Prevalence of psychoactive substances in truck drivers in the Nord-Pas-de-Calais region (France)

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Abstract

A previous study conducted in 1995 showed that psychoactive drug use by workers was higher in safety/security workstations than in the rest of the labour force. In order to verify this finding, we conducted a new study in 2003–2004 in the Nord-Pas-de-Calais region, restricted to truck drivers. The aim of this study was to allow harmonizing the professional practice of the occupational physicians, proposing drug prevention and drug testing policies, validating the analytical methods and the guidelines in case of positive testing results.

One thousand truck drivers were studied. Urines were tested for amphetamines, cannabinoids, cocaine, opiates, benzodiazepines, buprenorphine and methadone by immunoassay. Urine ethanol determinations were performed by an ADH method. Positive urines for drugs of abuse, methadone or buprenorphine were then tested by gas chromatography or liquid chromatography coupled to mass spectrometry. Out of the 1000 drivers, cannabinoids were detected in 85 cases, opiates in 41 cases, amphetamines in 3 cases and cocaine in only one case. Buprenorphine was detected in 18 cases, methadone in 5 cases and benzodiazepines in 4 cases. Urine ethanol was positive in 50 cases. We found only one case with 6-monoacetylmorphine. Other positive opiates were metabolites of antitussives. The relatively low number of benzodiazepine positive urines could be explained by the lack of sensitivity of the test we used.

All these results confirm those of the previous study for cannabinoids and ethanol in safety/security workstations. Positive results for methadone and buprenorphine are eight times higher than in the general population. In conclusion, the authors think that it will be of a great interest to test urine of truck drivers for other classes of psychoactive drugs, using a liquid chromatography–mass spectrometry method.

Introduction

There is increasing interest in the incidence of drugs in driving and in their contribution to road trauma specifically [1], [2], [3]. The prevalence of alcohol and drugs in fatally injured drivers were described in Australia for the period of 1990–1999 [2]. Alcohol (>0.5 g/L in blood) was present in 29.1% of all drivers (cars, motorcycles, trucks) and drugs of abuse or drugs (cannabinoids, cocaine, methadone, opiates, etc.) were present in 26.7%.

In Europe, not much is known on workplace drug testing, often performed on site and it is difficult to obtain reliable information [4]. Few studies have reported prevalence of drugs of abuse in workplace [2], [5], [6], [7]. In 1995, Haguenoer et al. observed alcohol in 5.4% and cannabinoids in 10.2% of workers in safety/security posts in the North of the France [5]. In the Australian study, alcohol was present in 8.6% of truck drivers [2] and cannabinoids had a larger prevalence in motorcycles (22.2%) whereas stimulants such as MDMA, cocaine or ephedrine were more often found in truck drivers (23%).

In order to verify the trend since the study realised in 1995 in the north of the France, the local group “Toxicomanie et Travail” has initiated a multicenter study in truck drivers. The purpose of this study was to measure the prevalence of alcohol and substances altering vigilance in safety/security posts in workplaces and to standardize occupational medicine practice to harmonize prevention and the course of action in the case of positive detection.

Section snippets

Study population

Only truck drivers (n = 1000) were included. The urines were collected from four different areas: (1) Regional transportation Center of Lesquin (Nord), (2) Multimodal platform of Hénin-Beaumont (Pas-de-Calais), (3) Transportation companies of Douai (Nord) and (4) Formation center for adults of Douai-Cantin (Nord). In this last area, drivers were training to obtain the truck driver's license.

The urines were collected during annual examinations, before recruitment of new drivers (pre-employment

Results

The study was started in 2003. A total of 1000 urine specimens have been collected for analysis in July 2004. The proportion of males was 99.2%. The mean age was 36.7 ± 9.8 years.

Fig. 1 describes the distribution of truck drivers by day of sampling, age and medical examination type. Nearly 80% of the subjects were less than 45 years old.

The urine samples were tested for opiates, cannabinoids, cocaine metabolites, amphetamines, buprenorphine, methadone, benzodiazepines and ethanol. Table 1 shows

Discussion

Few studies have reported the prevalence of drugs of abuse in the workplace in Europe [4]. In our study, 1000 truck drivers have been included allowed improvement of knowledge on workplace drug abuse in the Nord-Pas-de-Calais region for safety/security posts. Workers and employers have been informed of the study but urine samples have been collected anonymously.

All specimens were initially screened for drugs (except alcohol and buprenorphine) using an immunoassay technique. This first screening

Conclusion

Prevalence results of this study confirm those of Haguenoer et al. in safety/security workstations for cannabinoids and ethanol. The number of positive cases for amphetamines, opiates and benzodiazepines are lower. For the other drugs, no results were described in the previous study.

Now, there is an increasing interest concerning the incidence of drugs, in particular ethanol and cannabinoids in fatally injured drivers and we hope that these results will have an influence in France for

Acknowledgments

The authors thank all the members of the regional network “Addiction and Workplace”: Dr. J.C. Archange (SNCF Lille), Dr. J.M. Brillet and Dr. A. Chatfield (DRTEFP Lille), Dr. B. Pamart (Renault, Douai), Dr. P. Pradeau (Cogéma, La Hague), D. Vanberkel and S. Vandenbussche (ISTNF Lille).

This study had been supported by a Regional Health program (PRS CCAR 2002-447) and by ISTNF (Institut de Santé au Travail du Nord de la France).

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