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CORK Bibliography: The Workplace

79 citations. January 2010 to present

Prepared: September 2011

Aspropoulos E; Lazuras L; Rodafinos A; Eiser JR. Can you please put it out? Predicting non-smokers' assertiveness intentions at work. Tobacco Control 19(2): 148-152, 2010. (32 refs.)

Objective The present study aimed to identify the psychosocial predictors of non-smoker employee intentions to ask smokers not to smoke at work. The predictive effects of past behaviour, anticipated regret, social norms, attitudinal, outcome expectancy and behavioural control beliefs were investigated in relation to the Attitudes-Social influence-self-Efficacy (ASE) model. Methods: Data were collected from Greek non-smoker employees (n = 137, mean age = 33.5, SD = 10.5, 54.7% female) in 15 companies. The main outcome measure was assertiveness intention. Data on participants' past smoking, age, gender and on current smoking policy in the company were also collected. Results: The majority of employees (77.4%) reported being annoyed by exposure to passive smoking at work, but only 37% reported having asked a smoker colleague not to smoke in the last 30 days. Regression analysis showed that the strongest predictor of non-smokers' assertiveness intentions was how often they believed that other non-smokers were assertive. Perceived control over being assertive, annoyance with secondhand smoke (SHS) exposure at work and past assertive behaviour also significantly predicted assertiveness intentions. Conclusions: Assertiveness by non-smoker employees seems to be guided mainly by normative and behavioural control beliefs, annoyance with SHS exposure at work, and past behaviour. Interventions to promote assertiveness in non-smokers might benefit from efficacy training combined with conveying the messages that the majority of other non-smokers are frequently annoyed by exposure to SHS, and that nearly half of all non-smokers are assertive towards smokers.

Bacharach SB; Bamberger P; Biron M. Alcohol consumption and workplace absenteeism: The moderating effect of social support. Journal of Applied Psychology 95(2): 334-348, 2010. (82 refs.)

Although it is commonly assumed that alcohol consumption has a significant impact on employee absenteeism, the nature of the alcohol absence relationship remains poorly understood. Proposing that alcohol impairment likely serves as a key mechanism linking drinking and work absence, we posit that this relationship is likely governed less by the amount of alcohol consumed and more by the way it is consumed. Using a prospective study design and a random sample of urban transit workers, we found that the frequency of heavy episodic drinking over the previous month is positively associated with the number of days of absence recorded in the subsequent 12-month period, whereas modal consumption (a metric capturing the typical amount of alcohol consumed in a given period of time) is not. In addition, consistent with both volitional treatments of absenteeism and social exchange theory, perceived coworker support was found to attenuate, and supervisory support to amplify, the link between the frequency of heavy episodic drinking and absenteeism.

Claessen H; Arndt V; Drath C; Brenner H. Smoking habits and occupational disability: A cohort study of 14,483 construction workers. Occupational and Environmental Medicine 67(2): 84-90, 2010. (39 refs.)

Objectives Although smoking causes a variety of diseases and both, a high smoking prevalence and permanent occupational disability are a great burden on the population level, data about the impact of smoking habits on occupational disability are sparse. The objective of this study was to examine the influence of smoking habits on occupational disability among construction workers, an occupational group with particularly high smoking prevalence. Methods The association between smoking and occupational disability was examined during a mean follow-up of 10.8 years in a cohort of 14,483 male construction workers in Wurttemberg, Germany. The cohort was linked to the regional pension register of the German pension fund to identify workers who were granted a disability pension during the follow-up. HRs (Hazard Ratios) were calculated with non-smokers as reference by the Cox proportional hazards model adjusting for potential confounding factors such as age, nationality, type of occupation, alcohol consumption and body mass index. Results Overall, 2643 cases of occupational disability were observed, with dorsopathy (21%) being the most common cause. Clear dose-response relationships were seen between smoking and occupational disability due to all causes, as well as occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy. Particularly strong associations were seen between heavy smoking (>= 20 cigarettes/day) and occupational disability due to mental and respiratory diseases (HR 3.25, 95% CL 1.93 to 5.46 and HR 3.26, 95% CL 1.69 to 6.27, respectively). Conclusion: Smoking is associated with increased risk of occupational disability among construction workers, in particular occupational disability due to respiratory, cardiovascular and mental diseases, cancer and dorsopathy.

del Libano M; Llorens S; Salanova M; Schaufeli W. Validity of a brief workaholism scale. Psicothema 22(1): 143-150, 2010. (29 refs.)

The current study contributes to our understanding of workaholism as a negative construct, and to its measurement by examining the psychometric properties of a short 10-item workaholism scale called DUWAS (Dutch Work Addiction Scale). Confirmatory factor analyses were carried out in a heterogeneous sample of 2,714 employees from the Netherlands (n= 2,164) and Spain (n= 550). The results confirmed the expected two-factor structure of workaholism: working excessively and working compulsively. Moreover, multi-group analyses showed that this two-factor structure was invariant across both countries. Lastly, negative correlations among workaholism and psychosocial well-being (i.e., perceived health and happiness) are indicators of the negative nature of workaholism.

Gadomski AM; Stayton M; Krupa N; Jenkins P. Implementing a smoke-free medical campus: Impact on inpatient and employee outcomes. Journal of Hospital Medicine 5(1): 51-54, 2010. (18 refs.)

BACKGROUND: Hospitals fear that transitioning to a smoke-free medical campus will decrease patient volume, particularly for patients who smoke. When our hospital campus, a 180-bed acute care facility located in a small town, implemented the smoke-free medical campus on July 1, 2006, we prospectively monitored inpatient and employee outcomes. METHODS: inpatient volume, percentage of inpatients who currently smoke, nicotine replacement therapy (NRT) orders (obtained from electronic medical records), the number of inpatients who signed out against medical advice (obtained from incident reports), and employee tobacco-use rates from annual occupational health assessments were compared pre-ban and post-ban. RESULTS: The monthly average for the percentage of inpatients who currently smoke has been steady, at 20% to 22% post-ban. NRT orders tripled after the ban. There was no significant change in the rate of inpatients who signed out against medical advice pre-ban and post-ban. During the year preceding the ban, 1.50 employees participated in a cessation program offered by Employee Health. The pre-ban employee self-reported smoking rate for the same 4-month period (March-June) was 14.3% in 2005, 14.8% in 2006, and 9% in 2007 (P < 0.0002). CONCLUSIONS: Implementing a smoke-free medical campus did not adversely affect inpatient volume (even among smokers), significantly increased inpatient NRT use, and decreased hospital employee smoking rates.

Eisner MD. Secondhand smoke at work. (review). Current Opinion in Allergy and Clinical Immunology 10(2): 121-126, 2010. (46 refs.)

Purpose of review: Secondhand smoke (SHS) exposure in the workplace remains common and has important acute and chronic health effects. The present study reviews the recent evidence linking workplace SHS exposure with poor health and the benefits of smoke-free workplace legislation. Recent findings: Workplace SHS exposure continues to occur in many parts of the United States and around the world. Occupational SHS exposure has been linked to serious chronic health effects including lung cancer, cardiovascular disease, chronic obstructive pulmonary disease, and poor general health. Smoke-free workplace laws rapidly reduce workplace SHS exposure and improve respiratory health including symptoms and lung function. Smoke-free workplace legislation is also expected to reduce the chronic health effects of passive smoking, including cardiopulmonary disease and lung cancer. Summary: Occupational exposure to SHS has serious negative health consequences and will shorten lifespan. Smoke-free workplace legislation should be universally adopted around the world.

Hermansson U; Helander A; Brandt L; Huss A; Ronnberg S. Screening and brief intervention for risky alcohol consumption in the workplace: Results of a 1-year randomized controlled study. Alcohol and Alcoholism 45(3): 252-257, 2010. (35 refs.)

Aims: To assess the effectiveness of brief alcohol intervention on hazardous and harmful drinking in the 12-month period after a voluntary alcohol screening. Methods: At a large transport company, employees presenting to the occupational health services for a routine health and lifestyle check-up were offered to undertake an alcohol screening by means of self-report (the Alcohol Use Disorders Identification Test-AUDIT) and a biomarker (carbohydrate-deficient transferrin in serum-CDT). Those screening positive for the AUDIT and/or CDT were randomized to a brief or comprehensive intervention group or to a control group. An identical follow-up session was performed 12 months later. Results: Of 990 employees (68% men) that volunteered for the alcohol screening, 194 (20%) tested positive for the AUDIT and/or CDT. Among the 158 (81%) subjects who also attended the follow-up session, the frequency of positive screening results at baseline/follow-up were 51%/23% for the AUDIT (P < 0.0001) and 58%/34% (P < 0.0001) for CDT. However, there were no significant differences between the brief and comprehensive intervention groups or between the intervention groups and the control group. Conclusion: The results suggested that alcohol screening and brief intervention performed in connection with routine health and lifestyle examinations in the workplace may be effective in reducing alcohol consumption. Given the lack of difference in outcome between the intervention groups and the control group, alcohol screening may in itself cause reduction in drinking. In addition, at least some of the positive effect may be explained by regression towards the mean.

Macdonald S; Hall W; Roman P; Stockwell T; Coghlan M; Nesvaag S. Testing for cannabis in the work-place: A review of the evidence. (review). Addiction 105(3): 408-416, 2010. (75 refs.)

Background: Urinalysis testing in the work-place has been adopted widely by employers in the United States to deter employee drug use and promote 'drug-free' work-places. In other countries, such as Canada, testing is focused more narrowly on identifying employees whose drug use puts the safety of others at risk. Aims: We review 20 years of published literature on questions relevant to the objectives of work-place drug testing (WPDT), with a special emphasis on cannabis, the most commonly detected drug. Results: We conclude (i) that the acute effects of smoking cannabis impair performance for a period of about 4 hours; (ii) long-term heavy use of cannabis can impair cognitive ability, but it is not clear that heavy cannabis users represent a meaningful job safety risk unless using before work or on the job; (iii) urine tests have poor validity and low sensitivity to detect employees who represent a safety risk; (iv) drug testing is related to reductions in the prevalence of cannabis positive tests among employees, but this might not translate into fewer cannabis users; and (v) urinalysis has not been shown to have a meaningful impact on job injury/accident rates. Conclusions: Urinalysis testing is not recommended as a diagnostic tool to identify employees who represent a job safety risk from cannabis use. Blood testing for active tetrahydrocannabinol (THC) can be considered by employers who wish to identify employees whose performance may be impaired by their cannabis use.

Osilla KC; dela Cruz E; Miles JNV; Zellmer S; Warkins K; Larimer ME et al. Exploring productivity outcomes from a brief intervention for at-risk drinking in an employee assistance program. Addictive Behaviors 35(3): 194-200, 2010. (64 refs.)

Brief intervention (BI) research has traditionally examined alcohol and drug use outcomes; however it is unknown whether BIs can also impact on-the-job productivity. This exploratory study examines changes in workplace productivity and related costs for clients receiving a BI for at-risk drinking in the employee assistance program (EAP). Participants were 44 clients attending the EAP for behavioral health concerns, screened for at-risk drinking, assigned to BI + Usual Care (n = 25) or UC alone (n = 19). and who completed 3-month follow-up. Absenteeism, presenteeism, and productivity costs were derived as outcomes. At follow-up, participants in the BI + UC group had improved productivity when at work (presenteeism) compared to the UC group. The estimated cost savings from improved productivity for the BI + UC group was $1200 per client over the UC group. Groups did not differ by absenteeism (missed days of work). Preliminary evidence suggests the broad impact Bls may have. Implications for future BI research are discussed.

Osypuk TL; Acevedo-Garcia D. Support for smoke-free policies: A nationwide analysis of immigrants, US-born, and other demographic groups, 1995-2002. American Journal of Public Health 100(1): 171-181, 2010. (50 refs.)

Objectives. We examined whether support for tobacco control policies varies by demographic group, including nativity status (i.e., immigrant versus US born). Methods. We analyzed 1995 to 2002 data from the Current Population Survey Tobacco Use Supplement (n=543951). The outcome was a summary attitudinal measure assessing support of smoking bans in 4 of 6 venues. Results. US-born respondents, smokers, male respondents, Native Americans, Whites, and those who were unmarried, of lower socioeconomic status, and whose workplaces and homes were not smoke free were less likely to support smoking bans. Immigrants exhibited stronger support for banning smoking in every venue, with a generation-specific gradient in which support eroded with increasing assimilation to the United States. Levels of support were more than twice as high among immigrants as among US-born respondents (odds ratio [OR]=216; 95% confidence interval [CI]= 2.08, 2.23). Naturalized citizens displayed higher support than US-born citizens, which may be relevant for mobilization of the electorate. Differences in population composition and contexts (e.g., smoke-free workplaces) only partially accounted for immigrants' stronger level of support. Conclusions. Immigrants and their children may be valuable tobacco control allies given their supportive attitudes toward smoke-free policies.

