EurWORK European Observatory of Working Life

France: EWCO CAR on Use of Alcohol/Drugs at the Workplace

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  • Published on: 07 May 2012



About
Country:
France
Author:
Sebastian Schulze-Marmeling
Institution:

Disclaimer: This information is made available as a service to the public but has not been edited by the European Foundation for the Improvement of Living and Working Conditions. The content is the responsibility of the authors.

Data available on alcohol and drugs at work are still limited, but attention increases and data sources are improving considerably. Available information shows relationships between the use of alcohol and drugs, and, among others, employment status, socio-professional indicators, sector, and education. Consumption in the transport sector is high but testing and prevention receives increasing attention. Similar developments can be observed in the construction sector as link between intoxication and work-related accidents is emphasised. Legal regulation exists, but leaves considerable leeway. Systematic testing for alcohol and drugs is generally forbidden, but gradual allowance is currently debated.

QUESTIONNAIRE

Block 1: Main sources of information dealing with the issue of alcohol/drug use at the workplace at national level and its relation with working conditions, etc.

1.1 Are there national statistical sources (surveys, administrative registers including company reports as surveys / reports from the Labour Inspectorate, Labour doctors, etc) that provide information on the issue of alcohol/drug use at the workplace in your country? If so, identify them and explain their characteristics and methodology. Please refer both to general population health surveys/sources or general alcohol/drug use surveys/sources as to working conditions or workplace specific surveys/sources

A 2010 report by the French Monitoring Centre for Drugs and Drug Addiction (Observatoire français des drogues et des toxicomanies, OFDT) reveals a number of data sources. Table 1 gives a summary. The focus of these surveys is, however, not so much on the use of drugs at work, but on professional risks associated with the abuse of alcohol and drugs.

Table 1 - Sources of information dealing with alcohol/drug use and work issues
Surveys that are conducted in regular intervals
Name Scope Goals Methodology Periodicity
Health Barometer (Baromètre Santé)

Representative sample of the French population

To monitor the general health conditions of the French population

Telephone interviews (ca. 30,000 in 2005, 28,000 in 2010)

5 years

Health and Behaviour Study on the National Defence Preparation Days (Enquête sur la santé et les comportements lors de l’appel de préparation à la défense, ESCAPAD)

Study of young people between 16 and 18 years old participating in the National Defence Preparation Days (Journée d’appel de préparation à la défense, JAPD)

To survey the amount and types of drugs consumed by young people, as well as the developments over time

Questionnaires handed out during the JAPD (ca. 50,000 responses in 2008)

yearly

1.2. Are there any other sources of information (published after mid-2000s) that may provide valuable information on the issue (i.e. ad-hoc studies, sectoral studies, administrative reports, articles, published case studies, etc). If so, identify and describe them.

There are a number of ad-hoc studies on these issues with different foci (non-exhaustive list):

  • Regional studies (Orset, et al. 2007; Société Française d’Alcoologie 2010)

  • Studies by occupational group:

  • Road transport workers (Delzenne and Pradeau 2001; Devos and Masson 2006; Labat, et al. 2004; Laumon, et al. 2005)

  • Medical professions (Beaujouan, et al. 2005)

  • Maritime workers (Bergeret and Fort 2008)

  • In addition, there are studies that use qualitative methods to tackle the phenomenon (Fontaine 2006; Fontaine and Fontana 2003).

In spite of the existence of some studies the Inter-departmental Mission for the Fight Against Drugs and Drug Addiction (Mission interministérielle de lutte contre la drogue et la toxicomanie, MILDT) criticises that most data are declarative and might thus be biased.

Block 2: Information on the extent of the use of alcohol and drugs at the workplace in your country, as well as the type of situations (sectors, occupations, working conditions, etc.) in which this use occurs, its consequences (production process, social relations at work) and the rationale behind it

2.1. Please provide the available data and information on the prevalence of drug/alcohol use at the workplace in your country, if possible differentiating data by:

Probably the most important source that systematically and regularly collects data on alcohol and drugs at work is the Health Barometer. The preliminary results of its latest 2010 version do not yet include specific information with regards to the world of work. This is unfortunate as the new survey contains more detailed questions on the context and the consequences of the use of drugs. In lack of these data, however, a summary of the findings from the 2005 survey are reported here.

Comparing employed and unemployed survey respondents it is found that the unemployed are more likely to consume alcohol on a daily or regular basis (1.2 and 1.3 times respectively). For those being in employment the socio-professional category is a crucial factor. Farmers are reported to fall more often in the category of “risk of chronic drinking or addiction” than all other professions. Employees are the least concerned. Independent tradesmen, heads of enterprises, managers and intermediate professions seem to drink less and less often whereas blue-collar workers are the most likely to be inebriated at least once per year. Furthermore, all alcohol-related indicators are negatively related with education, i.e. the higher the levels of education obtained the less likely are people in the workforce to drink or to be inebriated regularly.

