From the NATCA VOICE, a publication of the National Air
Traffic Controller's Assn.(Feb.'99)
Fit
For Duty...Or Is It? by Gene Tinelli, MD, addiction
psychiatrist, with Lee Hamlett, Syracuse Tower NATCA Local
president, and Mike Smithson, Syracuse Tower NATCA Local legislative
rep.
It is an uncomfortable event that each air traffic
control facility experiences about once a year. Management informs
the union that the people with the official looking white coats are
here to collect a urine sample from a "randomly" selected list of
people and make those randomly selected people prove they are
innocent of any illegal substance use.
First of all, there is
nothing really random about the selection process. If you happen to
have a day shift, you will probably be tested. If you work mostly
evenings or midnight shifts, there is a good chance you may never
have to prove your innocence.
The drug testing process puts a
reverse spin on innocent until proven guilty. When the white coats
visit, everyone selected is instructed to provide a urine specimen.
Tampering with the specimen or obstructing the collection process
can result in termination of employment. Resistance is futile. One
feels like they are being viewed at as guilty and the hope is the
urine specimen accurately proves "innocence", if not
competence.
But is drug testing's primary goal to insure the
flying public's safety? From the employee's point of view, it
appears to be a way for a not so benevolent employer to humiliate,
insult and possibly persecute their own employees. If the employer
were most concerned about insuring the flying public's safety, they
would not have a drug testing system in place that allowed employees
tested to continue working for days to weeks until the results are
known. Potentially, anyone legitimately testing positive will have
been allowed to work a minimum of 2-3 shifts before being prevented
from working airplanes. Those that test negative unfortunately are
not told by management for 2-3 weeks. This can result in increased
anxiety on the part of the employee waiting for the results and does
nothing to enhance employee morale or competence. Not only would it
be appropriate to be informed immediately about negative results,
but an apology for an undignified invasion of privacy would also be
in order.
The FAA, for some reason, doesn't realize that
their 'get the controller' attitude makes it more difficult for
those few that may have a substance use problem from coming forward
and getting real help for their situation, instead of hiding it
until it possibly gets out of control. Anyone that does have a
problem has to get help without the benefit of insurance or employer
support. So how did we get into this mess?
Due to the Drug
Free Workplace Act of 1986, there have been dramatic increases in
the use of pre-employment and random testing of American workers for
illicit drugs such as heroin, cocaine, amphetamines and marijuana.
Whereas in 1987, only 21.5% of the respondents surveyed by the
American Management Association reported that they conducted some
form of drug testing, 87.3 % indicated that they tested in 1994. The
rationale for this testing is to assure a drug free work force, to
increase safety by lowering accidents, mistakes or errors in
judgment, and to enhance worker productivity. However, given
testing's cost, intrusiveness and dislike among the work force, it
is reasonable to ask whether it works.
In 1994, the National
Academy of Sciences issued a report which was a comprehensive
analysis of all available data regarding the effect of drug use upon
employers, including discussions of the relationship between drug
use and safety and productivity. With regard to drug testing
lowering drug use, they concluded ³despite beliefs to the contrary,
the preventative effects of drug testing programs have never been
adequately demonstrated². The studies they reviewed suffered ³from
serious methodological problems that preclude any scientific
assessment of the impact . . . on work force productivity².
Recreational drug users were found to be no less productive than
their co-workers and the report concluded that most recreational
drug users, like most social drinkers, do not become drug dependent
and do not use drugs on the job. The Academy also found no
relationship between drug test results and safety. Employees who
used illegal drugs off-the-job were no more likely to be involved in
workplace accidents that other employees.
The National
Institute of Drug Abuse has also published results of companies with
drug testing programs. For example, Georgia Power and Light
conducted an extensive analysis of their testing program and
examined rates of promotion, demotion, and absenteeism to see if
there were differences in the performance of employees who tested
positive and negative for off-duty drug use. They found no
significant differences between those who tested positive and those
who tested negative.