Okechukwu CA; Krieger N; Chen J; Sorensen G; Li Y; Barbeau EM. The association of workplace hazards and smoking in a US multiethnic working-class population. Public Health Reports 125(2): 225-233, 2010. (53 refs.)

Objective. We investigated the extent to which smoking status was associated with exposure to occupational (e.g., dust, chemicals, noise, and ergonomic strain) and social (e.g., abuse, sexual harassment, and racial discrimination) workplace hazards in a sample of U.S. multiethnic working-class adults. Methods. United for Health is a cross-sectional study designed to investigate the combined burden of occupational and social workplace hazards in relation to race/ethnicity, gender, and wage and to evaluate related health effects in a working-class population. Using validated measures, we collected data from 1,282 multiethnic working-class participants using audio computer-assisted interviews. We used multiple imputation methods to impute data for those missing data. Crude and adjusted logistic odds ratios (ORs) were modeled to estimate ORs and 95% confidence intervals (CIs). Results. The prevalence of smoking was highest among non-Hispanic white workers (38.3%) and lowest for foreign-born workers (13.1%). We found an association between racial discrimination and smoking (OR=1.12, 95% Cl 1.01, 1.25). The relationship between smoking and sexual harassment, although not significant, was different for black women compared with men (OR=1.79, 95% Cl 0.99, 3.22). We did not find any associations by workplace abuse or by any of the occupational hazards. Conclusion. These results indicate that racial discrimination might be related to smoking in working-class populations and should be considered in tobacco-control efforts that target this high-risk population.

Ota A; Masue T; Yasuda N; Tsutsumi A; Mino Y; Ohara H et al. Psychosocial job characteristics and smoking cessation: A prospective cohort study using the Demand-Control-Support and Effort-Reward Imbalance job stress models. Nicotine & Tobacco Research 12(3): 287-293, 2010. (33 refs.)

A prospective cohort study was conducted to examine the effects of psychosocial job characteristics on smoking cessation. Previous studies have failed to indicate consistently that psychosocial job characteristics predicted smoking cessation. Using the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models simultaneously, we assessed psychosocial job characteristics more comprehensively than did previous researchers. This study was performed using a population derived from a corporate manufacturing group in Japan. At the baseline, 579 (41%) of 1,423 middle-aged (>= 39 years) male employees were smokers. These male smokers were considered as the study subjects and were asked to undergo a follow-up examination after 2 years. Prospective analysis of the relationship between psychosocial job characteristics at the baseline and smoking cessation at the follow-up was performed. Job strain, social support, effort-reward imbalance, and overcommitment to work were assessed as psychosocial job characteristic factors. The smoking cessation rate among the study subjects at the follow-up was recorded as 5% (31/579). No psychosocial job characteristic factors at the baseline were significantly related to smoking cessation at the follow-up. Even with the simultaneous use of the DCS and ERI models, we did not find positive results in terms of the prospective effects of psychosocial job characteristics on smoking cessation. Considering the results of relevant previous studies and those of the present study, we suppose that psychosocial job characteristics could have essentially little effect on smoking cessation.

Pollack KM; Austin W; Grisso JA. Employee assistance programs: A workplace resource to address intimate partner violence. Journal of Women's Health 19(4): 729-733, 2010. (29 refs.)

Purpose: Intimate partner violence (IPV) is a major public health problem with significant impact on the workplace. Employee assistance programs (EAPs) are a confidential benefit to assist employees and their families with a variety of problems that may negatively affect their job performance. The purpose of this systematic review is to study the extant literature to identify articles that have explored the role of EAPs in addressing IPV. Methods: We searched Medline, PsychINFO, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) for English-language papers that have explored how EAPs can address IPV. Articles published through 2008 were included. Results: Our review yielded nine articles, mostly from EAP-centered journals. Nearly all of the studies were published before the year 2000 and primarily describe the need for EAPs to be more engaged in preventing violence against women. Most of the studies were commentaries, often using case reports to support recommendations on how EAPs could address IPV. Results from the two intervention studies revealed close connections between EAP clients being treated for alcoholism and IPV perpetration and the effectiveness of a standardized tool to identify EAP clients experiencing IPV. Conclusions: Research in this area is in its infancy, and more studies are needed to inform the formulation of evidence-based policies and programs that guide the role of EAPs in addressing IPV. The lack of research on how EAPs address IPV is alarming, as many employers state that they often refer employees affected by IPV to the EAP for assistance.

Vinnikov D; Brimkulov N; Shahrir S; Breysse P; Navas-Acien A. Excessive exposure to secondhand tobacco smoke among hospitalitality workers in Kyrgyzstan. International Journal of Environmental Research and Public Health 7(3): 966-974, 2010. (18 refs.)

The aim of this study was to assess the levels of secondhand smoke (SHS) exposure of men and women in public places in Kyrgyzstan. This cross-sectional study involved 10 bars and restaurants in Bishkek the capital city of Kyrgyzstan. Smoking was allowed in all establishments. Median (interquartile range) air nicotine concentrations were 6.82 (2.89, 8.86) mu g/m(3). Employees were asked about their smoking history and exposure to SHS at work. Employees were exposed to SHS for mean (SD) 13.5 (3.6) hours a day and 5.8 (1.4) days a week. Women were exposed to more hours of SHS at work compared to men. Hospitalitality workers are exposed to excessive amounts of SHS from customers. Legislation to ban smoking in public places including bars and restaurants is urgently needed to protect workers and patrons from the harmful effects of SHS.

Wang M; Liu SQ; Zhan YJ; Shi JQ. Daily work-family conflict and alcohol use: Testing the cross-level moderation effects of peer drinking norms and social support. Journal of Applied Psychology 95(2): 377-386, 2010. (69 refs.)

In the current study, we conducted daily telephone interviews with a sample of Chinese workers (N = 57) for 5 weeks to examine relationships between daily work family conflict and alcohol use. Drawn from the tension reduction theory and the stressor vulnerability model, daily work family conflict variables were hypothesized to predict employees' daily alcohol use. Further, social variables (i.e., peer drinking norms, family support, and coworker support) were hypothesized to moderate the relationship between work family conflict and alcohol use. Results: showed that daily work-to-family conflict but not family-to-work conflict had a significant within-subject main effect on daily alcohol use. In addition, there was significant between-subject variation in the relationship between work-to-family conflict and alcohol use, which was predicted by peer drinking norms, coworker support, and family support. The current findings shed light on the daily health behavior consequences of work family conflict and provide important theoretical and practical implications.

Leeks KD; Hopkins DP; Soler RE; Aten A; Chattopadhyay SK. Worksite-based incentives and competitions to reduce tobacco use: A systematic review. (review). American Journal of Preventive Medicine 38(2, Supplement 2): S263-S274, 2010. (55 refs.)

The Guide to Community Preventive Service (Community Guide) methods for systematic reviews were used to evaluate the evidence of effectiveness of worksite-based incentives and competitions to reduce tobacco use among workers. These interventions offer a reward to individuals or to teams of individuals on the basis of participation or success in a specified smoking behavior change (such as abstaining from tobacco use for a period of time). The review team identified a total of 26 published studies, 14 of which met study design and quality of execution criteria for inclusion in the final assessment. Only one study, which did not qualify for review, evaluated the use of incentives when implemented alone. All of the 14 qualifying studies evaluated incentives and competitions when implemented in combination with a variety of additional interventions, such as client education, smoking cessation groups, and telephone cessation support. Of the qualifying studies, 13 evaluated differences in tobacco-use cessation among intervention participants, with a median follow-up period of 12 months. The median change in self-reported tobacco-use cessation was an increase of 4.4 percentage points (a median relative percentage improvement of 67%). The present evidence is insufficient to determine the effectiveness of incentives or competitions, when implemented alone, to reduce tobacco use. However, the qualifying studies provide strong evidence, according to Community Guide rules, that worksite-based incentives and competitions in combination with additional interventions are effective in increasing the number of workers who quit using tobacco. In addition, these multicomponent interventions have the potential to generate positive economic returns over investment when the averted costs of tobacco-associated illnesses are considered. A concurrent systematic review identified four studies with economic evidence. Two of these studies provided evidence of net cost savings to employers when program costs are adjusted for averted healthcare expenses and productivity losses, based on referenced secondary estimates.

Muggli ME; Lockhart NJ; Ebbert JO; Jimenez-Ruiz CA; Miranda JAR; Hurt RD. Legislating tolerance: Spain's national public smoking law. Tobacco Control 19(1): 24-30, 2010. (96 refs.)

While Spain's national tobacco control legislation prohibits smoking in many indoor public places, the law provides for an exception to the prohibition of smoking by allowing separate seating sections and ventilation options in certain public places such as bars and restaurants, hotels and airports. Accordingly, Spain's law is not aligned with Article 8 Guidelines of the World Health Organization's Framework Convention on Tobacco Control, which requires parties to ensure universal protection against secondhand smoke exposure in all enclosed public places, workplaces and on all means of public transport. Spain's law is currently being promoted by the tobacco companies in other countries as a model for smoke-free legislation. In order to prevent weakening of smoke-free laws in other countries through industry-supported exceptions, we investigated the tactics used by the tobacco companies before the implementation of the new law and assessed the consequences of these actions in the hospitality sector. Internal tobacco industry documents made public through US litigation settlements dating back to the 1980s were searched in 2008-9. Documents show that tobacco companies sought to protect hospitality venues from smoking restrictions by promoting separate seating for smokers and ineffective ventilation technologies, supporting an unenforceable voluntary agreement between the Madrid local government and the hospitality industry, influencing ventilation standards setting and manipulating Spanish media. The Spanish National Assembly should adopt comprehensive smoke-free legislation that does not accommodate the interests of the tobacco industry. In doing so, Spain's smoke-free public places law would be better aligned with the Framework Convention on Tobacco Control.

Butler AB; Dodge KD; Faurote EJ. College student employment and drinking: A daily study of work stressors, alcohol expectancies, and alcohol consumption. Journal of Occupational Health Psychology 15(3): 291-303, 2010. (73 refs.)

We examined the within-person relationships between daily work stressors and alcohol consumption over 14 consecutive days in a sample of 106 employed college students. Using a tension reduction theoretical framework, we predicted that exposure to work stressors would increase alcohol consumption by employed college students, particularly for men and those with stronger daily expectancies about the tension reducing properties of alcohol. After controlling for day of the week, we found that hours worked were positively related to number of drinks consumed. Workload was unrelated to alcohol consumption, and work-school conflict was negatively related to consumption, particularly when students expressed strong beliefs in the tension reducing properties of alcohol. There was no evidence that the effects of work stressors were moderated by sex. The results illustrate that employment during the academic year plays a significant role in college student drinking and suggest that the employment context may be an appropriate intervention site to address the problem of student drinking.

Frone MR; Brown AL. Workplace substance-use norms as predictors of employee substance use and impairment: A survey of US workers. Journal of Studies on Alcohol and Drugs 71(4): 526-534, 2010. (41 refs.)

Objective: Although much research has explored the relation of substance-use norms to substance use among college students, much less research has focused on employed adults and the workplace as a social context for social norms regarding substance use. This study explored the relation of descriptive and injunctive workplace substance-use norms regarding alcohol and illicit drug use to employee substance use. Both alcohol use and illicit drug use were explored, as well as overall and context-specific use and impairment. Method: Data were collected from a national probability sample of 2,430 employed adults (55% female) using a random-digit-dial telephone survey. Overall employee alcohol and illicit drug use were assessed, as well as use before work, use and impairment during the workday, and use after work. Results: After controlling for a number of potential covariates, injunctive norms regarding workplace alcohol and illicit drug use predicted substance use and impairment overall and across all contexts of use. Descriptive norms predicted alcohol and illicit drug use before and during work, as well as workplace impairment. Conclusions: This study shows that both workplace injunctive and descriptive norms are important predictors of substance use in the U.S. workforce. There were two general patterns, however, that were consistent across both alcohol and illicit drug use. Social norms marketing campaigns, therefore, may be a useful way for employers to target employee substance use. The present results also helped to integrate the results of several prior studies that employed narrower samples and measures.

Griffin KW; Bang H; Botvin GJ. Age of alcohol and marijuana use onset predicts weekly substance use and related psychosocial problems during young adulthood. Journal of Substance Use 15(3): 174-183, 2010. (15 refs.)

