Questionnaire for EWCO CAR on Use of Alcohol/Drugs at the Workplace

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  • Observatory: EurWORK
  • Topic:
  • Published on: 07 May 2012

Mats Kullander and Kina Lundqvist

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.

Alcohol and drugs at the workplace is a relatively unexplored field in Sweden, although several sources claim that it is occurring – and increasing. Calculations show that the cost for alcohol related production losses was estimated to SEK 9.8 billion (approximately EUR 1.1 billion) in 2002. In order to prevent accidents at the work place, employers are obliged to provide a safe work environment which among other things requires an alcohol and drug policy. Alcohol and drug tests may be a part of this policy as there is no legislation controlling the right to impose such tests.

Alcohol and drugs at the workplace is a relatively unexplored field in Sweden, although several sources claim that it is occurring – and increasing. Calculations show that the cost for alcohol related production losses was estimated to SEK 9.8 billion (approximately EUR 1.1 billion) in 2002. In order to prevent accidents at the work place, employers are obliged to provide a safe work environment which among other things requires an alcohol and drug policy. Alcohol and drug tests may be a part of this policy as there is no legislation controlling the right to impose such tests.


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

  • Name of the statistical source

  • Scope

  • Goals

  • Methodology

  • Periodicity

The Swedish National Institute of Public Health (FHI) is a national knowledge centre with the mandate to follow up and evaluate the politics of public health, as well as supervising areas concerning alcohol, narcotics and tobacco. FHI carries out a national health survey on a yearly basis, with the scope to disclose the health status of the Swedish population and to identify changes over time. The survey consists of 75 questions that are posed to a simple random sample of 20,000 people between the ages 16 and 84.

The latest survey from 2010 demonstrates that 12% of women and 22% of men with risky alcohol consumption are to be found in the working life (FHI 2010). Numbers regarding drugs are not as informative, since these questions only concern the use of cannabis (hash and marijuana). Among the people who have been smoking cannabis over the last month (which is the most frequent consumption level possible of the answering alternatives), only 1% is employed. Of all those who have tried cannabis sometime in their life, 14.9% is employed. However, these numbers do not provide any information on use specifically at the workplace.

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.

The Centre for Social Research on Alcohol and Drugs (SoRAD) provides national data on alcohol consumption in Sweden, and in the latest report from 2010 it is shown that the total amount of alcohol consumed in 2009 is 9.3 litres pure alcohol per person above 15 years of age (SoRAD 2010). Men consume twice as much as women in relation to these average numbers, which means that men in 2009 consumed approximately 13 litres of pure alcohol. Differences between the genders are even more striking when it comes to intensive consumption, i.e. drinking a lot at one specific time; the share of intensive consumers (drinking at least once a week) is four times higher among men – 10% - compared to 2.5% among women.

According to FHI, Sweden has – in an international perspective – a low level of drug consumption. Of the Swedish population between 16 and 64 years of age, 12% has tried cannabis sometime in their life. This can be compared to the European average that was 22.5% in 2010. (FHI 2011). FHI acknowledges that it is hard to know how widespread the problem with drugs is in Sweden, partly because the meddling of drugs is criminalised, and partly because the use of drugs is versatile and hard to affirm.

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:

  • Type of substance

  • Sectors => specific focus on the construction and transport sectors

  • Occupational profiles

  • Other relevant variables

Surveys unveiling to what extent consumption of alcohol and drugs take place specifically at the work place are not available on a national level. However, the Swedish Work Environment Authority (Arbetsmiljöverket) claims that the abuse of alcohol and drugs is a common feature in the Swedish working life (Arbetsmiljöverket 2011).

A survey performed in 2006 by the Centre for Social Research on Alcohol and Drugs (SoRAD) at Stockholm University, examines alcohol consumption in different occupational groups. The findings show that people working in media and communication have a 76% higher consumption of alcohol than the average among the professional groups in the study, which is 681 centilitres pure alcohol per year (SoRAD 2006). Other groups with a high consumption are company salespersons, engineers and chauffeurs. Again, these numbers do not provide any information on the use of any other drugs, and they do not take into account whether the alcohol is being consumed at the workplace or not.

