March 2000

Grant Results

SUMMARY

A team led by researchers at Harvard School of Public Health sought to identify modifiable factors in workplaces that could affect alcohol problems.

Seven Fortune 500 companies with 114 worksites participated in the study. Investigators collected data through extensive in-person interviews, surveys, and focus groups of senior executives, managers, supervisors, and employees.

The study was conducted jointly with researchers at JSI Research and Training Institute, Boston, and Boston University School of Public Health.

Key Findings
The study's findings contradict six beliefs widely held by corporate executives and senior managers concerning alcohol issues in their companies:

  1. Belief: Alcohol-related work performance problems are caused mostly by a few alcohol-dependent employees.

    Finding: The majority of alcohol-related work performance problems (60 percent) are associated with nondependent drinkers — people who may occasionally drink too much and who constitute 80 percent of all drinkers.
  2. Belief: Work performance suffers only among employees who drink on the job.

    Finding: Two specific kinds of drinking behavior contribute significantly to the level of work performance problems: drinking immediately before or during working hours (including drinking at lunch and at company functions) and heavy drinking the night before work that leads to a hangover the next day.
  3. Belief: Hourly workers are more likely to drink during work hours than managers or supervisors are.

    Finding: Upper-level managers are more likely to drink during the workday than first-line supervisors or hourly workers are.
  4. Belief: Current policies and strategies that deal with alcohol-dependent drinkers are effective.

    Finding: Managers and supervisors report a variety of organizational, interpersonal, and individual barriers to implementing corporate alcohol policies and procedures.
  5. Belief: Companies have little influence on the drinking behavior of employees away from work.

    Finding: Workplace culture and norms have the potential to influence drinking behavior both at work and beyond the workplace.
  6. Belief: Workers perceive additional company interventions regarding alcohol behaviors as intrusive.

    Finding: There is broad support among managers, supervisors, and hourly workers for assisting employees whose drinking behavior causes problems for themselves, their co-workers, or the company.

Communications
To disseminate the study's findings, the investigators:

  • Published five articles in professional journals and presented their findings at various conferences nationwide.
  • Wrote a book chapter on the project, "Alcohol and Work — Results from a Corporate Drinking Study," for the Robert Wood Johnson Foundation (RWJF) anthology To Improve Health and Healthcare 1998–1999.
  • Conducted a more extensive dissemination effort that included a four-prong approach:
    • Worked with corporate executives and workplace alcohol researchers to develop and refine messages that derived from the study.
    • Continued work with executives and researchers to develop a model alcohol policy and workplace strategy.
    • Reprinted the RWJF anthology chapter and distributed it to:
      • The study sites and their corporate headquarters.
      • Employee assistance organizations.
      • Health promotion groups.
      • 300 companies that are part of a national alcohol/depression screening project.
      • 600 corporations that have substance abuse programs.
  • Mass media coverage included articles in USA Today, Time magazine, and the Wall Street Journal.

    "This research is a wake-up call," said Bruce Davidson, manager of employee assistance and work-life programs at Digital Equipment Corporation, in the Wall Street Journal article.

Funding
RWJF supported the project with a $1,111,230 grant to Harvard University School of Public Health to conduct the study.

RWJF made a $196,397 grant to JSI Research & Training Institute to support dissemination of the study's findings.

 See Grant Detail & Contact Information
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THE PROBLEM

The workplace is a priority locus for the prevention of alcohol problems, according to a 1991 report by the Institute of Medicine. That is because problem drinking presents demonstrable physical, social, psychological, and economic costs to both the individual and the employer. The cost is $27 billion in lost productivity alone, according to the National Institutes of Health's 1995 Report to Congress.

As awareness of the problem has increased among employers, many have appeared ready to modify work policies, procedures, services, and even design features of jobs in order to minimize productivity losses, accidents, and other costs associated with alcohol problems.

The proposal for the current project was submitted first to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which agreed to fund $1 million of the project's cost. Because the total cost of the project exceeded NIAAA limits, the agency approached RWJF to cofund the project.

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THE PROJECT

The study (which was conducted jointly by researchers at Harvard University School of Public Health; JSI Research and Training Institute, Boston; and Boston University School of Public Health under grant ID# 018525 to Harvard University School of Public Health) sought to identify modifiable factors in work organizations that could affect alcohol problems.