The present study examined whether age of alcohol and marijuana use onset during adolescence predicted later substance use and related problems in several areas of psychosocial functioning among young adults. A total of 621 participants completed surveys regarding current substance use from 7th through 12th grades and also completed a survey as young adults (age 24) that included questions regarding the impact of alcohol and drug use on several areas of functioning. Findings indicated that earlier age of substance use onset was positively associated with weekly use of alcohol and marijuana during young adulthood, as well as substance-related occupational, relationship, and legal problems. The majority of young adults reporting problems due to alcohol or drug use had first reported alcohol and/or marijuana use before entering high school. For women, onset of substance use prior to high school was more strongly related to negative drug-related occupational outcomes than was concurrent weekly substance use as a young adult. Findings indicated that the negative effects of early onset substance use are strongest in social and occupational functioning, areas that correspond to the DSM criteria relevant to the diagnosis of alcohol or substance use disorder.

Martin AD. Work-related negative experience: A unification model of poor employee well-being and work-related mental ill-health and substance consumption. European Psychologist 15(2): 109-120, 2010. (82 refs.)

This cross-sectional study examines the relationship between poor employee well-being (PEWB) and work-related mental ill-health and substance consumption (MIH). It is proposed as a unification model that links both work-related negative consequences on the basis of the experiences of threat, loss, and frustration at work. PEWB contains the following elements: emotional discomfort, bodily uneasiness, organizational distance, task impairment, and dragging workday; and MIH includes work-related anxiety, depression, irritability, cigarette smoking, alcohol and drug consumption, and physical illness. Six hundred ninety-seven participants, working in a wide range of jobs and occupations, completed the survey. Results indicated that PEWB and MIH are significantly associated, after controlling for demographic and personal factors. Sense sharing between PEWB-MIH and PEWB element combination explained the relationships between both constructs. These findings could be helpful for organizations interested in preserving and improving worker mental health.

Perdikaris P; Kletsiou E; Gymnopoulou E; Matziou V. The relationship between workplace, job stress and nurses' tobacco use: A review of the literature. International Journal of Environmental Research and Public Health 7(5): 2362-2375, 2010. (44 refs.)

The aim of this study was to provide a summary of the existing published knowledge on the possible relationship between the workplace as a stressor factor and nurses' tobacco use. A systematic review of the literature from 1995 to 2009, using the MEDLINE database took place. Studies, that referred to nurses' smoking habit exclusively or as a part of the study, were included in the review. 491 studies were retrieved and their titles/abstracts were examined systematically. Twenty one studies were retrieved for further consideration by a comprehensive literature review. Ten studies fulfilled the eligibility criteria and they were examined further. There is a conflict on the possible relationship between workplace as a stressor factor and nurses' smoking habits, because there is no evidence on if the nurses' work environment causes smoking initiation.

Sapp AL; Kawachi I; Sorensen G; LaMontagne AD; Subramanian SV. Does workplace social capital buffer the effects of job stress? a cross-sectional, multilevel analysis of cigarette smoking among US manufacturing workers. Journal of Occupational and Environmental Medicine 52(7): 740-750, 2010. (94 refs.)

Objective: To investigate whether workplace social capital buffers the association between job stress and smoking status. Methods: As part of the Harvard Cancer Prevention Project's Healthy Directions-Small Business Study, interviewer-administered questionnaires were completed by 1740 workers and 288 managers in 26 manufacturing firms (84% and 85% response). Social capital was assessed by multiple items measured at the individual level among workers and contextual level among managers. Job stress was operationalized by the demand-control model. Multilevel logistic regression was used to estimate associations between job stressors and smoking and test for effect modification by social capital measures. Results: Workplace social capital (both summary measures) buffered associations between high job demands and smoking. One compositional item -- worker trust in managers -- buffered associations between job strain and smoking. Conclusion: Workplace social capital may modify the effects of psychosocial working conditions on health behaviors.

Yang X; Telama R; Hirvensalo M; Hintsanen M; Hintsa T; Pulkki-Raback L et al. The benefits of sustained leisure-time physical activity on job strain. Occupational Medicine 60(5): 369-375, 2010. (30 refs.)

Background: The long-term effects of leisure-time physical activity (LTPA) on job strain have not been assessed in a large prospective population-based cohort study. Aims To examine the relationship between the LTPA and the prevalence of job strain. Methods The participants were 861 full-time employees (406 men and 455 women), aged 24239 years in 2001, from the ongoing Cardiovascular Risk in Young Finns Study. LTPA was assessed using a self-report questionnaire in 1992 and in 2001. The participants were grouped into four categories according to tertiles of LTPA index at two time points: persistently active, increasingly active, decreasingly active and persistently inactive. Job strain was measured in 2001 by indicators of job demands and job control. Results: Baseline LTPA was inversely associated with job strain (P < 0.001) and job demands (P < 0.05) and directly associated with job control (P < 0.05) in both sexes in a model adjusted for the change in 9-year LTPA, age, educational level, occupational status and smoking. Compared with persistently active participants, persistently inactive participants had a 4.0-fold higher job strain after adjustment for the confounders. Similarly, persistently inactive participants had a 2.7-fold higher job demands and a 1.8-fold lower job control. Decreasing physical activity was independently associated with high job strain (P < 0.01) and with low job control (P < 0.01). Conclusions: Participation in regular LTPA during leisure may help young adults to cope with job strain. A long-term benefit of LTPA may play a role in the development of mental well-being.

An LC; Betzner A; Schillo B; Luxenberg MG; Christenson M; Wendling A et al. The comparative effectiveness of clinic, work-site, phone, and Web-based tobacco treatment programs. Nicotine & Tobacco Research 12(10): 989-996, 2010. (21 refs.)

Tobacco treatment programs may be offered in clinical settings, at work-sites, via telephone helplines, or over the Internet. Little comparative data exist regarding the real-world effectiveness of these programs. This paper compares the reach, effectiveness, and costs of these different modes of cessation assistance. This is an observational study of cohorts of participants in Minnesota's QUITPLAN programs in 2004. Cessation assistance was provided in person at 9 treatment centers, using group counseling at 68 work-sites, via a telephone helpline, or via the Internet. The main outcomes of the study are enrollment by current smokers, self-reported 30-day abstinence, and cost per quit. Reach was calculated statewide for the helpline and Web site, regionally for the treatment centers, and for the employee population for work-site programs. Enrollment was greatest for the Web site (n = 4,698), followed by the helpline (n = 2,351), treatment centers (n = 616), and work-sites (n = 479). The Web site attracted younger smokers. Smokers at treatment centers had higher levels of nicotine dependence. The helpline reached more socially disadvantaged smokers. Responder 30-day abstinence rates were higher for the helpline (29.3%), treatment centers (25.8%), and work-sites (19.6%) compared with the online program (12.5%). These differences persisted after controlling for baseline differences in participant characteristics and use of pharmacological therapy. The cost per quit was lowest for the Web site program ($291 per quit, 95% CI = $229-$372). Treatment center, work-site, helpline, and Web site programs differ in their reach, effectiveness, and estimated cost per quit. Each program plays a part in assisting populations of tobacco users in quitting.

Burkholder JD; Joines R; Cunningham-Hill M; Xu BW. Health and well-being factors associated with international business travel. Journal of Travel Medicine 17(5): 329-333, 2010. (14 refs.)

Background. International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. Methods. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Results. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. Conclusions. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs.

Dale CE; Livingston MJ. The burden of alcohol drinking on co-workers in the Australian workplace. Medical Journal of Australia 193(3): 138-140, 2010. (16 refs.)

Objective: To estimate the cost of the extra time worked by Australian workers due to their co-workers' alcohol drinking. Design, setting and participants: A secondary analysis of data obtained from 1677 Australian workers aged 18 years or older collected as part of a broader national study into the third-party harms of alcohol. Computer-assisted telephone interviews were conducted between October and mid December 2008. Main outcome measures: Self-reported measures of the time spent covering for other people at work because of their alcohol drinking; measures of other impacts from co-workers' alcohol drinking; and self-reported income. Results: Around a third of Australian workers have experienced negative effects from their co-workers' alcohol drinking, with 3.5% of workers reporting having to work extra hours to cover for others. The total annual cost to the Australian economy of this extra work is estimated to be $453 million. Conclusions: The results of this study suggest that Australian workers are significantly affected by other people's alcohol drinking, at considerable cost. This finding highlights the significant cost to the workplace of alcohol consumption, extending previous work which has focused only on alcohol-related absenteeism.

Jensen HK; Wieclaw J; Munch-Hansen T; Thulstrup AM; Bonde JP. Does dissatisfaction with psychosocial work climate predict depressive, anxiety and substance abuse disorders? A prospective study of Danish public service employees. Journal of Epidemiology and Community Health 64(9): 796-801, 2010. (46 refs.)

Background: The aim of this study was to examine if dissatisfaction with psychosocial work climate predicts psychiatrically diagnosed depressive, anxiety and substance abuse disorders. Methods: In Aarhus County, Denmark, 13 423 public service employees at 683 workplace units answered a questionnaire survey assessing psychosocial work environment. An average workplace unit score of overall satisfaction with psychosocial working conditions, rated on a scale from 0-10 with 10 being most satisfied, was computed and assigned to the individual employees at each work unit. Aggregated satisfaction scores were divided into three levels, according to the 25-75 percentiles. Data on hospitalisations and outpatient treatments for depressive, anxiety and substance abuse disorders was obtained from the Danish Central Psychiatric Research Register. HRs and 95% CIs were computed for first onset of studied disorders, starting from the baseline survey at 1 January 2002 through to 30 April 2008. Risk estimates were adjusted for sociodemographic variables. Results: A low satisfaction with psychosocial working conditions was associated with an increased risk of any mental health disorder, HRadj 1.71, 95% CI 1.04 to 2.82. The lower the satisfaction level, the higher was the risk of mental health disorders. Moreover, substance abuse disorders were more frequent among men dissatisfied with work climate, HRadj 3.53, 95% CI 1.55 to 8.03. Conclusion: Working in a dissatisfying psychosocial environment increases the risk of subsequent mental health disorders. Randomised, controlled intervention trials may help in resolving whether this association is causal.

Kaarne T; Aalto M; Kuokkanen M; Seppa K. AUDIT-C, AUDIT-3 and AUDIT-QF in screening risky drinking among Finnish occupational health-care patients. Drug and Alcohol Review 29(5): 563-567, 2010. (25 refs.)

Introduction and Aims. Primary care physicians need a brief screening instrument to detect risky drinkers. In previous studies, the three first questions of the Alcohol Use Disorders Identification Test-C (AUDIT-C) and the third question on heavy episodic drinking alone (AUDIT-3) have been shown to be almost as effective as the whole AUDIT. Also, AUDIT-QF (the first two questions of AUDIT) can be a potential screening instrument. However, the validity of these short questionnaires has not been studied among the occupational health-care patients. Design and Methods. Patients visiting their doctor in six occupational health clinics were asked to fill in a health questionnaire containing AUDIT. All together 759 patients participated in the study. Risky drinking was defined as having scored of >= 10 for men or >= 8 or more for women in the AUDIT questionnaire. Validity of AUDIT-C, AUDIT-3 and AUDIT-QF were compared against the whole AUDIT. Results. Based on the whole AUDIT, 92 (24%) of the men and 33 (9%) of the women were risky drinkers. For men and women, area under the curve was relatively high for all tested questionnaires. For AUDIT-C, the best combination of sensitivity and specificity was yielded at cut-off point of 6 for men and 4 for women. Discussion and Conclusion. Short questionnaires perform almost as well as the whole AUDIT screening risky drinking among men and women. This is why they can be recommended for clinical use in busy settings. The cut-off points, however, have to be tailored for gender and culture.

Kolb S; Bruckner U; Nowak D; Radon K. Quantification of ETS exposure in hospitality workers who have never smoked. (review). Environmental Health 9(e-article 49), 2010. (112 refs.)

Background: Environmental Tobacco Smoke (ETS) was classified as human carcinogen (K1) by the German Research Council in 1998. According to epidemiological studies, the relative risk especially for lung cancer might be twice as high in persons who have never smoked but who are in the highest exposure category, for example hospitality workers. In order to implement these results in the German regulations on occupational illnesses, a valid method is needed to retrospectively assess the cumulative ETS exposure in the hospitality environment. Methods: A literature-based review was carried out to locate a method that can be used for the German hospitality sector. Studies assessing ETS exposure using biological markers (for example urinary cotinine, DNA adducts) or questionnaires were excluded. Biological markers are not considered relevant as they assess exposure only over the last hours, weeks or months. Self-reported exposure based on questionnaires also does not seem adequate for medico-legal purposes. Therefore, retrospective exposure assessment should be based on mathematical models to approximate past exposure. Results: For this purpose a validated model developed by Repace and Lowrey was considered appropriate. It offers the possibility of retrospectively assessing exposure with existing parameters (such as environmental dimensions, average number of smokers, ventilation characteristics and duration of exposure). The relative risk of lung cancer can then be estimated based on the individual cumulative exposure of the worker. Conclusion: In conclusion, having adapted it to the German hospitality sector, an existing mathematical model appears to be capable of approximating the cumulative exposure. However, the level of uncertainty of these approximations has to be taken into account, especially for diseases with a long latency period such as lung cancer.