Similarly, the use of cannabis is more likely among the unemployed, particularly in the age group 35-44, whereas it increases with level of diploma. With regards to socio-professional characteristics and the use of cannabis the report proposes three groups: farmers consume less than average, whereas the consumption of craftsmen, head of enterprises and workers are considerably higher. Managers and intermediate professions are close to the mean.

The consumption of cocaine is significantly higher among the unemployed (6.2% have consumed it at least once and 1.8% within the last year) in comparison to the employed population (2.6% and 0.5%, respectively). Among the working population, on the contrary, socio-professional characteristics are of minor importance although farmers consume less than all others. Unlike alcohol the use of cocaine increases with the level of diploma obtained. A particularly high level of consumption is reported by managers working in the art and festival sector (3.9 times as often as other managers). Similarly, ecstasy is more often consumed by the unemployed. There is, however, no significant link between either level of diploma or belonging to a socio-professional group and the use of ecstasy. As for cocaine managers in the arts and festival sector are more likely to consume the drug than all other categories analysed.

There are a number of studies on the use of alcohol and drugs in the transport sector (as reported by the report cited above). Research conducted in the Nord Pas-de-Calais region analysed some 1,000 urine samples of haulage drivers. They found the traces of opiates in 4.1% of the samples, cannabinoids (8.5%), cocaine (0.1%), amphetamines (0.3%), buprenorphine (an opioid that is used to treat opioid addiction, found in 1.8% of all samples), methadone (0.5%), benzodiazepine (used in sedatives, 0.4%), and alcohol (5%) (Labat, et al. 2004). An earlier study came to similar results for alcohol and cannabis (Haguenoer, et al. 1997). Other research tested candidates for jobs as haulage drivers. Some 10% of the 313 applicants withdrew after they had been informed about the testing. 11% of the remaining candidates were tested positive on cannabis (Delzenne and Pradeau 2001). A study commissioned by a leading health insurer among drivers of haulages, tractors, forklifts and construction machines in the agricultural sector found that 8% of the surveyed had smoked cannabis in the previous 12 months and 22% had a “risky” level of alcohol consumption (Devos and Masson 2006).

The National Institute for Prevention and Health Education (Institut national de prévention et d'éducation pour la santé, INPES) draws its findings on two studies conducted with human resource (HR) managers and workers, respectively. 25% of the surveyed workers state that the use of cannabis at the workplace is increasingly worrying. This is particularly the case in the construction sector (36%). 10% of the workers report that the consumption of alcohol at work is part of the organisational culture. This trend is particularly pronounced in agriculture and transport (23% each). A MILDT report and an article published in the daily newspaper Le Figaro mention the construction sector as particularly concerned by the use of alcohol and drugs without providing further details.

2.2. Please provide data and information on the rationale and consequences of drug/alcohol use at work. Focus on construction, transport:

The health barometer report does not contain information on the reasons or consequences for the use of drugs or alcohol. It is reported, however, that cannabis is perceived as a very accessible substance as 58% of the surveyed think that they could obtain it easily if they wanted to. The INPES study cited above reports the high level of concern about alcohol-related accidents at work, particularly in the transport and construction sectors. A study commissioned by OFDT analysed urine and blood samples of almost 11,000 drivers involved in deadly traffic accidents. It is found that driving under the influence of alcohol and/or cannabis drastically increases the likelihood of being involved in a deadly accident. Drivers below the legal limit of alcohol (0.5g/litre of blood) are 2.7 times more likely, but the ratio increases rapidly with the concentration of alcohol (see Table 2). Drivers whose urine or blood samples show traces of cannabis were 1.8 times more likely to be involved in a deadly accident. A strong effect was found for those where traces of both alcohol (>0g/l) and cannabis (>0ng/ml) could be found. The odd ratio for this group is 14.0.

Table 2 – Alcohol and Deadly Car Accidents

Concentration of alcohol in the blood (g/l)

Odds ratio of being involved in a deadly accident

0

1.0

< 0.5

2.7

0.5 – 0.8

6.3

0.8 – 1.2

7.6

1.2 – 2.0

13.2

≥ 2.0

39.6

Total (> 0)

8.5

Notes: controlled for consumption of cannabis, age, vehicle, time of accident

Source: OFDT

Block 3: Identify legislation and agreements at national level concerning alcohol/drugs use at the workplace, specifically those related to testing practices

3.1. Please identify and describe the main existing legislation and agreements concerning the prohibition/limitation of alcohol/drug use at work:

  • Is there any legislation or agreement specifically intended to prohibit or limit alcohol/drug use at work? Please describe:

  • Type of legislation / agreement (Government or parliament laws, agreements from social dialogue, from the Governments and social partners, from other organisations, etc.)