Occupational risk factors were examined at three levels:

  1. Corporate culture as expressed in company-wide policies and practices that may affect the physical, economic, and social availability of alcohol to employees.
  2. Worksite policies and norms, particularly managers' attitudes toward appropriate drinking behavior, their supervisory styles, and their own drinking behavior (which can modify implementation of corporate policy and exert an independent or interacting effect on employee behavior).
  3. Work-group factors, including norms in teams of workers under a single supervisor, as well as job conditions and social influences on the job.

Individual characteristics of employees and social influences off the job (for example, individual predispositions to alcohol abuse, local religious constraints, and to access and availability of alcohol) were also measured in order to examine workplace factors either in isolation or in interaction with off-the-job influences.

Methodology

The study focused on seven Fortune 500 firms, which were chosen to include a diversity of industry types as well as various gender and educational work force compositions. The companies were an appliance conglomerate with 40 sites in 12 business groups, a technology conglomerate with 20 sites in six business groups, a natural gas supplier with 10 sites, a building supply company with 10 sites, a regional utility company with 11 sites, a paper manufacturer with 15 sites, and a large insurance company with 8 sites.

Data collection was conducted in two phases. Phase 1 assessed corporate and worksite variables through face-to-face interviews with 45 senior managers at each of the seven firms and through self-administered, confidential surveys of 7,255 managers from the 114 worksites in the seven firms. (Originally 10,000 surveys were planned; however, due to the difficulties of conducting research within real-world companies and engaging the voluntary participation of subjects, the final sample size was reduced.)

Phase 2 focused on worksite and work-group variables. Sixteen worksites were selected based on preliminary analyses of phase 1 data and included:

  1. Sites where more than 50 percent of the work force was professional.
  2. Manufacturing sites that were less than 50 percent professional.
  3. Sites in nonmanufacturing industries — such as transportation, communications, finance, and insurance — in which less than 50 percent of the work force was professional.

The sites represented a range of industries and management attitudes toward drinking. (Due to downsizing and restructuring, one company withdrew from the project after the first phase of the research; the 16 sites were from the remaining six companies.) This phase consisted of:

  • Self-administered, confidential surveys mailed to approximately 800 employees at each of the 16 sites. A total of 6,540 employees responded to the survey. Response rates varied from a low of 59 percent to a high of 91 percent, with a median response rate of 71 percent.
  • Extensive interviews with key informants at the 16 sites. Informants included plant/site managers, human resources directors, employee assistance or site nurses, site historians, operations engineers, and first-line supervisors; a total of 105 key informant interviews were conducted.
  • Six focus groups with supervisors and workers at each of the 16 worksites.
  • Visits by researchers for a minimum of two days to observe work settings at each of the 16 worksites.

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FINDINGS

The project's findings contradict six beliefs widely held by corporate executives and senior managers concerning alcohol issues in their companies.

  1. Belief: Alcohol-related work performance problems are caused mostly by a few alcohol-dependent employees.

    Finding: The majority of alcohol-related work performance problems (60 percent) are associated with nondependent drinkers — people who may occasionally drink too much and who constitute 80 percent of all drinkers.
  2. Belief: Work performance suffers only among employees who drink on the job.

    Finding: Two specific kinds of drinking behavior contribute significantly to the level of work performance problems: (1) drinking immediately before or during working hours (including drinking at lunch and at company functions) and (2) heavy drinking the night before work that leads to a hangover the next day.
  3. Belief: Hourly workers are more likely to drink during work hours than managers or supervisors are.

    Finding: Upper-level managers are more likely to drink during the workday than first-line supervisors or hourly workers are.
  4. Belief: Current policies and strategies that deal with alcohol-dependent drinkers are effective.

    Finding: Managers and supervisors report a variety of organizational, interpersonal, and individual barriers to implementing corporate alcohol policies and procedures.
  5. Belief: Companies have little influence on the drinking behavior of employees away from work.

    Finding: Workplace culture and norms have the potential to influence drinking behavior both at work and beyond the workplace.
  6. Belief: Workers perceive additional company interventions regarding alcohol behaviors as intrusive.

    Finding: There is broad support among managers, supervisors, and hourly workers for assisting employees whose drinking behavior causes problems for themselves, their co-workers, or the company.