Laaksonen M; Piha K; Rahkonen O; Martikainen P; Lahelma E. Explaining occupational class differences in sickness absence: Results from middle-aged municipal employees. Journal of Epidemiology and Community Health 64(9): 802-807, 2010. (23 refs.)

Objectives: Low socioeconomic position is consistently associated with higher rates of sickness absence. We aimed to examine whether working conditions, health-related behaviours and family-related factors explain occupational class differences in medically certified sickness absence. Methods: The study included 5470 women and 1464 men employees of the City of Helsinki, surveyed in 2000-2002. These data were prospectively linked to sickness absence records until the end of 2005, providing a mean follow-up time of 3.9 years. Poisson regression was used to examine the occurrence of medically certified sickness absence episodes lasting 4 days or more. Results: Medically certified sickness absence was roughly three times more common among manual workers than among managers and professionals in both women and men. Physical working conditions were the strongest explanatory factors for occupational class differences in sickness absence, followed by smoking and relative weight. Work arrangements and family-related factors had very small effects only. The effects of psychosocial working conditions were heterogeneous: job control narrowed occupational class differences in sickness absence while mental strain and job demands tended to widened them. Overall, the findings were quite similar in women and men. Conclusions: Physical working conditions provided strongest explanations for occupational class differences in sickness absence. Smoking and relative weight, which are well-known determinants of health, also explained part of the excess sickness absence in lower occupational classes. Applying tailored work arrangements to employees on sick leave, reducing physically heavy working conditions and promoting healthy behaviours provide potential routes to narrow occupational class differences in sickness absence.

Li GH; Brady JE; DiMaggio C; Baker SP; Rebok GW. Validity of suspected alcohol and drug violations in aviation employees26. Addiction 105(10): 1771-1775, 2010. (26 refs.)

Aims: In the United States, transportation employees who are suspected of using alcohol and drugs are subject to reasonable-cause testing. This study aims to assess the validity of suspected alcohol and drug violations in aviation employees. Methods: Using reasonable-cause testing and random testing data from the Federal Aviation Administration for the years 1995-2005, we calculated the positive predictive value (PPV) and positive likelihood ratio (LR+) of suspected alcohol and drug violations. The true status of violations was based on testing results, with an alcohol violation being defined as a blood alcohol concentration of >= 0.04 mg/dl and a drug violation as a test positive for marijuana, cocaine, amphetamines, phencyclidine or opiates. Results: During the 11-year study period, a total of 2284 alcohol tests and 2015 drug tests were performed under the reasonable-cause testing program. The PPV was 37.7% [95% confidence interval (CI), 35.7-39.7%] for suspected alcohol violations and 12.6% (95% CI, 11.2-14.1%) for suspected drug violations. Random testing revealed an overall prevalence of 0.09% for alcohol violations and 0.6% for drug violations. The LR+ was 653.6 (95% CI, 581.7-734.3) for suspected alcohol violations and 22.5 (95% CI, 19.6-25.7) for suspected drug violations. Conclusion: The discriminative power of reasonable-cause testing suggests that, despite its limited positive predictive value, physical and behavioral observation represents an efficient screening method for detecting alcohol and drug violations. The limited positive predictive value of reasonable-cause testing in aviation employees is due in part to the very low prevalence of alcohol and drug violations.

Liu F; Zhang N; Cheng KW; Wang H. Reduced smoking and rising obesity: Does smoking ban in the workplace matter? Economics Letters 108(3): 249-252, 2010. (11 refs.)

Using worksite smoking ban as an instrumental variable for smoking, we examine the relationship between smoking and body weight in a two-stage least square estimation. We find evidence that reduced smoking may lead to the rising of obesity.

Mcpherson TL; Goplerud E; Derr D; Mickenberg J; Courtemanche S. Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study. Drug and Alcohol Review 29(6): 641-646, 2010. (18 refs.)

Introduction and Aims. Substantial empirical support exists for alcohol screening, brief intervention, and referral to treatment (SBIRT) in medical, but not non-medical settings such as the workplace. Workplace settings remain underutilised for delivering evidenced-based health services. This research aims to translate medical research into behavioural health-care practice in a telephonic call centre acting as a point of entry into an Employee Assistance Program (EAP). The goal of the study is to examine the feasibility of implementing routine telephonic alcohol SBIRT in an EAP call centre and assess whether routine SBIRT results in increased identification of workers who misuse alcohol. Design and Methods. The design was pretest-posttest, one-group, pre-experimental. An alcohol SBIRT program developed based on World Health Organization recommendations was implemented in one EAP call centre serving one large employer. Workers were offered screening using the Alcohol Use Disorder Identification Test (AUDIT) during intake, brief counselling using motivational interviewing, referral to counselling, and follow-up. Results. At 5 months, 93% of workers contacting the EAP completed the AUDIT-C: 40% prescreened positive and 52% went on to screen at moderate or high risk for an alcohol problem. Overall identification rate (18%) approached general US population estimates. Most agreed to follow-up and three-quarters set an appointment for face-to-face counselling. Discussion and Conclusions. Integration of routine alcohol SBIRT into EAP practice is feasible in telephonic delivery systems and increases identification and opportunity for brief motivational counselling. When SBIRT is seamlessly integrated workers are willing to answer questions about alcohol and participate in follow-up.

Mohammadi S; Mazhari MM; Mehrparvar AH; Attarchi MS. Cigarette smoking and occupational noise-induced hearing loss. European Journal of Public Health 20(4): 452-455, 2010. (25 refs.)

Background: Noise is the most common occupational hazard. Noise-induced hearing loss (NIHL) is a known occupational disease. The economic costs of NIHL have been estimated to be billions of dollars. Besides, cigarette smoking is a common habit worldwide. Methods: In a cross-sectional study, we surveyed the effect of smoking on NIHL in 504 workers in a large wagon manufacturing company exposed to noise >85 dBA. All required data were obtained using direct interview and questionnaires. To determine noise exposure level, we used industrial hygienist's reports of sound level measurements. A qualified audiologist assessed hearing status using standardized audiometric examination. Results: We concluded that the frequency of hearing loss in smokers was higher than non-smokers [based on Model 1: odds ratio (OR) = 9.35, 95% confidence interval (CI) = 5.74-15.22 and P-value <0.001; and based on Model 2: OR = 9.06, 95% CI = 5.93-13.84 and P-value <0.001]. Besides, these results were confirmed by logistic regression statistical method. Conclusions: It can be concluded that smoking may accelerate NIHL, but for confirming this opinion, further studies are warranted.

Wang LM; Wheeler K; Bai L; Stallones L; Dong YM; Ge J et al. Alcohol consumption and work-related injuries among farmers in Heilongjiang Province, People's Republic of China. American Journal of Industrial Medicine 53(8): 825-835, 2010. (35 refs.)

Background: Alcohol consumption has been found to be associated with work-related injuries among workers around the world, but this association has not well been studied among agricultural workers in China. Methods: This population-based survey aimed to study the association between alcohol use and work-related agricultural injury. Farmers in a northeastern province of China were questioned about work-related injury in the past year (May 2007 April 2008), alcohol use, farming practices, and sociodemographic factors. The Chi-square test and logistic regression analyses were used to investigate the role of alcohol drinking in agricultural injuries. Results: Among 2,050 farmers who completed the survey, the 12-month prevalence of work-related injury was 12.2%. The leading external cause of injury was exposure to mechanical force. The odds of injury among farmers with past month drinking, who drank distilled spirits, and reported intoxication were respectively 1.77 (95% CI = 1.27-2.47), 1.89 (95% CI = 1.35 2.66), 2.12 (95% CI = 1.42-3.11). The odds of injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and with greater reported years of drinking. Each alcohol use variable was associated with injury in logistic regression models while controlling for sex, age, years of farm work, months of farm work in the past 12 months, driving a motor vehicle, and agricultural machinery use. Conclusions: We found a significant association between alcohol consumption and work-related injuries among farmers. Our findings stress the need for culturally appropriate interventions which affect alcohol use and prevent injuries among Chinese farmers.

Young K. Policies and procedures to manage employee Internet abuse. Computers In Human Behavior 26(6): 1467-1471, 2010. (21 refs.)

Industry analysts estimate that billions of dollars in lost revenue were attributed to employee Internet abuse. Trends also suggest that lost job productivity and corporate liability have emerged as new workplace concerns due to growth of new online technologies and mobile computing. Such employee Internet misuse creates new management dilemmas on how to respond to incidences of such misuse as well poses network security risks and drains on network bandwidth. Within an organization, it is imperative to ensure that employees are using computing resources effectively and appropriately. Utilizing the previous literature in the field, this paper proposed a revised framework to manage employee Internet abuse. The former model proposed did not account for new digital media and recommended screening applicants for Internet addiction, using more of a clinical test than a job performance test. This new model describes both prevention and intervention methods to address incidents of online misuse in the workplace and refocuses hiring decisions into post-employment training. It also examines the new hiring concerns with the new iGeneration of college graduates and it examines how organizations should best utilize acceptable Internet use policies with clear methods of Internet monitoring to enforce that workers are complying with company policies. This paper also talks about the potential benefits of rehabilitation approaches to manage employees who abuse instead of terminating them to decrease job turnover and improve job retention. Implications for current management practices are also discussed.

Alexander LA; Crawford T; Mendiondo MS. Occupational status, work-site cessation programs and policies and menthol smoking on quitting behaviors of US smokers. Addiction 105(Supplement 1): 95-104, 2010. (47 refs.)

Aim: This exploratory study sought to examine the relationships among occupational status, menthol smoking preference and employer-sponsored smoking cessation programs and policies on quitting behaviors. Design: Data for this cross-sectional study were obtained from the 2006 Tobacco Use Supplement to the Current Population Survey (TUS CPS), a large national survey representative of the civilian population, containing approximately 240 000 respondents. The total sample for the current study was 30 176. Measurements: The TUS CPS regularly collects data on cigarette prevalence, quitting behaviors, smoking history and consumption patterns. We performed a logistic regression with 'life-time quitting smoking for 1 day or longer because they were trying to quit' as outcome variable. Independent variables included type of occupation, employer-sponsored cessation programs and policies and menthol status. Findings: When controlling for occupational status and work-place policies, there were no differences for menthol versus non-menthol smokers on quitting behaviors [odds ratio (OR) = 0.98; 95% confidence interval (CI) = 0.83, 1.15]. Service workers were less likely to quit compared with white-collar workers (OR = 0.80; 95% CI = 0.69, 0.94), and those with no employer-sponsored cessation program were less likely to quit (OR = 0.70; 95% CI = 0.60, 0.83). White-collar workers, compared with blue-collar and service workers, were more likely to have a smoking policy in the work area (93% versus 86% versus 88%, respectively). Conclusions: When occupational status and work-place smoking policies are controlled for, smokers of menthol cigarettes in the United States appear to have similar self-reported life-time rates of attempts to stop smoking to non-menthol smokers.

Broome KM; Bennett JB. Reducing heavy alcohol consumption in young restaurant workers. Journal of Studies on Alcohol and Drugs 72(1): 117-124, 2011. (28 refs.)

Objective: Restaurant employees often have high rates of heavy drinking and problems with alcohol. This study evaluates reductions in drinking and associated problems at work, in connection with a new program for prevention and early intervention. The program, called Team Resilience, is designed for young restaurant workers. Method: A cluster-randomized trial design was used, with 28 stores from a national casual-dining restaurant chain and 235 of their employees (54% male, 46% female). Fourteen stores received the Team Resilience training workshop, consisting of three 2-hour sessions held on 3 consecutive days. Sessions included group discussion, role-play and practice activities, and a learning game. Results: Workers in trained stores reported significantly greater decreases in recurring heavy drinking (i.e., having five or more drinks on the same occasion, on 5 or more days in the past month) and work-related problems with alcohol than workers in control stores. In the intervention group, the odds of recurring heavy drinking declined by about one half and the number of work-related problem areas declined by one third following training. In addition, drinking behaviors and problems were tied to age and were most common among employees in their middle 20s. Conclusions: Findings support Team Resilience as an effective intervention for reducing drinking and associated problems among young restaurant workers, a population with substantial needs.