  • Contents, stipulations

  • Collectives affected

  • Is there any sectoral legislation or agreement with the same purpose? Please focus on the construction and transport sectors

The French Labour Code (Code du Travail) contains a few direct references to the use of alcohol at work. The two most important provisions are:

  • Article R4228-20: No alcoholic beverage, except wine, beer, cider (cidre), or perry, is allowed at the workplace.

  • Article R4228-21: It is forbidden to allow intoxicated persons to enter or stay at the workplace.

No direct reference is made to the use of narcotic substances but article R4228-21 also applies to people under the influence of drugs. More generally, it is the responsibility of the employer to organise the provision of services that avoid any impact on workers’ health (Labour Code, Article L4633-2). More precisely, this explicitly includes the prevention of the consumption of alcohol and drugs at work (Article L4622-2). It is possible to draft internal regulations to deal with all issues regarding drugs and alcohol. Finally, the Labour Code states that alcohol may not be given to employees as remuneration or fringe benefit served with a common meal (Article R3231-16).

At present no collective agreement that deals with alcohol and drugs at work could be identified on national level. But some company level agreement on heath and safety deal with addiction. For example the food retailers Group Casino, signed such agreement in December 2010, with four (CFE-CGC, CFTC, FO, Unsa) on the six representative unions. The agreement aim is the prevention of any addiction by communication action and training, but without any sanction.

The Institute Gustave-Roussy (IGR), the leading European anticancer centre (2,500 employees), has also signed an agreement on health and safety with two representative unions (CFDT, Sud) on April 2010. The social partners launched a policy to prevent addictions (Tobacco and alcohol). The Institute has the commitment do launch initiative to support the employees when the impact of addiction have consequences on their professional behaviour.

A round table commissioned by MILDT and the Ministry of Labour, Solidarity and Public Service (Ministère du Travail, de la Solidarité et de la Fonction publique) that took place in June 2010 and dealt with these issues made references to examples from Belgium. The final report of the same meeting also concluded that it would not be necessary to introduce further legal regulation on the issue of drug abuse at work.

3.2. Specific focus on legislation / agreements regarding testing practices intended to control the use of alcohol/drugs at work. Please consider questions such us:

Describe changes, evolution development of regulation / agreements on testing, drawing the attention to the review in light of the improvement of the testing methods

In general it is not allowed to conduct systematic testing of employees on the use of alcohol or drugs. There are, however, a number of regulations that allow for certain exceptions. In particular, works doctors might detect during a general examination that employees’ psychological and/or physical capabilities are negatively affected by the consumption of alcohol and/or drugs. In this case, employees can be declared unfit for a certain kind of job by the works doctor if their consumption of alcohol and/or drugs impedes them to comply with the jobs requirements or health and safety standards.

When hired employees are subject to a medical examination that must take place before the end of the probation period. The test aims at verifying that the employee is fit for the job and does not suffer of a disease that might be dangerous for their co-workers (Labour Code, Article R4624-10). Some occupations that are exposed to physically hard or dangerous tasks require an intensified medical test before the hiring. Social partners may specify this provision in a collective agreement (Article R4624-19). The doctor reports to the employer only if the person is able to do a certain job, but will not share any medical details (Articles D4624-46 and D4624-47).

After an employee has passed the obligatory initial tests and is declared fit for the job they are obliged to be examined regularly; at least every two years (Article R4624-16). Those workers who fall under intensified testing before being hired (see above) have to pass an exam at least once a year (Article R4624-17). Moreover, some specific working conditions require an even shorter period between two examinations. Workers that are exposed, for instance, to paint or varnish, or those who do night work are subject to medical examination every six months. Special regulations also apply to, for instance, pregnant women, young, or disabled workers. Finally, both employer and employee may ask for extra examinations. If the examination is requested by the employee they may not be sanctioned based on its results.

