company, Consider the Following:
What industry is your company in?
Workplace impairment testing has been successfully implemented in a wide range of safety-sensitive industries such as; aviation, transportation, manufacturing, construction, mining, oil and gas, utilities, healthcare, and more.
What is the size of your company?
Workplace impairment testing is beneficial in different ways depending on the size of your company. Supervisors may have greater visibility in small companies and communicate more often with their workers than in large companies. Despite this, impairment testing is used as a way to identify sources of impairment that are subtle or easily masked. Fatigue, for example, is difficult to identify in its later stages even by the worker himself. An objective measure that can assess and monitor the progression of fatigue throughout a shift can prove life-saving in such a situation.
Further, workplace impairment testing in small companies is helpful in that it enforces personal responsibility for safety despite a lack of the stiff oversight, hierarchy, and discipline that are enforced by larger companies. Impairment tests can provide the structure or routine necessary to consistently prioritize safety even within the more relaxed and intimate team environment often seen in smaller companies.
In larger companies, impairment tests are a great way for overburdened supervisors to get a quick glimpse into the fitness of their entire team. Impairment tests with automated alerts, such as the AlertMeter®, instantly notify supervisors via text or email when a worker needs their attention. This ensures efficient and effective use of the supervisor's time and gets workers the help they need much quicker than if they had to wait until the next supervisor to walk through and notice them. As mentioned, a dangerously impaired worker is often unaware of his/her state and thus would be unlikely to seek attention on their own.
Where is your company located?
Workplace impairment tests have been successfully implemented everywhere from the gold mines of Siberia, to the coal mines in South Africa, to hospitals in England, and the truck stops of the Midwestern United States.
Thanks to modern technology, impairment tests can be integrated into telematics and timekeeping systems and can be used even on sites with limited internet service.
What is the language/education level of your workers?
The language and education level of your workers are irrelevant when implementing impairment tests because the tests are usually based either on monitoring biometric indicators such as pupil movement; or in the case of AlertMeter®, an easy-to-use game-like shapes test that doesn't require specific language skills. Technological savviness is also irrelevant on the AlertMeter® because workers establish their own personal baselines that control for their level of familiarity and comfort with apps and phones.
What are your workers’ shift schedules like?
Workplace impairment tests are a great safety boost for shift workers. Especially long or graveyard shifts and workers on rotating shift schedules can benefit from the additional visibility provided by impairment tests. Workers can suffer from reduced alertness and cognitive impairment at the beginning of early morning shifts before they've had time to sufficiently wake up; during the circadian dip after lunch; and at the ends of shifts.
One study that compared cognitive impairment due to alcohol intoxication with cognitive impairment due to fatigue, or "sustained wakefulness," found that,
"Sustained wakefulness may carry a risk comparable with moderate alcohol intoxication since approximately 50% of shift-workers on 8-hour shift patterns typically spend at least 24 hours awake on the first night shift in a roster (Knauth et al, 1981). Furthermore, the highest level of impairment observed in this study (0.096% BAC) would occur at the end of a typical night shift (i.e. 0600-0900h) and would frequently coincide with the trip home for many shift workers.”
The study notes that this BAC level (which, by the way, is higher than the driving limit) would be considerably higher for a worker on a rotating shift schedule who didn't have a chance to adjust to his/her new sleeping schedule and get sufficient restorative sleep before coming into work:
“Several studies have reported that the performance decrements, reduced alertness, and fatigue reported by night shift workers is greater on the second and third night shift (Tilley et al, 1981). If this is the case, then it may be reasonable to assume that the alcohol impairment equivalent on these nights may be even greater than reported here for the first night.”
What do worker's unions think about impairment testing?
Since workplace impairment tests put the focus on worker well-being rather than catching wrong-doing, they are usually welcomed by unions.
If your company is considering workplace impairment testing, it is important to involve union leaders in early conversations to ensure they are well-informed participants in the discussion.
Some aspects of impairment testing that union members appreciate are:
- not invasive
- can lead to more effective hiring practices
- helps workers keep each other safe and accountable
- supervisory access to data can be configured to minimize management involvement and maximize management by union leaders.
In fact, union members at one site volunteered to try out impairment testing with the AlertMeter®. After realizing that the nature of impairment testing was not punitive, total worker participation at the site increased from 10% at the beginning of the pilot to 95% three months later (from 40/400 original volunteers to 340/400 volunteers).
Peer pressure was also thought to play a role in the vast growth in participation. Workers who took the test and confirmed that they were fit-to-work wanted their coworkers also to confirm their fitness for work so that they could trust one another with their safety.
For a list of union FAQs about AlertMeter®, click here.
Most importantly, what does your safety culture look like now and what are your objectives going forward?
Companies who adopt workplace impairment testing have stated one or several of the following objectives in driving their decision:
- We want to become more proactive and positive in our safety culture.