A recent study by the Le Moyne College
Institute of Industrial Relations took a novel approach to drug
testing and compared productivity between 63 firms within the
computer and communications equipment industries. They found that
pre-employment and random drug testing did not succeed in improving
productivity and, surprisingly, companies adopting drug testing
programs were found to exhibit lower levels of productivity than
their counterparts that did not. There are possible explanations for
these findings.
Drug testing may not lower drug use. Although
proponents of drug testing presume it will discourage drug use,
those current employees most deterred by the prospect of workplace
testing are likely the most casual offers users who abstain from
their at-home use in order to avoid potential embarrassment and job
loss. Because people who have alcohol and other drug dependencies
have less control over their drug intake, testing may not so easily
deter their substance abuse, which has greater potential for
personal and organizational harm. Some members of this group may
thwart detectors by altering their own urine or even substituting
drug-free urine samples and testing cannot prevent employee drug use
in the workplace. Thus, applicant screening may not keep both
serious and casual users from gaining employment in the first
place.
Drug testing may not capture impairment on the job.
Workers may switch from drugs that persist in the urine for long
periods of time to other drugs that are either detectable for much
shorter periods of time or not check for at all. For example, when
the U. S. military started their mandatory urine screenings in Feb.
1981, marijuana use went down but use of alcohol, which may be the
drug most associated with work productivity losses, went up. Tests
can also produce false positives and negatives and workers can alter
their urine to lower the detection rate.
Drug testing may
lower productivity. First, testing could undermine worker morale and
motivation. Surveys have shown that workers have negative attitudes
toward testing, believing it is unreasonable search and seizure and
an unnecessary and intrusive invasion of privacy. Second, drug
testing is a large cost to an organization. When Texas Instruments,
one of America's largest electronics manufacturing companies,
evaluated their urine testing program, they found that it cost $1
million to test 1000 employees. Others have viewed costs in terms of
dollars-per-positive test. American Management Association data
suggests that the average cost of a confirmed positive test is in
excess of $10,000. The average cost of a confirmed 'positive' in
federal testing programs is in excess of $77,000! Drug testing as we
do it now does not directly affect safety as it cannot detect drug
use in time to prevent it from causing harm. Testing can only
distinguish between someone who has used or been exposed to a drug
and someone who has not; it cannot tell when the former took the
drug, how much was taken, how frequently this person has taken this
drug, or the effect of the drug on the user. By the time an
employee's test result has been interpreted as positive, any
drug-impaired behavior would already have taken its toll. On the
other hand, the metabolites in a person's urine that produce a
positive test result does not necessarily mean the person cannot
work, as any effects of the drug could have long worn off by the
time the test was administered. Furthermore, research finds that
most on-the-job accidents result from stress, fatigue and illness
rather than from drug use. The one drug test that is correlated with
actual real-time impairment, analysis of the breath for alcohol, is
the one least frequently used. Ironically, it is also one of the
cheapest.
Drug tests don't prevent accidents because they
don't address the root problems that lead to substance abuse. But
good management and counseling can. Three methods are generic. Good
reference checking can more effectively screen out poor employees,
especially if the checking involves personally speaking with the
applicantıs last direct supervisor. Also, retaining outside
professionals to do reference checks is very effective. Improved
supervisory training, especially of first line supervisors, can
detect impairment early and supervisors can be trained on how to
intervene. Finally, employee assistance programs (EAPs) help people
facing emotional, health, financial or substance abuse problems that
can affect job performance. EAP counselors decide what type of help
is needed: staff support, inpatient treatment, AA meetings, and the
like. In this context, the goal is rehabilitation and wellness
not punishment. These methods also show that impairment results more
commonly from domestic problems, poor management of human resources,
and, when alcohol or other drugs are involved, drug dependency
rather than drug use.
However, our war on drugs (actually, a
war on users of certain politically incorrect drugs) obscures our
vision in a more fundamental manner. In our myopic focus on
chemicals in the body, we lose sight of the actual goal, fitness for
duty. The fundamental question is: Does the employee know their job
description and can they do it on a daily basis? Fitness for duty is
what occupational competency and safety are all about and drug
testing only gives the illusion of capturing it.