An informer at the Swedish Construction Federation (BI) witness a change in the attitude towards alcohol and drugs at the work place within the construction sector, compared to 30-40 years ago. Unlike then, it is now not socially accepted to drink or be affected by substances at the work place. He is however aware of a youth culture where substances like cannabis is common, and this also exists within the construction sectors just like in other sectors. (Interview BI)

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

Reasons for consuming alcohol/drugs

  • Use of drugs related to certain working conditions (e.g. alcohol when working in cold / warm environments; stimulants when working at high rhythm, etc…)

  • Accessibility/availability

Consequences of consuming alcohol/drugs

  • working conditions affected by drug use (risk increase, accidents, absenteeism, sick leave…):

  • Accidents and fatalities due to alcohol/drug use

  • Sick leaves attributed to alcohol/drugs, absenteeism

  • Assessment of costs

  • Use of alcohol/drugs negatively affecting other working conditions:

  • Uneven workload distribution…

  • Work organisation

  • working environment (deteriorated social relations at work, higher number of conflicts…)

Prevent is a nonprofit organisation whose responsible authority is shared by The Confederation of Swedish Enterprise (Svenskt Näringsliv), the Swedish Trade Union Confederation (LO), and the Council for Negotiation and Co-operation ( PTK) (formerly known as the Federation of Salaried Employees in Industry and Services). Its mission is to convey knowledge about work environmental questions and to develop methods to support each working place in their work environmental work. They bring up several factors at the work place that can contribute to increasing employees’ alcohol and drug consumption. These are lack of specific goals; uncommitted working hours; low social control; workaholicism; superfluous competence; alcohol consumption as a part of the work culture; social press to drink alcohol; stress; and solitude work. Many motives are thus related to the social environment and to stress. According to Prevent, alcohol is often used as a way to release tension, which is why it is important to acknowledge the relationship between stress and alcohol. A high workload can have direct effects in terms of stress, and indirect effects in terms of alcohol as a way of escaping work pressure. (Prevent 2011).

A report from SoRAD in 2006 provides data on production and health costs in Sweden during 2002. There are no recent data focusing on the exact same issue in relation to alcohol, which is why this source will be included and accounted for here.

Costs for production losses derive from lost societal resources due to decreased working capability. Such alcohol related costs are accounted for by deaths, early retirement, as well as long term and short term absence due to illness. Calculations are made both on actual days lost due to illness in 2002, and early retirements and future deaths are calculated as future lost production during the expected remaining lifetime (death) and up until 65 years of age (retirement) (SoRAD 2006). The total cost for alcohol related production losses is estimated to SEK 9.8 billion (approximately EUR 1.1 billion), of which SEK 3.1 billion (EUR 343 million) is attributed to deaths; SEK 2.4 billion (EUR 265 million) to early retirement; and SEK 4.3 billion (EUR 467 million) to absence due to illness (ibid.).

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

According to the Work Environment Act (AFS 1994:1), each work place should have an alcohol and drug policy, as well as a plan of action on how to attain the content of that policy. Swedish employers are obliged to provide a safe work environment and to inform employees of internal rules and routines in case an employee should be affected by alcohol or drugs. According to the Swedish Work Environment Agency, it is imperative to be sober and drug free at work – and the responsibility of achieving this lies with the employer. This requires a clear and explicit alcohol and drug policy, which should be developed together by both employers and employees (this topic will be discussed more in-depth in next section)

Work places are required to have routines for work adaption and rehabilitation which also includes intervention in case of alcohol or drug abuse. This means that the employer must provide the appropriate measures for the employees to be able to return to their employment. The Swedish Work Environment Agency recommends employers to regard the work’s organization and its content, which can be a contributing factor to misuse of substances, as mentioned in the previous section.

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:

  • how are the tests regulated (agreements / legislation or are there guidelines)?

  • what type/forms of tests – testing methods and for what type of substances?

  • who can ask for tests, on who's initiative are tests initiated? for what purpose/reasons?

  • is the consent of the person to be tested needed?

  • is pre-employment testing (before work contract signing) allowed? can tests be included as a clause in work contracts?