- We just had an accident we weren’t able to predict.
- We need to combat fatigue better.
- We need to address drug and alcohol impairment in real-time.
- Cannabis was just legalized and we’re looking for a way to adapt.
- We need more realistic hiring practices to overcome labor shortages.
- We are trapped in an accident cycle.
- We need to reduce our error rate.
- We want to improve productivity.
- We want to address invisible safety threats (personal family crises, emotional distractions, changes in medications, etc.).Our supervisors don’t have enough time to check in on everyone every day, so we need more automated, timely insights.
- We are looking for something new and innovative to keep us competitive in safety.
Workplace impairment testing technologies have come a long way in the last few decades.
Although there is a rapidly growing demand for comprehensive insights and positivity in modern workplaces, there is a general lack of awareness surrounding impairment tests.
Impairment testing solutions that are well-suited for the workplace have only emerged quite recently, and the market is mostly comprised of wearable tracking devices and the AlertMeter® app.
With COVID-19 compounding concerns over cognitive impairment in the workplace (see COVID-19 and Absenteeism in the Workplace: Causes and Costs) and also making it more unlikely for wearable or shared devices to be safely shared amongst workers, the AlertMeter® has cemented its position as the most viable and most popular workplace impairment solution on the market.
Workplaces that have implemented AlertMeter® impairment testing during this time have seen tremendous improvements in overall safety metrics as well as safety culture:
- Decreases in worker's compensation claims
- Decreases in safety incidents
- Decreases in accident severity
- Decreases in costs of accidents
- Decreases in turnover rate
- Decreases in error rate
- Increases in safety awareness
- Increases in safety compliance
- Increases in worker alertness
- Increases in productivity
- Increases in worker accountability and responsibility
- Increases in communication
- Increases in trust and morale
Achieving similar results requires companies to raise awareness about what impairment testing is and what it involves. This means educating workers, unions, company executives, and fellow managers so that everyone is well-informed and stands unified behind the decision. It has been shown that any hesitance or pushback against the implementation of impairment tests arises due to a lack of understanding.
For example, companies who use AlertMeter® often report that any workers who are initially opposed to the idea of impairment testing end up fully embracing it once they recognize how it works. An AlertMeter® case study at one construction site reported:
"When new middle management came on and were not debriefed on the AlertMeter® system, they did not understand its value and discarded using it. However, most employees who were using AlertMeter® before the new managers came on continued to use it and thought it was valuable, even though they were no longer being compelled to use it. Now, new manager orientation includes an introduction to AlertMeter®."
When a company's goal is to increase safety and improve safety culture, impairment testing with AlertMeter® has never disappointed. If your company, your executives, your workers, and your fellow managers stand united behind the belief that safety is and always should be the number one priority, you're ready for AlertMeter®.
Basner, Mathias, and Joshua Rubinstein. “Fitness for duty: a 3-minute version of the Psychomotor Vigilance Test predicts fatigue-related declines in luggage-screening performance.” Journal of occupational and environmental medicine vol. 53,10 (2011): 1146-54. doi:10.1097/JOM.0b013e31822b8356
Butler B, Tranter D. Behavioral tests to assess performance. In: Macdonald S, Roman P, editors. Research Advances in the Workplace: Volume 11. Drug Testing in the Workplace. New York: Plenum Press; 1994. pp. 231–255. [Google Scholar]
Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon.
Dawson, D., Reid, K. Fatigue, alcohol and performance impairment. Nature 388, 235 (1997). https://doi.org/10.1038/40775
ECA. (2016). Problematic substance abuse in aviation: Testing & peer support programmes. European Cockpit Association AISBL. Retrieved from https://www.eurocockpit.be/sites/default/files/problematic_substance_
Fell, James C, and Robert B Voas. “The effectiveness of a 0.05 blood alcohol concentration (BAC) limit for driving in the United States.” Addiction (Abingdon, England) vol. 109,6 (2014): 869-74. doi:10.1111/add.12365
Lamond N, Dawson D. "Quantifying the performance impairment associated with fatigue." J Sleep Res. 1999 Dec;8(4):255-62. doi: 10.1046/j.1365-2869.1999.00167.x. PMID: 10646165.
Maltby, L. (2010). Impairment testing—Does it work? National Workrights Institute. Retrieved from http://www.workrights.org/nwi_drugTesting_impairmentTesting.html
Seijts, G. H. & O’Farrell, G. (2005). Urine collection jars versus video games: Perceptions of three stakeholder groups
toward drug and impairment testing programs. Journal of Drug Issues 35(4): 885–916. doi:10.1177/002204260503500411
Zhang, Jiawei. "Cognitive functions of the brain: Perception, attention and memory." arXiv preprint arXiv:1907.02863 (2019).