Implications of Findings

  • Policymakers should expand their focus beyond alcohol-dependent employees to look at employees who drink heavily from time to time. Employees who are not alcohol dependent account for 60 percent of alcohol-related work performance problems reported in the study. Any corporate strategy aimed only at reducing the consequences of alcohol-dependent employees, even if it is totally effective, will miss the problems caused by the alcohol consumption of the majority (80 percent) of drinkers, who are not dependent on alcohol. A shift of the focus of worksite alcohol interventions from a model that focuses exclusively on alcoholism to one that recognizes the inherent risks of alcohol consumption at any level is suggested.
  • Corporate decision-makers should consider adopting policies that more explicitly address the consequences of drinking before work, at lunch, at company functions, and before driving company vehicles. In addition, they should undertake efforts to increase awareness among employees that heavy drinking the night before work has consequences for work performance the next day. This raises the issue of personal privacy, because it implies that employers have reason to be concerned about their employees' behavior outside work. Companies, however, already undertake similar education efforts for other health-related lifestyle issues such as fitness, cholesterol levels, and smoking.
  • The limits set on blood content of alcohol to regulate safety-sensitive industries may be too high. The 0.04 percent allowed by some safety-sensitive industries is equal to approximately two drinks at lunch. Those regulations may need to be revised downward to a zero tolerance, and safety-sensitive industries may need to regulate drinking for a significant amount of time before work.
  • Alcohol has a far greater impact on the workplace than current estimates depict. Estimates of the economic costs of alcohol to corporations are based on the proportion of alcohol-dependent workers in the workplace. They attribute to alcohol only those accidents or production errors associated with acute alcohol exposure. Data from the current study suggest that a significant share of work performance problems are attributable to employees who drink heavily the night before. Further, current cost estimates miss secondhand effects. For example, 14 percent of the survey employees said they had to redo work within the previous year because of a co-worker's drinking.
  • Corporate culture itself can contribute to employee drinking behavior. Corporate policymakers can play a role in shaping worksite norms about alcohol use. By acknowledging responsibility for worksite drinking cultures, companies may develop norm-based intervention strategies that reduce the impact of alcohol on work performance.

Communications

Under grant ID# 018525, the investigators published five articles in professional journals, including the Journal of Occupational and Environmental Medicine. The investigators also presented findings at various conferences nationwide, including the annual meeting of the American Public Health Association. (See Bibliography for more information on publications and presentations regarding both grants.)

Under a separate grant from the Foundation (ID# 031314), the investigators wrote a book chapter on the project, "Alcohol and Work — Results from a Corporate Drinking Study," for the Robert Wood Johnson Foundation anthology To Improve Health and Healthcare 1998–1999. They also conducted a more extensive dissemination effort to further publicize the study findings among leaders in the business community. (JSI contributed approximately $2,000 in postage toward that effort.) The dissemination included a four-prong approach.

  • Refined the message. Work was conducted with corporate executives and workplace alcohol researchers to develop and refine messages that derive from the study and help develop policies and strategies for addressing alcohol issues. Investigators recontacted five of seven medical directors of corporations in the study and conducted 21 seminars at national business associations, corporations, and academic institutions.
  • Created model workplace policies. Work was continued with executives and researchers to develop a model policy and workplace strategy. The outcome of this objective will be to design an intervention by using an educational program — probably through workplace wellness programs — aimed at reducing workplace problems related to occasional, excessive alcohol use.
  • Reprinted and distributed report. The Foundation anthology chapter was reprinted as a report entitled New Perspectives for Work Site Alcohol Strategies: Results from a Corporate Drinking Study. It was distributed to the 16 study sites at the participating corporations and their corporate headquarters, employee assistance organizations, and health promotion groups; to human resources directors at 300 companies that are part of a national alcohol/depression screening project; and to 600 corporations that have substance abuse programs.
  • Achieved significant mass media coverage. Findings were broadly disseminated through the mass media to corporate policymakers and practitioners, business leaders, and others. (The release of press materials was intentionally delayed until fall 1998 to coincide with publication of the Foundation's anthology and to allow media interest in the President's impeachment trial to abate.) Other mass media coverage included articles in USA Today, Time magazine, and the Wall Street Journal. "This research is a wake-up call," said Bruce Davidson, manager of employee assistance and work-life programs at Digital Equipment Corporation, in the Wall Street Journal article.