What is
needed and what should ultimately concern managers is an alternative
to biological testing that is better suited to identifying the
substandard work -- before it occurs -- while preserving employees'
rights: actual performance-based fitness-for-duty testing.
Computer-assisted performance tests, which measure hand-eye
coordination and response time, Is a better way of detecting whether
employees are up to the job. NASA, for example, has long used
task-performance tests to determine whether astronauts and pilots
are fit or unfit for work whether the cause is substance
abuse, fatigue, or physical illness.
The technology of
performance testing was developed 30 years ago, but it has been
applied commercially only since the late 1980s. According to
accounts in the popular press, the computer-based critical tracking
test, a sort of 'video game' in which employees engage in the same
psychomotor skills their jobs require, is less intrusive and more
valid than urine testing for determining impairment that may or may
not stem from drug use. Test-takers use a control knob to try to
keep a constantly and randomly veering cursor centered on their
video screen. Employees' scores at a given trial, based on speed and
accuracy, are compared to their average previous performance.
Although test-takers' baseline performance may eventually improve, a
complex algorithm precludes mastery and the test has been designed
so that an employee cannot trick the computer into establishing a
low baseline (so as to pass the test later while impaired), because
an unusual lack of progress on baseline-setting trials is
recognizable.
Fitness-for-duty testing has been faulted for
not ascertaining if an employee who fails an impairment test is
using drugs. As discussed, however, a major asset of
behaviorally-based tests is that they protect employee rights by not
disclosing to employers the cause of impairment. Rather, unlike
biochemical tests, they are designed to determine whether or not the
employee is impaired. If the goal is to identify impaired workers
and either refer them to treatment or to prevent them from
performing a task that may endanger themselves or others, then
behavioral indicators provide a more direct means than drug tests of
identifying employees unable to perform at required levels. To
minimize hazardous behavior and other performance problems,
behavioral indicators may be a better means than chemical
tests.
Again, the real issue should not be whether an
individual has been engaging in certain behavior (that is, ingesting
a particular quantity of a drug) that could compromise some
individuals' performance, but whether this individual's performance
has, in fact, been impaired. A valid fitness-for-duty test, unlike a
biochemical test, can more accurately assess an employee's actual
readiness for work.
Behavioral performance testing could also
detect system problems and assist management with its scheduling
practices. Imagine, for example, if everyone on a 'quick-turn'
schedule scored lower consistently over a long period. The problem
might not be drug use but rather a work recovery time that is too
short. Or, what about a controller who is bothered by a domestic
problem at home, or financial difficulties, or a family illness. A
manager aware of his or her employees may suspect something is
amiss, and, with the assistance of performance testing as a tool,
may be better able to determine a problem. A concerned, caring
manager could then initiate a private conversation, informing the
employee of the manager's observations, including the employee's
performance scores are erratic and ask if there is there anything
they'd wish to discuss. This approach would be an entirely different
scenario than the one currently in place that is known all too well:
no trust by management of it's employees, total disregard of the
fourth amendment to the Constitution (illegal search and seizure),
and the big-brother attitude that says, "'If we don't test you all
the time, then illicit drug use would be rampant."
Drug
testing could still remain a part of the process. If performance
scores are erratic and an employee asserts that a problem doesn't
exist, a voluntary physical examination, including drug screening
could be very useful. These tests, not meant as a condemnation of
activity, may identify other problems, like a low blood sugar level,
or other ailment. A case can be made of the collateral benefits from
performance testing.
There are a number of concerns of
performance based fitness-for-duty testing. Can they predict actual
job performance? Can employees cheat or override impairment to pass
a fitness-for-duty test? What are the costs of these tests and what
kinds of policies have organizations devised to administer these
tests and address test failures? How do employees view
fitness-for-duty testing?
