Present but Overlooked: A Scoping Review of Instruments and Approaches for Measuring Presenteeism Related to Alcohol, Tobacco, and Drug Use.
Kirrilly Thompson, Md Abdul Ahad, Gianluca Di Censo and 4 others
PMID 40745493WHAT IT FOUND
Most studies measuring how alcohol and drug use affects work performance use indirect comparisons rather than asking workers directly.
This inconsistency in tools and recall periods makes it hard to compare results or accurately assess workplace interventions.
Key findings
01The indirect approach, which compares performance between users and non-users, was used in 81% of studies, while only 19% asked workers directly about the impact of their substance use on productivity.
02Measurement was highly inconsistent, with recall periods ranging from seven days to twelve months and various reporting units like hours lost or performance scales, complicating comparisons across studies.
03Only 45% of the 29 unique instruments identified in the review had evidence of validation, raising concerns about the accuracy of the data collected on substance-related presenteeism.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review only included studies published in English, Spanish, and Portuguese, potentially missing relevant instruments in other languages. Most included studies were cross-sectional, limiting the ability to infer causality between substance use and presenteeism. Nearly half of the studies did not specify the type of worker or industry, making it difficult to assess risks in safety-sensitive jobs. The review did not assess the quality of the included studies, only the instruments they used.
Declared interests
The study was funded by the Australian Government and Flinders University.
The easy way to misread this
Do not assume that the high prevalence of presenteeism reported in these studies accurately reflects the true impact of substance use. Because most studies used indirect comparisons with unvalidated or inconsistently applied tools, the measured differences may be exaggerated or obscured by measurement error and reporting bias.
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