Campbell RB; Balbach ED. Manufacturing credibility: The National Energy Management Institute and the Tobacco Institute's strategy for indoor air quality. American Journal of Public Health 101(3): 497-503, 2011. (95 refs.)

Objectives. We studied tobacco industry efforts during the 1980s and 1990s to promote the National Energy Management Institute (NEMI), a nonprofit organization, as an authority on indoor air quality as part of the industry's strategy to oppose smoke-free worksite policies. Methods. We analyzed tobacco industry documents, conducted literature searches in Lexis-Nexis for background and historical literature, and reviewed relevant public health and policy literature. Results. The tobacco industry provided more than US $6 million to NEMI to establish it as an authority on indoor air quality and to work with it to undermine support for smoke-free air policies by promoting ventilation as a solution to indoor air quality problems. Tobacco industry support for NEMI was not publicly disclosed. Conclusions. NEMI was a valuable ally for the tobacco industry through NEMI's ties to organized labor, its technical background, and its status as a third-party actor. NEMI also helped the industry to portray ventilation to improve overall indoor air quality and smoke-free worksites as an either-or choice; in fact, both can improve worker health.

Corrigan PW; Tsang HWH; Shi K; Lam CS; Larson J. Chinese and American employers' perspectives regarding hiring people with behaviorally driven health conditions: The role of stigma. Social Science & Medicine 71(12): 2162-2169, 2010. (37 refs.)

Work opportunities for people with behaviorally driven health conditions such as HIV/AIDS, drug abuse, alcohol abuse, and psychosis are directly impacted by employer perspectives. To investigate this issue, we report findings from a mixed method design involving qualitative interviews followed by a quantitative survey of employers from Chicago (U.S.), Beijing (China), and Hong Kong (China). Findings from qualitative interviews of 100 employers were used to create 27 items measuring employer perspectives (the Employer Perspective Scale: EPS) about hiring people with health conditions. These perspectives reflect reasons for or against discrimination. In the quantitative phase of the study, representative samples of approximately 300 employers per city were administered the EPS in addition to measures of stigma, including attributions about disease onset and offset. The EPS and stigma scales were completed in the context of one of five randomly assigned health conditions. We weighted data with ratios of key demographics between the sample and the corresponding employer population data. Analyses showed that both onset and offset responsibility varied by behaviorally driven condition. Analyses also showed that employer perspectives were more negative for health conditions that are seen as more behaviorally driven, e.g., drug and alcohol abuse. Chicago employers endorsed onset and offset attributions less strongly compared to those in Hong Kong and Beijing. Chicago employers also recognized more benefits of hiring people with various health conditions. The implications of these findings for better understanding stigma and stigma change among employers are considered.

Currie LM; Clancy L. The road to smoke-free legislation in Ireland. Addiction 106(1): 15-24, 2011. (26 refs.)

Aim: To describe the process through which Ireland changed its policies towards smoking in work-places and distil lessons for others implementing or extending smoke-free laws. Design, setting, participants, measurements This analysis is informed by a review of secondary sources including a commissioned media analysis, documentary analysis and key informant interviews with policy actors who provide insight into the process of smoke-free policy development. The policy analysis techniques used include the development of a time-line for policy reform, stakeholder analysis, policy mapping techniques, impact analysis through use of secondary data and a review process. The policy analysis triangle, which highlights the importance of examining policy content, context, actors and processes, will be used as an analytical framework. Findings: The importance of the political, economic, social and cultural context emerged clearly. The interaction of the context with the policy process both in identification of need for policy and its formulation demonstrated the opportunity for advocates to exert influence at all points of the process. The campaign to support the legislation had the following characteristics: a sustained consistent simple health message, sustained political leadership/commitment, a strong coalition between the Health Alliance, the Office of Tobacco Control and the Department of Health and Children, with cross-party political support and trade union support. The public and the media support clearly defined the benefit of deliberate and consistent planning and organization of a communication strategy. Conclusions: The Irish smoke-free legislation was a success as a policy initiative because of timing, dedication, planning, implementation and the existence of strong leadership and a powerful convinced credible political champion.

Dove MS; Dockery DW; Mittleman MA; Schwartz J; Sullivan EM; Keithly L et al. The impact of Massachusetts' smoke-free workplace laws on acute myocardial infarction deaths. American Journal of Public Health 100(11): 2206-2212, 2010. (33 refs.)

Objectives. We examined the rate of acute myocardial infarction (AMI) deaths in Massachusetts before and after the implementation of a comprehensive smoke-free workplace law in July 2004. Methods. We used Poisson regression models to examine the impact of the state law in cities and towns with and without previous local smoking bans and the effect of the local laws for the period of 1999 through 2006. Results. The AMI mortality rate decreased by 7.4% (95% confidence interval [CI]=3.3%, 11.4%) after implementation of the state law. The state ban had an impact in cities and towns with no prior local smoking ban (9.2% decrease; P<.001) but not cities and towns with a prior local smoking ban. However, there was a nonsignificant 4.9% (95% CI=-5.0%, 13.9%) decrease associated with the local smoking ban that preceded the effect of the state ban. The effect of the state ban was modest (-1.6%) in the first 12 months after implementation but much larger after the first 12 months (-18.6%; P<.001). Conclusions. Comprehensive statewide smoke-free workplace laws in Massachusetts were associated with an estimated 270 fewer AMI deaths per year. These results add to the evidence suggesting that smoke-free air laws are associated with lower rates of AMI.

Erazo M; Iglesias V; Droppelmann A; Acuna M; Peruga A; Breysse PN et al. Secondhand tobacco smoke in bars and restaurants in Santiago, Chile: Evaluation of partial smoking ban legislation in public places. Tobacco Control 19(6): 469-474, 2010. (38 refs.)

Objective: To compare air nicotine concentrations according to the smoking policy selected by bars/restaurants in Santiago, Chile before and after the enactment of partial smoking ban legislation in 2007 (establishments could be smoke free, have segregated (mixed) smoking and non-smoking areas, or allow smoking in all areas). Methods: The study measured air nicotine concentrations over 7 days to characterise secondhand smoke exposure in 30 bars/restaurants in 2008. Owner/manager interviews and physical inspections were conducted. Results: Median OR air nicotine concentrations measured in all venues were 4.38 (0.61-13.62) mu g/m(3). Air nicotine concentrations were higher in bars (median 7.22, IQR 2.48-15.64 mu g/m(3)) compared to restaurants (1.12, 0.15-9.22 mu g/m(3)). By smoking status, nicotine concentrations were higher in smoking venues (13.46, 5.31-16.87 mu g/m(3)), followed by smoking areas in mixed venues (9.22, 5.09-14.90 mu g/m(3)) and non-smoking areas in mixed venues (0.99, 0.19-1.27 mu g/m(3)). Air nicotine concentrations were markedly lower in smoke-free venues (0.12, 0.11-0.46 mu g/m(3)). After adjustment for differences in volume and ventilation, air nicotine concentrations were 3.2, 35.5 and 56.2 times higher in non-smoking areas in mixed venues, smoking areas in mixed venues and smoking venues, respectively, compared to smoke-free venues. Conclusions: Exposure to secondhand smoke remains high in bars and restaurants in Santiago, Chile. These findings demonstrate that the partial smoking ban legislation enacted in Chile in 2007 provides no protection to employees working in those venues. Enacting a comprehensive smoke-free legislation which protects all people from exposure to secondhand smoke in all public places and workplaces is urgently needed.

Griffith G; Cardone A; Jo C; Valdemoro A; Sebrie E. Implementation of smokefree workplaces: Challenges in Latin America. Salud Publica de Mexico 52(Supplement 2): S347-S354, 2010. (36 refs.)

Latin America is at the forefront of global progress in smokefree workplaces. Comprehensive smokefree laws have been implemented in four countries, and in many cities, states and provinces. More than 130 million people in Latin America are now protected from secondhand tobacco smoke. Nevertheless, a survey of tobacco control advocates and governments in Latin America found several challenges to progress in smokefree workplaces: the need for voluntary workplace programs where there is no smokefree legislation; weak legislation or lack of comprehensive national smokefree laws; tobacco industry attempts to undermine progress with smokefree laws or overturn existing laws via litigation; lack of compliance with laws; the need for monitoring and evaluation of smokefree laws; the need to make better use of mass media campaigns; and strengthening civil society. However, much progress has already been achieved to address these challenges, in particular through collaborations and the exchange of experience and expertise across Latin America.

Halpern MT; Taylor H. Employee and employer support for workplace-based smoking cessation: Results from an international survey. Journal of Occupational Health 52(6): 375-382, 2010. (26 refs.)

Employee and Employer Support for Workplace-based Smoking Cessation: Results from an International Survey: Michael T. HALPERN,//// Division of Health Services and Social Policy Research, Rh I International, USA-Objectives: Workplace smoking cessation programs can increase smoking cessation rates, improve employee health, reduce exposure to second-hand smoke, and decrease costs. To assist with the development of such programs, we conducted a Global Workplace Smoking Survey to collect information on workplace attitudes towards smoking cessation programs. Methods: Data were collected from 1,403 employers (smoking and non-smoking) and 3,525 smoking employees participating in surveys in 14 countries in Asia, Europe, and South America in 2007. Results were weighted to ensure that they were representative of smokers and employers at companies with the specified number of employees. Results: More than two-thirds of employers (69%) but less than half of employees (48%) indicated that their company should help employees with smoking cessation. Approximately two-thirds of employees and 81% of employers overall felt that smoke-free policies encourage cessation, but fewer individuals from Europe (vs. from Asia or South America) agreed with this. In companies with a smoke-free policy, 76% of employees and 80% of employers felt that their policy had been somewhat, very, or extremely effective in motivating employees to quit or reduce smoking. Employers and employees differed substantially regarding appropriate methods for encouraging cessation, with more employees favouring financial incentives and more employers favouring education. Conclusions: Both employees and employers value smoke-free workplace programs and workplace cessation support activities, although many would like their companies to offer more support. These results will be useful for organizations exploring means of facilitating smoking cessation amongst employees.

Jaakkola MS; Sripaiboonkij P; Jaakkola JJK. Effects of occupational exposures and smoking on lung function in tile factory workers. International Archives of Occupational and Environmental Health 84(2): 151-158, 2011. (36 refs.)

The aims of this study were to investigate the relations of occupational exposures in tile industry to lung function and to evaluate potential interaction between smoking and tile dust exposure containing silica. A cross-sectional study of 232 workers (response rate 100%) in a tile factory and 76 office workers (response rate 73%) from four factories in Thailand was conducted in 2006-2007. Participants answered a questionnaire and performed spirometry. Factory workers had lower spirometric functions than office workers, especially those with high dust exposure. There was a dose-response relation between duration of dust exposure and FEV1 and FVC, the adjusted effect of a parts per thousand yen21 years of exposure on FEV1 being -240 ml (-100 to -380) and on FVC -300 ml (-140 to -460). The adverse effect of dust on lung function was larger in current smokers suggesting synergism between smoking and tile dust exposure. This study provides evidence that long-term exposure to dust in tile industry is related to lung function reduction. There was a suggestion of synergistic effect between dust exposure and smoking. Tile factories should consider measures to reduce dust exposure and arrange spirometry surveillance for workers with such exposure. Smoking cessation should be promoted to prevent harmful effects of occupational tile dust exposure.

Kim A; Kamyab K; Zhu JS; Volpp K. Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation. Journal of Occupational and Environmental Medicine 53(1): 62-67, 2011. (22 refs.)

Objective: Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Methods: Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Results: Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P < 0.01). Most quitters (69.8%) in the incentive group who were already motivated to quit and reported that they would have quit for less money, said incentives were "not at all" or only "somewhat" important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Conclusions: Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.

Ma JM; Apelberg BJ; Avila-Tang E; Yang G; Ma SJ; Samet JM; Stillman FA. Workplace smoking restrictions in China: Tesults from a six county survey. Tobacco Control 19(5): 403-409, 2010. (30 refs.)