Systematic testing for drugs is generally forbidden, but may be permitted for certain kinds of work that require high safety standards. These include jobs that include tasks which are dangerous for the employee or a third person. Although there is no detailed list, the following jobs have been identified as falling into this legislation (non-exhaustive list):

  • Most jobs that involve handling heavy or potentially dangerous vehicles such as haulages, deliverymen, metro and train drivers, truck drivers transporting inflammable goods

  • Jobs that involve the handling of dangerous machines

  • Jobs that involve the handling of dangerous products

  • Jobs that involve the carrying of weapons

Spontaneous alcohol or drug tests cannot, however, be requested by the employer and must be conducted by a medical doctor or a trained biologist. The results must not be communicated to the employer as they are under professional secrecy. The employer is only informed about the employee’s ability or inability to perform certain tasks. The employee must be informed in advance about the purpose of the test as well as possible consequences.

Recently, the National Consulting Ethics Committee (Comité consultatif national d’éthique, CCNE) on behalf of MILDT issued a recommendation in favour of a liberalisation of systematic drug testing. This should, however, be restricted to precisely defined high-risk jobs, which are to be defined in cooperation with the social partners and included into the legal framework. The committee is against a general application of alcohol and drug tests to other professions as this would constitute a strong restriction of the individual’s personal liberties and privacy.

Block 4: Identify and describe national prevention programmes to combat the use of alcohol/drugs at the workplace, especially those based on agreements and cooperation of the social partners:

MILDT is a major actor in the prevention of alcohol and drugs at work. The governmental agency has organised a roundtable in Paris in 2010 that dealt with the scientific analysis of the problem, effective measures of prevention, the role of legal regulation, and the involvement of employers and trade unions. The main outcomes of this high-level meeting are cited above. Other meetings took place in Angers and Bordeaux. The aim of these conferences is to analyse the problem and to elaborate new approaches that involve the state, the employer and employees. At the Paris conference the involvement of social partners into the prevention of alcohol and drug abuse at work was discussed. The interprofessional agreement in Belgium (BE0905029I) was presented and discussed as ‘good practise’. Participants expressed the need for similar concerted agreements in France. The CCNE recommendation cited above brings forward similar propositions that emphasise that a strong involvement of social partners is needed to tackle the problem.

Despite its mainly state-driven character there are numerous prevention measures in place in France. More general, one of the major information campaign was launched by MILDT and INPES, and is named Drugs and Addiction (Drogues et Dépendance). The online platform is a comprehensive information resource and provides numerous contact details for organisations that help with addictions. With regards to alcohol and drugs at work the National Research and Security Institute for the Prevention of Accidents at Work and Occupational Illnesses (Institut national de recherche et de sécurité pour la prévention des accidents du travail et des maladies professionnelle, INRS) has published a DVD that aims at training employers and managers to identify concerned employees and to deal with their problems sensibly. Furthermore, several hotlines exist where anonymous and informal help is provided. These include help for young people (Les points accueil écoute jeunes, PAEJ), a hotline for consumers of cannabis (Ecoute Cannabis) and the Centres of Assistance and Prevention in Addictology (Centres de Soins d’Accompagnement et de Prévention en Addictologie, CSAPA).

A comprehensive programme to tackle alcohol and drug addiction was implemented in the city of Nantes in western France that was targeted at all 4,700 employees in the local public administration. As the magazine Health and Work (Santé et travail) reported the project had three main objectives – to raise awareness among all actors involved and to train managers to deal with addiction at work, to identify the factors that favour addictions, and to establish working conditions that discourage employees to use alcohol and drugs. The latter was based on the assumption that no alcohol at work at all was not realistic and, thus, it was tried to minimise the consumption. In particular, recommendations were made to reduce the consumption, workers were encouraged to be aware of their colleagues’ consumption, and the offer of alcohol at official receptions was reduced. The programme had a budget of €100,000. Although some difficulties and shortcomings are reported the authors of the article, who were involved in the project, draw positive conclusions. In the first year 3,500 employees have been made aware of the problem and 450 managers have been trained. Moreover, 3,500 voluntary alcohol tests were carried out among the workforce. The authors also report that the support offered has helped five employees to be abstinent for more than a year, but there were also three disciplinary measures against employees who did not comply. The difficulties and shortcomings reported include lack of time and time-consuming tasks, low participation in the early period of the project, and a reluctance to talk openly about a sensitive issue.

The use of alcohol and drugs in the construction sector has been identified as a major reason for accidents at work and may account for up to 20% of all work-related injuries. For this reason, the bipartite Professional Organisation for Prevention in the Construction Sector (Organisme professionnel de prévention du bâtiment et des travaux publics, OPPBTP), in cooperation with the Institute of Medical Education and Prevention (Institut d’éducation médicale et de prevention, IEMP), has launched an information campaign. A comprehensive leaflet was drafted containing practical information and recommendations on the risks and consequences of consuming alcohol and drugs at work, and measures for prevention. The information was distributed through the professional journal Prévention BTP that has some 17,000 subscribers.

