Zwerling C, Ryan J
Department of Preventive Medicine and Environmental Health, College of Medicine, University of Iowa, Iowa City 52242.
J Occup Med. 1992 Jun;34(6):595-9.
Deciding to test applicants for employment for drugs raises complex, legal, moral, economic, and technical issues. However, we focus here on three epidemiologic issues germane to this decision. In one industry, the United States Postal Service, two recent studies suggest associations between positive preemployment drug screens and turnover, absenteeism, accidents, injuries, and discipline, but these associations are weaker than had been assumed. Cost-benefit analyses show that whether drug screening saves money depends both on the costs associated with adverse outcomes such as accidents and on the prevalence of drug use in the population screened. Finally, the predictive value of a positive drug screen also depends crucially on the prevalence of drug use. In populations with low prevalence of drug use, a large proportion of the positives may be false positives.
决定对求职者进行药物检测会引发复杂的法律、道德、经济和技术问题。然而，我们在此关注与这一决定相关的三个流行病学问题。在一个行业，即美国邮政服务中，最近的两项研究表明，入职前药物检测呈阳性与人员流动、旷工、事故、受伤及纪律处分之间存在关联，但这些关联比之前设想的要弱。成本效益分析表明，药物检测是否能节省资金既取决于与事故等不良后果相关的成本，也取决于被检测人群中药物使用的流行率。最后，药物检测呈阳性的预测价值也至关重要地取决于药物使用的流行率。在药物使用流行率较低的人群中，很大一部分阳性结果可能是假阳性。