  • by whom are the tests undertaken? are tests limited to safety sensitive positions or specific sectors (transport, etc.) or are they overall?

  • when, at what moment can tests be undertaken?

  • What are the necessary established pre-conditions for proceeding for a test?

  • what are the conditions/rules/procedure under which tests can be undertaken? what is the role of the labour doctor and labour inspectorate in testing?

  • To whom will the results be communicated and under what reporting form/

  • who has access to the results of the tests?

  • what can be the consequences of positive results on the work contractual relation?

In Sweden there is not yet any legislation controlling the right of employers to impose drug tests on their employees, and it is thus up to each individual work place to decide whether or not to use drug tests. This requires that employers and employees collectively regulate how these should be implemented. The use of drug tests has increased since the beginning of the 1990s. Drug tests are also used when it comes to pre-employment, as many employers want to guarantee that their future employees will be able to accomplish their work adequately. Alcohol tests are not as common as drug tests, but are sometimes used as a complement to interlock devices.

Labour unions have for a long time tried to achieve legislation against random testing in order to protect their members’ integrity. The Swedish Trade Union Confederation (LO), which is a national trade union centre, organises 14 labour unions including both the construction and the transport sectors. They have a clear standpoint when it comes to drug tests, and has several conditions which have to be met in order for the employer to impose drug tests on employees. Examples of these requirements are that the employee has to be working with something that involves a high degree of security; that the tests are effected by an accredited laboratory; and that the tests are only executed when they are a part of a general necessary security check, which means no random drug tests.

At some work places, especially risky ones predisposed to accidents employers and labour unions agree on the use of drug tests in order to ensure security and to work preventively with alcohol and drug related issues. An employer can also unilaterally decide to introduce drug testing at the work place, as long as the decision is preceded by negotiation according to the Co-determination Act, which is a law “intended to promote employee participation in decision-making on employment and working conditions” (Medbestämmandelagen).

The Transport Group (TransportGruppen) is an umbrella organisation for employers’ associations and companies in the transportation sector in Sweden. The organisation approves of alcohol- and drug tests as a measure to improve traffic security, but this has to be made clear by the company’s alcohol and drug policy as a part of the general program to prevent substance abuse. With regard to the Transport Group’s collective agreement, employees should also have the opportunity to take part in the formulation of such a policy. The Transport Group defends employers’ right to effect drug and alcohol tests – both standardised and random – which sometimes causes disagreements with labour unions. For example, the Swedish Transport Workers’ Union, also called Transport, agrees on the use of interlock devices in order to prevent alcohol affected drivers on the road. However, Transport opposes the use of alcohol lockers (a key locker with an integrated interlock device), as they claim it violates the personal integrity of the chauffeurs. (Transportgruppen 2011).

The Swedish Construction Federation (BI) reports that there is no general agreement on their position regarding drug tests since this is something to be agreed upon locally at each work place. The forms for the implementation of drug tests are however regulated; tests have to be executed in a way that does not abuse the integrity of the employee, and results have to be treated confidentially.

Alna, an organisation owned by the Swedish labour market parties (outlines below) with the mission to prevent alcohol in the work place, stresses the importance of using an accredited provider that guarantees a high quality of the tests. Otherwise it can be hard to claim their accuracy, and it also jeopardises the legal security of the tested individual. Alna recommends work places to use drug tests as one measure among others, as a part of a larger preventive work plan – but they emphasises that the use of drug tests exclusively do not solve any problems. (Interview Alna).

The Labour Court has several times handled cases where the employer and the labour union cannot agree regarding the use of drug tests. Past experience show that the court often judges that the introduction of drug tests falls within the employers’ right to direct work if there is a reason for the drug test, for instance precarious work environment such as use of heavy tools or nuclear plants. The drug tests must however be performed in a proper manner with an accredited supplier.