Unfortunately, the answers to these
questions are mixed or the data is not yet available. The best and
most recent review (Comar, 1995) stated ³performance-based
fitness-for-duty testing would seem to be a promising tool to
prevent substandard work and unsafe behavior. The popular press has
sung the virtues of fitness-for-duty tests, and laboratory research
has supplied evidence that they are psychometrically solid. But what
has been conspicuously absent from the literature is a systematic
investigation of fitness-for-duty testing programs in
organizations². Her study reviewed archival data from two commercial
test manufacturers, interview data with managers of former and
current clients of fitness-for-duty tests, and questionnaires
completed by employees who take fitness-for-duty tests. The results
suggest that fitness-for-duty testing loses something in the
translation from theory to practice. These tests emerge valid and
reliable in laboratory investigations; yet current test-takers and
managers of former test-takers assert that fit individuals fail
while obviously impaired individuals pass, and employees claim they
can pass or fail their performance tests at will. Further,
introducing and administering a fitness-for-duty testing program
require an ongoing commitment, which, apparently, has left most
organizations no time to monitor whether fitness-for-duty testing
actually enhances organizational safety and productivity. Could the
FAA and NATCA be willing to 'join hands' on this project and
determine it's validity?
So, where does that leave us in the
workplace? "Random" substance abuse testing is wrong, although the
Supreme Court disagrees. Random drug testing appears to be a
violation of: 1) our right to not be required to testify against
ourselves (5th Amendment) and 2) an illegal search and seizure
without probable cause. (4th Amendment). Again, if our employer
really cared about safety and the well being of its employees, they
would use a different process for determining an employee's
fitness-for-duty and eliminate any punishment for an employee that
voluntarily sought help for an alcohol or drug problem. Even going
to EAP for relationship or financial problems could conceivably
result in the EAP counselor determining that the root of the problem
is alcohol or drug related. Urine drug screening is ineffective,
disliked and may be counterproductive. The future for this type of
testing is hair analysis, which can detect most politically
incorrect drug use (except alcohol) for months in the past but, like
urine screening, cannot tell us about real-time competency.
Performance based fitness-for-duty testing is a much more rational
approach but obviously needs more workplace evaluation to determine
its effectiveness and acceptability.
NATCA could be more
proactive on these issues by:
- Calling for a moratorium on current workplace testing.
- Sponsoring and conducting research on performance based
fitness-for-duty testing in the workplace.
- Devising acceptable organizational policies if research
indicates that fitness-for-duty testing is useful.
- Encouraging the use of known methods of ensuring productivity
- better reference checking, improved supervisory training, and
enhanced employee assistance plans.
Whether or not fitness for duty testing is the answer is yet to
be seen. It offers an interesting alternative to the distrustful
environment in place now. NATCA, while continuing to protect the
rights of bargaining unit members before, during and after alcohol
and substance testing, could become proactive in looking for
alternatives to our current process.
However, maybe the
answer is right in front of us. Good supervision is, after all,
nothing more than paying attention. If management does it's job and
properly and consistently observes the operation of its employees
and the system, that should be enough of a skills check for
anyone.
Written by Gene Tinelli, MD, addiction
psychiatrist, with Lee Hamlett, Syracuse Tower NATCA Local
president, and Mike Smithson, Syracuse Tower NATCA Local legislative
rep. All three are members of ReconsiDer: Forum on Drug Policy.
(http://www.reconsider.org)
Under the Influence? Drugs and the American Workforce, National
Academy of Sciences (Institute of Medicine), National Academy Press
(1994)
Drugs in the Workplace, Research and Evaluation Data,
National Institute of Drug Abuse (Department of Health and Human
Services) Research Monograph 91 (1989)
Drug Testing and
Labor Productivity: Estimates Applying a Production Function Model,
Edward M. Shepard and Thomas J. Clifton, College Institute of
Industrial Relations Research Paper 18 (1998)
Drug
Testing in the Workplace, American Civil Liberties Union Briefing
Paper #5 (1996) Privacy in America: Workplace Drug Testing, American
Civil Liberties Union Workplace Rights Briefing Paper
(1997)
An Evaluation of Fitness-for-Duty Testing,
Presented at the 1995 American Psychological Association Conference
by Debra R. Comer.