In the transport sector the main issue seems to be alcohol and drug-related road accidents. To tackle the issue one initiative aims at introducing strong elements of risk prevention into all compulsory courses for obtaining a driving license. A European project called Driving under the Influence of Drugs, Alcohol and Medicines (DRUID), in which France takes part, has researched that rehabilitation programmes after a road accident under the influence of alcohol or drugs significantly decreases the likelihood of having another accidents. Therefore, it is recommended that a rehabilitation programme is introduced at European level.

Commentary by the NC

Three aspects appear to be particularly noteworthy. The first one is the quality of the data available. Most information is based on declarative surveys and might not reflect the real extent of the problem as respondents are likely to understate their actual consumption and behaviour. Some smaller studies use medical data from the analysis of blood or urine samples. Although the reliability of these measures seems to be significantly higher there are obvious ethical reservations against such methods. Moreover, it more expensive and logistically difficult than a survey-based approach.

Second, existing data and data analysis are still rather patchy. Large-scale national studies such as the Health Barometer only contain superficial information and do not allow for a more in-depth analysis of the phenomenon. More detailed research, on the contrary, is often very limited in its scope and focus and does not allow to draw more general conclusions. There are, however, important developments. As discussed above the forthcoming 2010 edition of the Health Barometer promises a substantial increase in drug and alcohol-related data.

The issues of data quality and availability are crucial for a realistic assessment of the phenomenon. The third aspect, the development of the politics regarding the use of alcohol and drugs at work, is of major importance for tackling the problem. Overall, the issue seems to have moved up the agenda of all parties involved. There is a broad consensus that social partners need to play a more active and proactive role. With regards to policy the issue of testing is widely discussed. The obvious conflict of collective security and individual privacy is of major importance. Testing must not, however, be confused with prevention that should be the core of the political debate.

Sebastian Schulze-Marmeling, HERA

References

  • Beaujouan, L., Czernichow, S., Pourriat, J., Bonnet, F. (2005) Prévalence et facteurs de risque de l’addiction aux substances psychoactives en milieu anesthésique : résultats de l’enquête nationale. Annales Françaises d’Anesthésie et de Réanimation 24, 471-479.

  • Bergeret, A., Fort, E. (2008) Enquête descriptive sur les pratiques addictives en milieu maritime français. Actes des 13e journées de la médecine des Gens de mer 13 et 14 mars 2001.

  • Delzenne, C., Pradeau, P. (2001) Limite, intérêt et avenir du dépistage systématique des substances psychoactives, étude sur une population de candidats au poste de chauffeurs poids lourds. Étude présentée aux XXIèmes Journées méditerranéennes de médecine du travail 26-28 octobre 2001.

  • Devos, C., Masson, N. (2006) Conduites addictives et travail : enquête nationale chez les chauffeurs affiliés à la Mutualité Sociale Agricole. Actes du 29e congrès national de médecine et santé au travail. Archives des Maladies Professionnelles et de l’Environnement 67, 212.

  • Fontaine, A. (2006) Double vie : Les drogues et le travail. Paris: Les empêcheurs de penser en rond.

  • Fontaine, A., Fontana, C. (2003) Drogues, activité professionnelle et vie privée - Deuxième volet de l’étude qualitative sur les usagers intégrés en milieu professionnel. ODFT.

  • Haguenoer, J., Hannothiaux, M., Lahaye-Roussel, M., Fontaine, B., Legrand, P., Shirali, P., Pamart, B., Brillet, J., Brouck, N., Bailly, I., Bailly, C., Frimat, P. (1997) Prévalence des comportements toxicophiles en milieu professionnel : une étude dans la région Nord Pas de Calais. Bulletin de l’Ordre des médecins 80, 11-15.

  • Labat, L., Dehon, B., Lhermitte, M. (2004) Prévalence de la consommation de produits modifiant la vigilance chez les transporteurs routiers dans la région Nord-Pas de Calais. Annales de toxicologie analytique 16, 269-274.

  • Laumon, B., Gadegbeku, B., Martin, J.L., M.B., B. (2005) Cannabis intoxication and fatal road traffic crashes in France: population based case control study. British Medical Journal 331, 1371-1374.

  • Orset, C., Sarazin, M., Cabal, C. (2007) Les conduites addictives en milieu professionnel prévalence par questionnaire chez 1 406 salariés de la Loire ; étude en fonction du poste de travail. Archives des Maladies Professionnelles et de l’Environnement 68, 5-19.

  • Société Française d’Alcoologie (2010) Alcool, addictions et travail. Résumé des communications. Alcoologie et Addictologie 32.

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