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

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:

  • Organisation(s) responsible for these programmes

  • Drivers and motivations. Objectives

  • Target groups (sectors, specific occupations…)

  • Content and activities developed (campaigns for alcohol/drug free workplaces, information to workers, training, professional counselling and personal assistance, reintegration programmes…)

  • Tools (seminars, brochures, toolkits, guidelines, polls, tests…)

  • Inter-relation with other (health) programmes. Participation of health professionals

  • Are the prevention programmes integrated in the general working conditions/OSH training programmes and management systems?

  • Are the prevention programmes based on joint assessment of the social partners and defined in an agreed policy for the enterprises? Role of work councils and H/S committees.

  • Performance and outcomes of the programmes

  • Changes overtime

  • Assessment of the programmes. Point of view of the social partners

The Swedish National Institute of Public Health (FHI) has over the last years worked with the Risk Use Project (Riskbruksprojektet), a project aiming at increasing health personnel’s attention towards the alcohol habits of their patients. The scope is to detect and attend to alcohol problems in working life as early and effectively as possible. It is a part of the Swedish national alcohol policy, where it is stated that stronger efforts are needed to prevent injurious drinking habits among the adult Swedish population. One of the aims in this bill is specifically to reduce all alcohol consumption in relation to traffic and to work life.

As a part of this project, the government has asked FHI to increase competence within the occupational health care regarding preventive methods such as screening and brief intervention at work places, called the risk use model (Riskbruksmodellen). During the period 2005-2009, the project held 25 specialised courses for this target group. In addition to increasing the use of the risk use model within the occupational health care, the project has also had the mission to spread knowledge about this model to working life. (FHI 2011).

FHI has also, in cooperation with the Confederation of Swedish Enterprise, the Swedish Association of Local Authorities and Regions (Sveriges Kommuner och Landsting, SKL), Alecta and AFA Insurance, hosted 14 national conferences to reach out with information to working life. The target groups have foremost been people with the authority to decide whether or not to introduce the risk use model at the work place, i.e. executives, HR-personnel, union representatives, and safety representatives. In addition to these conferences, 160 seminars have taken place at local and regional level, reaching the same kind of target groups as at national level.

During the Risk Use Project, FHI has also mapped out to what extent Swedish companies use alcohol preventive methods. The results show that approximately 70% of all work places in the study have an alcohol policy, and that 50% have a drug policy. The analysis also reveals that public work places are better at working preventively with alcohol issues in comparison with private ones.

The social parties work preventively with alcohol and drug related issues through Alna (shortly introduced above), an organization that works proactively with enterprises and organisations to help them formulate a policy upon which both the management and the trade unions agree. Their work includes supporting the rehabilitative process, informing about individual responsibilities, raising the awareness of the rehabilitation process, labour laws, and the consequences of substance abuse. As mentioned, Alna is owned by the labour market parties and is thus an indication of these organisations’ ambition to cooperate and work with issues related to substance abuse at the work place. The parties consist of the Confederation of Swedish Enterprise (Svenskt Näringsliv), Swedish Association of Local Authorities and Regions, SALAR (SKL), Independent employers’ organization for co-operative business (KFO), the Employers Association for Non-Profit Organizations (Idea), the Swedish Trade Union Federation (LO), the Swedish Confederation of Professional Employees (TCO), the Swedish Confederation of Professional Associations (SACO). In 2009, the Swedish Building Workers Union (Svenska Byggnadsarbetareförbundet) and the Swedish Association of Plumbing and HVAC Contractors (VVS-företagen), together with the Swedish Organisation for Managers (Ledarna), the Swedish Association of Graduate Engineers (Sveriges Ingenjörer), Unionen (a white-collar trade union) and Alna initiated a vigorous effort against alcohol and drugs within the construction sector. The project aims at informing employers and employees about how to handle a coworker who drinks or takes drugs; it encourages employers to develop a policy regarding these issues; it also informs what responsibility coworkers and employers have in dealing with these problems.

Commentary by the NC

Alcohol and drugs at Swedish work places is a relatively unexplored field of study. Despite this, it seems to be acknowledged to be a (potential) problem; government agencies and the social parties have different projects and organisations with which they work preventively with these issues. More knowledge is however required, especially in order to see what effects these preventive programmes might have on specific work environments – and on society at large.

Mats Kullander and Kina Lundqvist, Oxford Research


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