Objective: To determine the coverage of smoking restriction policies in indoor workplaces in China and to assess the relationships between these restrictive policies and secondhand smoke (SHS) exposure and smoking behaviours. Methods: A cross sectional household survey was conducted in six counties in Sichuan Jiangxi and Henan provinces in 2004. Using a standardised questionnaire information on demographic characteristics knowledge attitudes and behaviours related to smoking and SHS exposure was collected through face to face interviews by trained local investigators among 12 036 respondents Of respondents 2698 individuals worked mainly indoors and were included in data analysis. Results: Only 28.5% of respondents reported that indoor workplaces had a smoke free policy. Even when respondents reported smoke free policies 41.1% smokers reported that they were non compliant with policies and smoked at work In addition 32.0% of non smokers reported being exposed to SHS at work despite smoke free policies. Non smokers who reported no smoking restriction policies were 3 7 times more likely to be exposed to SHS than those working in smoke free workplaces (adjusted OR 3 7 95% CI 1.3 to 10.1) On average respondents complying with smoke free policies smoked 3 8 fewer cigarettes than those reporting no policies in their workplaces at a marginally non significant level (p=0 06) (adjusted mean difference 3.8 95% CI 8.0 to 0.5) Conclusions: In China few workplaces have implemented policies to restrict smoking and even in workplaces that have policies workers report exposure to SHS while at their places of employment. Many workers report a lack of compliance with smoke free policies. China needs better implementation of SHS policies to promote compliance. Working to improve implementation of smoke free policies would promote cessation since Chinese smokers who were compliant with these efforts reported smoking fewer cigarettes per day

McNeilly B; Ibrahim JE; Bugeja L; Ozanne-Smith J. The prevalence of work-related deaths associated with alcohol and drugs in Victoria, Australia, 2001-6. Injury Prevention 16(6): artice DOI: 10.1136/ip.2010.027052, 2010. (18 refs.)

To describe the presence of alcohol, cannabis and amphetamines in work-related injury deaths in Victoria, 2001-6, an observational study of work-related deaths reported to the State Coroner's Office, Victoria, Australia was conducted. Case and postmortem forensic toxicology data were obtained from the National Coroner's Information System for work-related injury deaths with positive toxicology screens. Over 6 years there were 43 worker deaths in a total of 355 unintentional work-related injury deaths. The coroner mentioned the presence of alcohol/drugs in 22 of the 43 worker deaths with positive toxicology screens. Toxicology screens were positive for alcohol and/or drugs in 79 work-related deaths overall. Overall, alcohol was present in 26 (7%) work-related deaths and cannabis or amphetamines in 20 (6%). Incidents were mainly transport related. Alcohol and/or drugs were present in a significant portion of work-related deaths. Research is needed to determine the relative contribution of alcohol and drugs compared with other contributing factors to work-related deaths.

Monroe T; Kenaga H. Don't ask don't tell: Substance abuse and addiction among nurses. Journal of Clinical Nursing 20(3-4): 504-509, 2011. (27 refs.)

Aim. The purpose of this manuscript is to illustrate the challenges faced by nurses who abuse substances and to promote international dialogue about what practitioners, administrators, health care providers and students can do when they suspect someone in the profession is abusing substances, or they may themselves be suffering from addiction. Background. Addiction among nurses has been recognised by professionals in the field for over 100 years, and current estimates place rates of substance misuse, abuse and addiction rates as high as 20% among practicing nurses. Unfortunately, fear of punishment and discipline may keep nurses or students from asking for help for themselves or from reporting a colleague or friend who is in need of help. Design. Discursive paper. Method. This paper synthesises the results of three previous papers conducted on substance abuse policies in the nursing profession. In the first paper, the authors reviewed the history of addiction in nursing and compared disciplinary and alternative-to-discipline policies. The second focused on the development of an alternative-to-dismissal policy for substance abuse in a school of nursing and using telephone and email interviews, and the final paper reported findings of what types of polices seem to be working to retain and rehabilitate nurses who suffer from addiction in the. Lastly, this paper introduces international policy for nurses with addictions. Conclusions. Poor or ineffective policies that mandate punitive action endanger the public by making it difficult for impaired students or professionals to ask for help. Providing early intervention and assistance is essential in helping colleagues and students recover from an addictive disorder and providing a non-punitive atmosphere of support may well be a life-saving first step for nurses and those in their care. Many territories and countries throughout the world now offer confidential, non-punitive, assistance for nurses suffering from addictions. Relevance to clinical practice. Recognition of a colleague's need of treatment is the important first step in the rehabilitation process. Early intervention and assistance are essential for helping colleagues and students to recover from an addictive disorder and providing a confidential, non-punitive atmosphere of support may well be a life-saving first step for nurses and those in their care.

Movsisyan NK; Thompson ME; Petrosyan V. Attitudes, practices and beliefs towards worksite smoking among administrators of private and public enterprises in Armenia. Tobacco Control 19(4): 274-278, 2010. (15 refs.)

Background: In March 2005, Armenia enacted legislation protecting employees from secondhand smoke. This research was the first attempt to understand the attitudes, beliefs and practices of managers of public and private enterprises regarding smoke-free worksite policies. Methods: Mixed methods were used. The study team conducted focus group discussions with worksite administrators to explore their beliefs, attitudes and practices related to worksite smoking. These findings guided development of a quantitative instrument to collect more representative data on the same issues. Using stratified random sampling, 243 worksites were interviewed from June-July 2005, representing state/municipal, health, educational, culture and business institutions in three of Armenia's largest cities. Results/Discussion Smoking-related practices differed significantly across institutions. More than half of the managers (55.6%) reported having smoking restrictions at worksites, including 37.0% who reported smoke-free workplaces; however, smoking or the presence of ashtrays was observed in 27.8% of workplaces reported to be smoke-free. A substantial proportion of the administrators favored both banning indoor smoking and allowing smoking in special areas. Only 38.0% of managers were aware of employees' existing legal protections from exposure to secondhand smoke. Knowledge of these regulations was not related to adherence to smoke-free worksite policies. The research also revealed widespread confusion between the concepts of worksite smoking restrictions and smoke-free workplaces. Public awareness campaigns that promote promulgation and enforcement of worksite smoking regulations could increase employee demand for smoke-free worksites. Conclusion: As one of the first studies to investigate smoking-related worksite practices, attitudes and beliefs in former Soviet countries, these findings provide insight into law enforcement processes in economies in transition.

Peoples JD; Bishop J; Barrera B; Lamas O; Dunlap JL; Gonzalez PA et al. Health, occupational and environmental risks of emancipated migrant farmworker youth. Journal of Health Care for the Poor and Underserved 21(4): 1215-1226, 2010. (39 refs.)

This study examines the perceptions of health, health seeking behavior, access to information and resources, work related hazards, substance abuse, and social support of emancipated migrant youth (EMY) who come to the United States without their families to work. Methods. Semi-structured interviews were performed with EMY living without their families in Santa Clara County, California. Interviews were digitally recorded in Spanish, transcribed, translated into English, and analyzed by a five-person analysis team. Results. Eleven interviews were conducted with 29 participants. Work was identified as the overarching priority of the EMY. Their greatest concern was becoming sick and unable to work. They described their work environment as demanding and stressful, but felt obliged to work regardless of conditions. Alcohol and drug abuse were reported as prevalent problems. Conclusion. Emancipated migrant youth are a vulnerable population who have significant occupational stress, hazardous environmental exposures, social isolation, and drug/alcohol abuse.

Reijula JP; Reijula KE. The impact of Finnish tobacco legislation on restaurant workers' exposure to tobacco smoke at work. Scandinavian Journal of Public Health 38(7): 724-730, 2010. (25 refs.)

Aims: To evaluate the impact of Finnish tobacco legislation concerning restaurants, questionnaire surveys were carried out four times between 1999 and 2007. Their purpose was to assess the effects of the legislation on employees' exposure to tobacco smoke in bars and restaurants in Finland before the total prohibition of smoking. Methods: National questionnaire surveys on reported exposure to tobacco smoke among restaurant workers were conducted in 1999, 2001, 2003, and in the spring of 2007 just before the total smoking ban. Results: The data show that smoking is more common among restaurant workers than in the Finnish population in general. Reported exposure to tobacco smoke in bars and restaurants declined slowly after the launch of the renewed Tobacco Act. Between 1999 and 2007, it decreased from 73% to 43% among waiters who were exposed for over four hours per work shift and from 93% to 67% among bartenders. At the same time, non-exposed waiters increased from 15% to 39% and bartenders from 5% to 10%. The number of daily smoked cigarettes, however, remained the same among restaurant workers during the seven-year follow-up. Conclusions: We conclude that the reform of the Finnish tobacco legislation in 2000, which did not totally prohibit smoking in restaurants, decreased the exposure to environmental tobacco smoke but was not sufficiently effective in protecting restaurant workers from occupational exposure to tobacco smoke.

Ruge J; Broda A; Ulbricht S; Klein G; Rumpf HJ; John U et al. Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers. International Journal of Public Health 55(6): 599-608, 2010. (37 refs.)

In this study, the association between three levels of workplace smoking restrictions and smoking behavior and variables related to the intention to quit among continuing smokers was examined. Adult smokers were recruited from consecutive patients attending a random sample of 34 general medical practices from a pre-defined, north-eastern German region. Self-reported data were gathered in the waiting room by questionnaire. Cross-sectional data of 1,012 employees were analyzed using ordered logistic regression analyses. Among the sample, 12% reported a smoke-free workplace, 51% had partial, and 37% no smoking restrictions. Daily cigarette consumption was lower when there were higher levels of restriction. No association was found between smoking restrictions and previous attempts to quit, nicotine dependence, or indicators of adjusted inhalation to compensate for the lower number of cigarettes (e.g. puffs per cigarette, darker coloring of filter). Smoking restrictions were positively associated with single psychological measures related to the intention to quit. Employees who continue to smoke may benefit from workplace smoking restrictions in terms of reduced, active smoke exposure and psychological effects increasing their readiness to quit.

Thygerson SM; Merrill RM; Cook LJ; Thomas AM. Comparison of factors influencing emergency department visits and hospitalization among drivers in work and nonwork-related motor vehicle crashes in Utah, 1999-2005. Accident Analysis and Prevention 43(1): 209-213, 2011. (20 refs.)

This study identified contributing factors in the occurrence of motor vehicle crashes (MVCs) and the severity of crashes according to work-related status in Utah. Analyses were based on probabilistically linked data involving police crash reports and hospital inpatient and emergency department (ED) records for the years 1999-2005. Of 643,647 drivers involved in crashes, 73,437 (11.4%) went to the emergency department (ED) and 4989 (0.8%) were hospitalized. Of the drivers in crashes visiting the ED, 2330 (3.2%) were working at the time of the crash and of drivers in crashes who were hospitalized, 235 (4.7%) were working at the time of the crash. There was no significant difference between those working versus not working at the time of the crash in safety belt use (82%[53,947/66,188] for ED cases and 60% [2,489/4,176] for hospitalized cases) or fatigue (4%[ 2,697/70,536] for ED cases and 9% [450/4,824] for hospitalized cases) among drivers in crashes, but there was a significant difference with respect to alcohol drinking between workers versus nonworkers (ED: 1% [31/2,237] vs. 5% [3,455/68,299], P < 0.001; hospitalized: 3% [7/228] vs. 15% [673/4,596], P < 0.001). Of those attending the ED because of a crash, workers were significantly more likely to have broken bones, bleeding wounds, or to die. Of those hospitalized because of a crash, workers were significantly less likely to have caused the crash (65% [145/223] vs. 73% [3,315/4,566], P < 0.001). Yet although those drivers who were working at the time of the crash compared with those not working were less likely to have alcohol involved or to have caused the crash, there remains room for improvement among workers with respect to these factors, as well as safety belt use and fatigue.

Vander Weg MW; Cunningham CL; Howren MB; Cai XY. Tobacco use and exposure in rural areas: Findings from the Behavioral Risk Factor Surveillance System. Addictive Behaviors 36(3): 231-236, 2011. (40 refs.)

Evidence suggests that those residing in rural areas may be disproportionately affected by the health burden of tobacco use.. The present study examined tobacco use, self-reported exposure to tobacco smoke, and policies regarding public smoking according to area of residence, using data from the 2006 and 2008 Behavioral Risk Factor Surveillance System. Results indicated that, relative to those from suburban and urban locations, adults residing in rural areas were significantly more likely to smoke cigarettes (22.2% versus 17.3% (suburban) and 18.1% (urban), p<.001) and to use smokeless tobacco (p<.001). Rural residents were also more likely than those living in suburban and urban areas to report that someone had smoked in their presence during the past seven days both at home (p<.001) and at work (p<.001). Finally, rural participants reported policies that afforded less protection from tobacco smoke both at home and in the workplace. These findings suggest that those living in rural areas are at increased risk for tobacco-related illness due to both their own tobacco use and exposure to others' cigarette smoke.

Wetzler S; Schwartz B; Swanson A; Cahill R. Substance use disorders and employability among welfare recipients. Substance Use & Misuse 45(13): 2095-2112, 2010. (41 refs.)

