The Effects of Substance Use on Workplace Injuries
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Occupational injuries are a serious public-health issue and cause significant morbidity and mortality in the United States. In 2004, there were 3.4 million admissions to emergency rooms for job-related injuries and illnesses, a number that reflects an estimated rate of 2.5 admissions per 100 full-time equivalent (FTE) workers aged 15 and older (CDC, 2007b). In 2005, private industry employers reported 1.2 million injuries and illnesses that required days away from work, representing 135.7 per 10,000 FTE workers (IIF, 2007). The same year, data from the Census of Fatal Occupational Injuries (CFOI) estimated that there were approximately four occupational-injury deaths per 100,000 employed workers, which represented a total of 5,702 such deaths that year (CDC, 2007a). The costs of occupational injuries and illnesses in the United States exceed $100 billion annually and entail both direct (e.g., medical expenses) and indirect (e.g., loss of wages, loss of home, workplace disruption) costs borne by injured workers, their families, other workers through lower wages, firms through lower profits, and consumers through higher prices (Leigh, 2000). In this paper, we review the literature that has examined the impact of substance use on occupational injuries. We begin briefly by describing the so-called obvious associations between using on the job and occupational injuries and propose alternative reasons that sub- stance use may be linked to work-related accidents. We then review the most-recent empiri- cal literature that has attempted to document the relationship between substance use and occupational injuries. We highlight findings that are consistent across studies and address the limitations that most of these studies confront. We then proceed to examine the policies that attempt to address substance use at the workplace and, often without empirical analysis, hypothesize why each initiative may or may not influence rates of occupational injuries. We conclude by discussing what remains unknown about the relationship between substance use and occupational injuries and identify future avenues for research that could help fill some of these research gaps.
The article of record as published may be found at https://www.rand.org/pubs/occasional_papers/OP247.html
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