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LESSONS LEARNED

  1. Targeting dissemination material to those most affected by a study's findings can increase the impact of a project. By targeting one report of the study's findings to audiences often ignored in the dissemination of scientific findings — corporate executives, human resources employees, employee assistance personnel, and health promotion groups — the potential impact of the grant was increased. According to the investigators, the project received more than 1,000 requests for copies of one report from seminar groups and employee assistance program (EAP) providers; some asked for 30 to 40 additional copies. Weyerhaeuser Co. asked for permission to put the report on its company intranet for all of its managers to read.

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AFTER THE GRANT

Although the grantees discussed with RWJF staff the prospects for additional funding to support further analyses of the data set compiled during the current project and the development of a pilot intervention related to low-dose alcohol use and off-site drinking, no follow-up funding is anticipated at this time.

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GRANT DETAILS & CONTACT INFORMATION

Project

Study on Worksite Prevention of Alcohol Problems and its Dissemination

Grantee

Harvard University School of Public Health (Boston,  MA)

  • Study to Identify Modifiable Workplace Factors Affecting Alcohol Abuse
    Amount: $ 1,111,230
    Dates: September 1991 to June 1996
    ID#:  018525

Contact

Marianne Lee, M.P.A.
(617) 525-2732

Grantee

JSI Research & Training Institute, Inc. (Boston,  MA)

  • Dissemination of a Study on Worksite Prevention of Alcohol Problems
    Amount: $ 196,397
    Dates: September 1991 to January 1999
    ID#:  031314

Contact

Thomas W. Mangione, Ph.D.
(617) 482-9485
tmangione@jsi.com

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Books and Reports

Mangione TW, Howland J and Lee M. New Perspectives for Work Site Alcohol Strategies: Results from a Corporate Drinking Study. Reprinted with permission of Jossey-Bass Publishers, San Francisco, Calif., 1998. Approximately 74 copies distributed.

Mangione TW, Howland J and Lee M. Papers from the Worksite Alcohol Study. Supported by grants from the National Institute on Alcohol Abuse and Alcoholism and the Robert Wood Johnson Foundation, November 1997.

Book Chapters

Mangione TW, Howland J and Lee M. "Alcohol and Work — Results from a Corporate Drinking Study." In To Improve Health and Healthcare 1998–1999. The Robert Wood Johnson Foundation Anthology. Isaacs SL and Knickman JR, eds. San Francisco: Jossey-Bass Publishers, 1998.

Articles

Bell NS, Mangione TW, Howland J, Levine S and Amick B. "Worksite Barriers to the Effective Management of Alcohol Problems." Journal of Occupational and Environmental Medicine, 38(12): 1213–1219, 1996. Abstract available online.

Howland J, Mangione TW, Lee M, Bell N and Levine S. "Employee Attitudes Toward Work-Site Alcohol Testing." Journal of Occupational and Environmental Medicine, 38(10): 1041–1046, 1996. Abstract available online.

Howland J, Mangione TW, Kuhlthau K, Bell N, Heeren T, Lee M and Levine S. "Work-Site Variation in Managerial Drinking." Addiction, 91(7): 1007–1017, 1996. Abstract available online.

Mangione TW, Howland J, Amick B, Cote J, Lee M, Bell N and Levine S. "Employee Drinking Practices and Work Performance." Journal of Studies on Alcohol, 60(2): 261–270, 1999. Abstract available online.

Walsh DC, Rudd RE, Biener L and Mangione T. "Researching and Preventing Alcohol Problems at Work: Toward an Integrative Model." American Journal of Health Promotion, 7(4): 289–295, 1993. Abstract available online.

Presentations and Testimony

Thomas W. Mangione and Lois Biener, "Modifiable Risk Factors for Worksite Alcohol Problems," at the Workplace Alcohol Researchers' Conference, National Institute on Alcohol Abuse and Alcoholism, Washington, D.C., July 1993.

Sol Levine and Thomas W. Mangione, "Worksite Alcohol Project," at the 1993 Annual Conference of the American Public Health Association, San Francisco, Calif., October 1993.

Thomas W. Mangione. "Worksite Alcohol Project," at the National Research and Policy Conference: Alcohol, Tobacco, and Other Drug Problems in the Workplace: Incentives for Prevention, at the University of California San Diego, Sam Diego, Calif., May 1994.

Sol Levine, Thomas W. Mangione, Jonathan Howland, Marianne Lee, Nicole Bell, and Karen Kuhlthau. "Worksite Alcohol Project," at the 1994 Annual Conference of the American Public Health Association, Washington, D.C., October 1994.