The 2006 welfare reform legislation (Deficit Reduction Act of 2005) imposed more stringent work requirements and defined the amount of time cash assistance recipients are allowed to be exempted from the work requirement because of substance use treatment. As there is little empirical literature on the employability of substance users, it is difficult to know whether it is realistic to expect individuals with substance use disorders to meet the increased work requirement. Based on a comprehensive evaluation of nearly 9,000 substance-misusing welfare recipients from 2001 to 2007, University Behavioral Associates (UBA) Comprehensive Services Model program in Bronx, New York, found that 60% of recipients were not exempted from the work requirement owing to substance misuse at the outset, and an additional 24% were found nonexempt after 3 months of intensive outpatient treatment coupled with case management, resulting in a total of 84% of the UBA clients not being exempted from the work requirement because of substance misuse by Day 90. UBA also found that 25% of substance-misusing clients were able to obtain employment, and most successfully retained those jobs over the course of 6 months. These findings are discussed in relation to the new law's work requirements and the issue of the employability of substance misusers. Finally, the value of case management in serving this hard-to-engage population is discussed.

Zhu JF; Tews MJ; Stafford K; George RT. Alcohol and illicit substance use in the food service industry: Assessing self-selection and job-related risk factors. Journal of Hospitality & Tourism Research 35(1): 45-63, 2011. (56 refs.)

The present study examines alcohol and illicit substance use in the food service industry with a generalizable national sample. Specifically, using the National Longitudinal Survey of Youth, this research examines whether previous substance use predicts employment in food service and assesses the impact of job-related factors including cumulative experience, occupational differences, compensation, shifts worked, and holding multiple jobs on substance use. The results demonstrate that a modest self-selection effect does exist and that bartenders, employees who receive tipped compensation, and those who hold multiple jobs engage in greater substance use. These findings are discussed along with implications for practitioners and opportunities for future research attention.

Gao JN; Zheng PP; Gao JL; Chapman S; Fu H. Workplace smoking policies and their association with male employees' smoking behaviours: a cross-sectional survey in one company in China. Tobacco Control 20(2): 131-136, 2011. (23 refs.)

Objectives: The present work sought to evaluate different worksite smoking control policies and their associations with employees' smoking behaviours and attitudes among Chinese male workers. Methods: This was a cross-sectional survey with a self-administered standardised questionnaire, conducted among seven production workplaces of one multinational company in Shanghai in 2008. In total, 1043 male workers were involved. Current smoking prevalence, daily cigarette consumption, quitting intention and their potential association with workplace smoking control policies (smoke free or restricted smoking) were measured. Results: Current smoking prevalence in workplaces where smoke-free policies had been imposed for 3 years was 55.5%, about 18% lower than in workplaces that only restricted smoking. Smokers in smoke-free workplaces also smoked 3.4 cigarettes less per day, made more quit attempts, were more confident of successfully quitting and more willing to accept a company sponsored cessation programme. Those patterns declined or were not found among the workplaces where smoking control policies had been imposed for 10 years. Smoker quitting intentions were not associated with workplace smoking policies regardless of the duration of the policies imposed. Conclusions: A smoke-free workplace policy was found to have a significant association with lower smoking prevalence and daily cigarette consumption, but not with employee quitting intentions. Restrictive smoking policies had no impact on employee smoking behaviours. The impact of workplace smoking control policies may vary over time.

Henke RM; Goetzel RZ; McHugh J; Isaac F. Recent experience in health promotion at Johnson & Johnson: Lower health spending, strong return on investment. Health Affairs 30(3): 490-499, 2011. (26 refs.)

Johnson & Johnson Family of Companies introduced its worksite health promotion program in 1979. The program evolved and is still in place after more than thirty years. We evaluated the program's effect on employees' health risks and health care costs for the period 2002-08. Measured against similar large companies, Johnson & Johnson experienced average annual growth in total medical spending that was 3.7 percentage points lower. Company employees benefited from meaningful reductions in rates of obesity, high blood pressure, high cholesterol, tobacco use, physical inactivity, and poor nutrition. Average annual per employee savings were $565 in 2009 dollars, producing a return on investment equal to a range of $1.88-$3.92 saved for every dollar spent on the program. Because the vast majority of US adults participate in the workforce, positive effects from similar programs could lead to better health and to savings for the nation as a whole.

Issa JS; Abe TMO; Pereira AC; Megid MC; Shimabukuro CE; Valentin LSO et al. The effect of Sao Paulo's smoke-free legislation on carbon monoxide concentration in hospitality venues and their workers. Tobacco Control 20(2): 156-162, 2011. (21 refs.)

Background Studies have shown that there is no safe level of secondhand smoke (SHS) exposure and there is a close link between SHS and the risk of coronary heart disease and stroke. Carbon monoxide (CO) is one of the most important components present in SHS. Objective To evaluate the impact of the smoking ban law in the city of Sao Paulo, Brazil, on the CO concentration in restaurants, bars, night clubs and similar venues and in their workers. Methods In the present study we measured CO concentration in 585 hospitality venues. CO concentration was measured in different environments (indoor, semi-open and open areas) from visited venues, as well as, in the exhaled air from approximately 627 workers of such venues. Measurements were performed twice, before and 12 weeks after the law implementation. In addition, the quality of the air in the city during the same period of our study was verified. Results The CO concentration pre-ban and pot-ban in hospitality venues was indoor area 4.57 (3.70) ppm vs 1.35 (1.66) ppm (p<0.0001); semi-open 3.79 (2.49) ppm vs 1.16 (1.14) ppm (p<0.0001); open area 3.31 (2.2) ppm vs 1.31 (1.39) ppm (p<0.0001); smoking employees 15.78 (9.76) ppm vs 11.50 (7.53) ppm (p<0.0001) and non-smoking employees 6.88 (5.32) ppm vs 3.50 (2.21) ppm (p<0.0001). The average CO concentration measured in the city was lower than 1 ppm during both pre-ban and post-ban periods. Conclusion Sao Paulos smoking-free legislation reduced significantly the CO concentration in hospitality venues and in their workers, whether they smoke or not.

Leykin Y; Cucciare MA; Weingardt KR. Differential effects of online training on job-related burnout among substance abuse counsellors. Journal of Substance Use 16(2): 127-135, 2011. (15 refs.)

High voluntary turnover of substance abuse counsellors is a recognised and pervasive problem, likely due in large part to job-related burnout experienced by providers. This article explores the influence of the type of training on three facets of burnout (emotional exhaustion, depersonalisation and a reduced perception of personal accomplishments) among substance abuse counsellors participating in an online training protocol consisting of cognitive-behavioural therapy for substance use. Two training types were used: high fidelity (i.e. structured, didactic "classroom"-style training), and low fidelity (i.e. more flexible and customisable training). Participation in a more flexible training model predicted lower burnout scores for participants both immediately and 6 months after training. Participants with a history of personal recovery from substance abuse and those working in positions of leadership also reported lower burnout scores after training. We conclude that perception of support and flexibility in the workplace may be helpful to prevent burnout and decrease existing burnout.

Lippel K; Quinlan M. Regulation of psychosocial risk factors at work: An international overview. (editorial). Safety Science 49(4, special issue): 543-546, 2011. (43 refs.)

Moore C. Oral fluid and hair in workplace drug testing programs: new technology for immunoassays. Drug Testing and Analysis 3(3): 166-168, 2011. (5 refs.)

Workplace drug testing programs have embraced both oral fluid and hair as testing matrices. Saliva is popular due to its easy, rapid collection; its non-invasiveness compared to urine or blood; the convenience of collecting a specimen anywhere, anytime; and the difficulty of adulteration. The main advantage of saliva, however, remains its suitability for post-accident or 'for-cause' testing since the presence of a drug can assist in the determination of an individual being 'under the influence' of a drug. Hair, on the other hand, is useful for workplace programs, since its ability to provide historical information on drug intake ensures it is an excellent specimen for pre-employment testing. Both technologies have enjoyed collection and laboratory improvements for immunoassay screening over the last few years, and these are discussed in this perspective.

Ozturk A; Poyrazoglu S; Sarli S. The short term effect of the law prohibiting smoking in enclosed areas upon the smoking conditions of employees in Kayseri, Turkey. Turkish Journal of Medical Sciences 41(1): 165-171, 2011. (16 refs.)

Aim: A law prohibiting smoking in the enclosed areas of public and private workplaces was put into effect in Turkey on 19 May 2008. The objective of this study was to evaluate the effect of this law upon the smoking habits of the employees in this short period of 3 months. Materials and methods: This study was performed in Kayseri, in 3 public and 3 private workplaces, comprising 868 employees. A questionnaire was filled out, face-to-face, in the second week of August. Results: The ratio of the people supporting this smoke-free law was 68.7%. Among the employees who were smoking when the law was put into effect, 5 (1.5%) of them have stated that they quit smoking because of the law, within 3 months. Among employees still smoking, 54.1% stated that the number of cigarettes they smoked in the workplace had decreased following this law, and 43.4% stated that the number of cigarettes smoked during the entire day had decreased. The mean number of cigarettes smoked had decreased from 10.8 to 8.1 in the workplace and from 15.6 to 13.0 during the entire day. Conclusion: It was revealed that this new smoke-free law has been effective in decreasing the number of cigarettes smoked, both in the workplace and during the day.

Sorensen G; Stoddard A; Quintiliani L; Ebbeling C; Nagler E; Yang M et al. Tobacco use cessation and weight management among motor freight workers: Results of the Gear Up for Health Study. Cancer Causes & Control 21(12, special issue): 2113-2122, 2010. (57 refs.)

Objectives: To present the results of a study of a worksite-based intervention to promote tobacco use cessation and improve weight management among motor freight workers. Methods: This study used a pre-test/post-test, non-randomized design to assess the effectiveness of a four-month intervention that addressed the social context of the work setting. We evaluated 7-day tobacco quit prevalence among baseline tobacco users, and successful weight management, defined as no weight gain in workers with BMI <25 at baseline and any weight loss among overweight and obese workers. Results: At baseline, 40% were current tobacco users, and 88% had a BMI of 25 or greater. Of 542 workers invited to participate, 227 agreed to participate and received at least the first telephone call (42%). Ten-month post-baseline, baseline tobacco users who participated in the intervention were more likely to have quit using tobacco than non-participants: 23.8% vs. 9.1% (p = 0.02). There was no significant improvement in weight management. Conclusions: Incorporating work experiences and job conditions into messages of health behavior change resulted in significant tobacco use cessation among participating motor freight workers.

Babor TF. Commentary on Laslett et al. (2011): Alcohol-related collateral damage and the broader issue of alcohol's social costs. Addiction 106(9): 1612-1613, 2011. (2 refs.)

Ferris JA; Laslett AM; Livingston M; Room R; Wilkinson C. The impacts of others' drinking on mental health. Medical Journal of Australia 195(3, supplement): S22-S26, 2011. (23 refs.)

Objective: To analyse the links between other people's drinking and mental health and to explore the effects on mental health of heavy and problematic drinkers both within and outside spousal relationships. Design, setting and participants: A secondary analysis of data obtained as part of the Alcohol's Harm to Others survey from 2622 randomly sampled Australian adults interviewed by telephone between October and December 2008. Main outcome measures: Self-reported anxiety or depression and satisfaction with mental wellbeing; the presence of heavy and problematic drinkers in respondents' lives. Results: Identification of at least one heavy drinker in the respondents' social network of friends, family and co-workers was significantly negatively associated with self-reported mental wellbeing and anxiety or depression. If the heavy drinker was identified by the respondent as someone whose drinking had had a negative impact on their life in the past year, the adverse effect on mental wellbeing and anxiety was much greater. Conclusions: Our findings support a causal pathway between alcohol use and mental health problems by way of someone else's drinking. The association with adverse mental health is substantial regardless of the type of relationship an individual has with the heavy drinker whose drinking has had an adverse effect on them.

Hughes MC; Yette EM; Hannon PA; Harris JR; Tran NM; Reid TR. Promoting tobacco cessation via the workplace: Opportunities for improvement. Tobacco Control 20(4): 305-308, 2011. (24 refs.)

Introduction. Little research exists on the prevalence of evidence-based tobacco cessation practices in workplaces, employer promotion of state-sponsored quitlines and predictors of these practices. Methods. Cross-sectional analysis of the 2008 Healthy Worksite Survey, a telephone survey administered to Washington employers with 50 or more employees (n = 693). The objectives were to describe workplaces' implementation of evidence-based tobacco cessation practices and identify key predictors of implementation in order to highlight opportunities for interventions. Results. Among these employers, 38.6% promoted quitting tobacco, and 33.8% offered insurance coverage for cessation medications and counselling, 27.5% referred no-smoking violators to cessation services, and 5.7% included the state-sponsored quitline in health promotion messages. Larger workplaces and workplaces with a wellness staff, committee or coordinator had greater insurance coverage for tobacco cessation, communications promoting tobacco cessation, and promotion of the state-sponsored quitline (p<0.01). Workplaces with a wellness staff, committee or coordinator referred more violators of no-smoking policies to cessation services (p<0.01). Conclusions. In Washington State workplaces do little to promote tobacco cessation by their employees. The lack of tobacco cessation promoting practices at small businesses, restaurants and bars, and businesses without wellness personnel indicates an opportunity for finding and reaching current smokers at businesses with limited resources. By adopting inexpensive prevention efforts, such as promoting the state-sponsored tobacco cessation quitline, employers can help employees quit smoking and, thereby, assist in improving employee health and lower medical costs.

