Citation

Li G, Baker SP, Zhao Q, Brady JE, Lang BH, Rebok GW, DiMaggio C. Addiction 2011; 106(7): 1287-1292.

Affiliation

Department of Anesthesiology, Columbia University College of Physicians and Surgeons, 622 West 168th St., PH5-505, New York, New York 10032, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St., R1030, New York, New York, 10032, USA; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland 21205, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland 21205, USA.

Copyright

(Copyright © 2011, John Wiley and Sons)

DOI

10.1111/j.1360-0443.2011.03388.x

PMID

21306594

Abstract

Aims To assess the role of drug violations in aviation accidents. Design Case-control analysis. Setting Commercial aviation in the United States. Participants Aviation employees who were tested for drugs during 1995 through 2005 under the post-accident testing program (cases, n=4,977) or under the random testing program (controls, n=1,129,922). Measurements Point prevalence of drug violations, odds ratio of accident involvement, and attributable risk in the population. A drug violation was defined as a confirmed positive test for marijuana (≥ 50 ng/ml), cocaine (≥ 300 ng/ml), amphetamines (≥1000 ng/ml), opiates (≥ 2000 ng/ml), or phencyclidine (≥ 25 ng/ml). Findings The prevalence of drug violations was 0.64% [95% confidence interval (CI), 0.62-0.65%] in random drug tests and 1.82% (95% CI, 1.47-2.24%) in post-accident tests. The odds of accident involvement for employees who tested positive for drugs was almost three times the odds for those who tested negative (odds ratio 2.90, 95% CI, 2.35-3.57), with an estimated attributable risk of 1.2%. Marijuana accounted for 67.3% of the illicit drugs detected. The proportion of illicit drugs represented by amphetamines increased progressively during the study period, from 3.4% in 1995 to 10.3% in 2005 (p < 0.0001). Conclusions Use of illicit drugs by aviation employees is associated with a significantly increased risk of accident involvement. Due to the very low prevalence, drug violations contribute to only a small fraction of aviation accidents.

Language: en