Thomas W. Mangione, "Job Stress and Norms as Correlates of Drinking," at the Annual Meeting of the Research Society on Alcoholism, Steamboat Springs, Colo., June 1995.

Thomas W. Mangione, "Job Stress and the Relationship to Drinking," at the 1995 Annual Conference of the American Public Health Association, San Diego, Calif., October 1995.

Members of the project team, "Hangovers and Work Place Productivity: The Hidden Affects of Alcohol," at the 5th Intervention Congress of Behavioral Medicine, Copenhagen, Denmark, August 19, 1998.

Members of the project team, "New Strategies for Workplace Alcohol Intervention: Findings from Research on Drinking among Corporate Employees," at the 11th Annual National Prevention Network Research Conference, San Antonio, Texas, August 31, 1998.

Forums and Seminars

"New Perspectives for Worksite Alcohol Strategies: Results from a Corporate Drinking Study," a seminar presented by a member of the project team to the following groups:

Businesses

  • Advisory committee meeting at WNET public television with 25 alcohol specialists for a Bill Moyers series on addiction, April 1997.
  • Corporate senior executives, at a corporate headquarters, Allentown, Pa., February 3, 1998.
  • Digital Corporation Employee Assistance Program director and 40 EAP providers at Maynard, Mass., December 16, 1997.
  • 15 senior executives of corporations, at a corporate headquarters, Fairfield, Conn., January 23, 1998.
  • 60 EAP directors who are part of the National EAP Roundtable, Baltimore, Md., April 20, 1998.
  • 100 members of the South Carolina Employee Assistance Professionals Association, Charleston, S.C., September 24, 1998.

Academic institutions and government agencies

  • 15 graduate students researchers working with Dr. Robin Room, Director of the Addictive Research Foundation, Toronto, Ontario, Canada, August 1997.
  • Dr. Thomas Greenfield and 20 staff members and graduate students at the Alcohol Research Group, Berkeley, Calif., October 6, 1997.
  • Dr. Genevieve Ames and 20 staff members and NIAAA fellows at the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, Calif., October 7, 1997.
  • 12 National Institute on Drug Abuse/NIAAA training fellows at Brandeis University, Waltham, Mass., November 20, 1997.
  • Dr. Tom Babor, Dr. John Higgins-Biddle, and 18 graduate fellows and faculty members at the University of Connecticut Medical Center, Farmington, Conn., December 19, 1997. (Follow-up visit, January 19, 1999)
  • Dr. Paul Roman and 10 graduate students and faculty members at the University of Georgia, Athens, Ga., January 26, 1998.
  • Dr. Terry Blum and 35 faculty members of the School of Business Management at Georgia Institute of Technology, Atlanta, Ga., January 27, 1998.
  • Five graduate students and faculty members at Boston University School of Public Health, Boston, Mass., February 19, 1998.
  • Dr. Glorien Sorenson, Dr. Karen Emmons, and 20 graduate students and faculty members at Harvard School of Public Health and Dana Farber Cancer Institute, Boston, Mass., March 17, 1998.
  • National Institutes of Health-NIAAA, hosted by Dr. Enoch Gordis, Dr. Susan Martin, Dr. Jan Howard, and 15 staff members, Rockville, Md., April 21, 1998.
  • Ten staff members at Join Together, Boston, Mass., February 3, 1999.

Print Coverage

"Drinking and the Job," Bostonia, April–June 1997.

"Casual Drinkers Cause Majority of Workplace Problems, Study Finds," Boston Globe, December 22, 1998.

"Productivity Data Indict Casual Drinking," Wall Street Journal, December 22, 1998.

"How Drinking Harms on-the-Job Efficiency," Christian Science Monitor, December 23, 1998.

"Study Points to 'Casual' Drinkers as Biggest Danger," USA Today, December 23, 1998.

"Bad News on Drinking," Time, January 11, 1999.

"Study Highlights Casual Drinking's Effect on Productivity," Alcoholism & Drug Abuse Weekly, January 18, 1999.

"Workplace and Alcohol: British Attitudes Change Slowly," Beaver County Times (Beaver, Pa.), March 7, 1999.

"Casual Drinking Causes on-the-Job Problems," Times (Brownsville, Ore.), May 18, 1999.

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Report prepared by: Robert Crum
Reviewed by: David Kales
Reviewed by: Richard Camer
Reviewed by: Molly McKaughan
Program Officer: Marjorie A. Gutman
Program Officer: Joan K. Hollendonner

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