Lai HK; Hedley AJ; Repace J; So C; Lu QY; McGhee SM et al. Lung function and exposure to workplace second-hand smoke during exemptions from smoking ban legislation: an exposure-response relationship based on indoor PM2.5 and urinary cotinine levels. Thorax 66(7): 615-623, 2011. (35 refs.)

Background The effects of workplace second-hand smoke (SHS) on lung function remain uncertain because of a lack of objective measures for SHS exposures. Objective. To determine whether an exposure-response association exists between lung function and two different markers of SHS based on indoor fine particulate (PM2.5) and urinary cotinine levels in non-smoking catering workers. Design A cross-sectional study during a 1.5-year exemption of licensed catering premises from smoke-free legislation. Participants 186 non-smoking catering workers aged 18-65 years in Hong Kong were recruited. A declared non-smoking status was accepted in workers with exhaled breath carbon monoxide levels < 6 ppm and urinary cotinine levels < 100 ng/ml. Main outcome measures. Lung function measures of forced expiratory volume in 1s (FEV1 in litres), forced vital capacity (FVC in litres) and forced expiratory flow as 25-75% of FVC (FEF25-75 in l/s) were recorded. Results. Indoor fine particulate (PM2.5) concentrations were 4.4 times as high in smoking premises (267.9 mu g/m(3)) than in non-smoking premises (60.3 mu g/m(3)) and were strongly associated with the probability of permitted smoking (R-2=0.99). Smoking was the dominant source of particulates (R-2=0.66). Compared with workers exposed to the lowest indoor PM2.5 stratum (< 25 mu g/m(3)), lung function was lower in the three higher PM2.5 strata (25-75, 75-175, > 175 mu g/m(3)) with FEV1 -0.072 (95% CI -0.123 to -0.021), -0.078 (95% CI -0.132 to -0.024), -0.101 (95% CI -0.187 to -0.014); FEF25-75 -0.368 (95% CI -0.660 to -0.077), -0.489 (95% CI -0.799 to -0.179), -0.597 (95% CI -0.943 to -0.251); and FEV1/FVC (%) -2.9 (95% CI -4.8 to -1.0), -3.2 (95% CI -5.1 to -1.4) and -4.4 (95% CI -7.4 to -1.3), respectively. Urinary cotinine was associated positively with indoor PM2.5 but negatively with lung function. Consistently lower values for lung function per unit increase of indoor PM2.5 were found. Conclusion. Lung function is inversely associated with workplace SHS. Workplace exemptions and delays in implementing smoke-free policies and current moves to relax legislation are a major threat to the health of workers.

Laslett AM; Room R; Ferris J; Wilkinson C; Livingston M; Mugavin J. Surveying the range and magnitude of alcohol's harm to others in Australia. Addiction 106(9): 1603-1611, 2011. (32 refs.)

Aims This study aims to document the adverse effects of drinkers in Australia on people other than the drinker. Design Cross-sectional survey. Setting In a national survey of Australia, respondents described the harmful effects they experienced from drinkers in their households, family and friendship networks, as well as work-place and community settings. Participants A randomly selected sample of 2649 adult Australians. Measurements Problems experienced because of others' drinking were ascertained via computer-assisted telephone interviews. Respondent and drinker socio-demographic and drinking pattern data were recorded. Findings A total of 70% of respondents were affected by strangers' drinking and experienced nuisance, fear or abuse, and 30% reported that the drinking of someone close to them had negative effects, although only 11% were affected by such a person 'a lot'. Women were more affected by someone they knew in the household or family, while men were more affected by strangers, friends and co-workers. Young adults were consistently the most negatively affected across the majority of types of harm. Conclusions: Substantial proportions of Australians are affected by other people's drinking, including that of their families, friends, co-workers and strangers. These harms range in magnitude from noise and fear to physical abuse, sexual coercion and social isolation.

Lu SQ; Fielding R; Psychology C; Hedley AJ; Wong LC; Lai HK et al. Secondhand smoke (SHS) sxposures: Workplace exposures, related perceptions of SHS risk, and reactions to smoking in catering workers in smoking and nonsmoking premises. Nicotine & Tobacco Research 13(5): 344- 352, 2011. (34 refs.)

Introduction: Smoke-free workplace legislation often exempts certain venues. Do smoking (exempted) and nonsmoking (nonexempted) catering premises' workers in Hong Kong report different perceptions of risk from and reactions to nearby smoking as well as actual exposure to secondhand smoke (SHS)? Methods: In a cross-sectional survey of 204 nonsmoking catering workers, those from 67 premises where smoking is allowed were compared with workers from 36 nonsmoking premises in Hong Kong on measures of perceptions of risk and behavioral responses to self-reported SHS exposure, plus independent exposure assessment using urinary cotinine. Results: Self-reported workplace SHS exposure prevalence was 57% (95% CI = 49%-65%) in premises prohibiting and 100% (95% CI = 92%-100%) in premises permitting smoking (p < .001). Workers in smoking-permitted premises perceived workplace air quality as poorer (odds ratio [OR] = 9.3, 95% CI = 4.2-20.9) with higher associated risks (OR = 3.7, 95% CI = 1.6-8.6) than workers in smoking-prohibited premises. Workers in smoking-prohibited premises were more bothered by (OR = 0.2, 95% CI = 0.1-0.5) and took more protective action to avoid SHS (OR = 0.2, 95% CI = 0.1-0.4) than workers in smoking-permitted premises. Nonwork exposure was negatively associated with being always bothered by nearby smoking (OR = 0.3, 95% CI = 0.1-0.9), discouraging nearby smoking (OR = 0.5, 95% CI = 0.2-1.1), and discouraging home smoking (OR = 0.4, 95% CI = 0.2-0.9). Urinary cotinine levels were inversely related to workers' avoidance behavior but positively related to their perceived exposure-related risks. Conclusions: Different workplace smoking restrictions predicted actual SHS exposure, exposure-related risk perception, and protective behaviors. Workers from smoking-permitted premises perceived greater SHS exposure-related risks but were more tolerant of these than workers in smoking-prohibited premises. This tolerance might indirectly increase both work and nonwork exposures.

Marchand A; Parent-Lamarche A; Blanc ME. Work and high-risk alcohol consumption in the Canadian workforce. International Journal of Environmental Research and Public Health 8(7): 2692-2705, 2011. (65 refs.)

This study examined the associations between occupational groups; work-organization conditions based on task design; demands, social relations, and gratifications; and weekly high-risk alcohol consumption among Canadian workers. A secondary data analysis was performed on Cycle 2.1 of the Canadian Community Health Survey conducted by Statistics Canada in 2003. The sample consisted of 76,136 employees 15 years of age and older nested in 2,451 neighbourhoods. High-risk alcohol consumption is defined in accordance with Canadian guidelines for weekly low-risk alcohol consumption. The prevalence of weekly high-risk alcohol consumption is estimated to be 8.1% among workers. The results obtained using multilevel logistic regression analysis suggest that increased work hours and job insecurity are associated with elevated odds of high-risk alcohol consumption. Gender female, older age, being in couple and living with children associated with lower odds of high-risk drinking, while increased education, smoking, physical activities, and, and economic status were associated with higher odds. High-risk drinking varied between neighbourhoods, and gender moderates the contribution of physical demands. The results suggest that work made a limited contribution and non-work factors a greater contribution to weekly high-risk alcohol consumption. Limits and implications of these results are discussed.

Mezuk B; Bohnert ASB; Ratliff S; Zivin K. Job strain, depressive symptoms, and drinking behavior among older adults: Results: from the health and retirement study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 66(4): 426-434, 2011. (56 refs.)

Objective. To examine the relationship between job strain and two indicators of mental health, depression and alcohol misuse, among currently employed older adults. Method. Data come from the 2004 and 2006 waves of the Health and Retirement Study (N = 2,902). Multivariable logistic regression modeling was used to determine the association between job strain, indicated by the imbalance of job stress and job satisfaction, with depression and alcohol misuse. Results. High job strain (indicated by high job stress combined with low job satisfaction) was associated with elevated depressive symptoms (odds ratio [OR] = 2.98, 95% confidence interval [CI]: 1.99-4.45) relative to low job strain after adjusting for sociodemographic characteristics, labor force status, and occupation. High job stress combined with high job satisfaction (OR = 1.93) and low job stress combined with low job satisfaction (OR = 1.94) were also associated with depressive symptoms to a lesser degree. Job strain was unrelated to either moderate or heavy drinking. These associations did not vary by gender or age. Discussion. Job strain is associated with elevated depressive symptoms among older workers. In contrast to results from investigations of younger workers, job strain was unrelated to alcohol misuse. These findings can inform the development and implementation of workplace health promotion programs that reflect the mental health needs of the aging workforce.

Moodie R. Commentary on Pidd et al. (2011): Booze and drugs on the job - zeroing in on the industries at risk. (editorial). Addiction 106(9): 1634-1635, 2011. (4 refs.)

Pidd K; Roche AM; Buisman-Pijlman F. Intoxicated workers: Findings from a national Australian survey. Addiction 106(9): 1623-1633, 2011. (46 refs.)

Aims: To identify prevalence of alcohol and drug use and intoxication at work. Participants: A total of 9828 Australian workers >= 14 years old. Setting Australia 2007. Measurements Work-place alcohol use and drug use, intoxication at work, industry and occupation of employment. Design Secondary analysis of a large nationally representative survey involving descriptive and weighted multivariate logistic regressions. Findings Differential patterns were identified by drug type, worker characteristics and occupational setting, controlling for demographic variables. Nearly 9% of workers surveyed (8.7%) usually drank alcohol at work and 0.9% usually used drugs at work. Attending work under the influence of alcohol was more prevalent (5.6%) than attending work under the influence of drugs (2.0%), and significantly more likely among young, male, never married workers with no dependent children. Hospitality industry workers were 3.5 times more likely than other workers to drink alcohol and two to three times more likely to use drugs at work or attend work under the influence of alcohol or drugs. Other high-risk industries and occupations included construction, financial services, tradespersons and unskilled workers. Conclusion: More than one in 20 Australian workers admit to having worked under the influence of alcohol and almost one in 50 report attending work under the influence of psychoactive drugs. The rates are higher for some industries, such as the hospitality industry, than others.

Terry PE; Seaverson ELD; Staufacker MJ; Tanaka A. The effectiveness of a telephone-based tobacco cessation program offered as part of a worksite health promotion program. Population Health Management 14(3): 117-125, 2011. (34 refs.)

Extensive research on tobacco cessation affirms the effectiveness of interventions, although the literature is more limited concerning the impact of programs designed specifically for the workplace. The present study examines the effectiveness of a telephone-based health coaching tobacco cessation program that was provided as part of worksite health promotion programs by 10 large employers. The participants were recruited based on their health risks as identified by health assessments, and the program was personalized to meet their individual needs and stages of change. The results indicate that at 12 months, health coaching program participants achieved a 32% quit rate, compared to 18% for nonparticipants. The quit rate was highest (44%) among program completers who were ready to change at baseline. These results suggest that a tobacco cessation program offered as part of a worksite health promotion program can be highly effective, especially for those who are ready to change. However, the relatively low annual participation rate may indicate that tobacco users remain among the most difficult to engage and to support in their efforts to complete programs. Therefore, implementing a variety of engagement strategies, such as policy changes, as well as social and financial incentives and penalties will most likely have a positive effect at the population level.

Turel O; Serenko A; Bontis N. Family and work-related consequences of addiction to organizational pervasive technologies. Information & Management 48(2-3): 88- 95, 2011. (41 refs.)

While organizational pervasive technologies, such as mobile computing, can contribute to increased productivity, their nature can also result in technology addiction. We applied the behavior-environment interface of social cognitive theory to explain several negative familial and organizational consequences of addiction to work-related pervasive technologies. Our empirical study of 241 organizational mobile email users revealed that their levels of addiction to mobile email increased their perceived work overload and technology-family conflict. Perceived work overload, in turn, reduced their organizational commitment. Furthermore, elevated levels of perceived work overload together with augmented technology-family conflict fostered work-family conflict. Implications for research and practice are suggested.