1. Association between employment and drug abuse among young adults: National Health and Nutrition Examination Survey, 2001-2004 Alberto J. Caban-Martinez, Manuel A. Ocasio, Tainya C. Clarke, John D. Clark III, and Diana Kachan Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, Florida, USA This work was funded in part by the U.S. National Institute of Environmental Health Sciences Fellowship F30ES015969 (PI: Clark); and the U.S. National Institute for Occupational Safety and Health R01 0H03915 (PI Lee/Fleming). Contact: Alberto Caban-Martinez | Email: acaban@med.miami.edu Introduction: Harmful substance use patterns among young adults that are established before or during employment represent an important public health concern. The social, economic, and health consequences of illicit drug abuse may persist not only into their young adult life, but may carry forward into their professional life. We examine the association between employment status, occupation type and drug use among U.S. young adults. Methods: We analyzed pooled data on 1,009 U.S. young adults (representing an annual 5,119,332 young people) age 20-25 participating in the 2001-2004 National Health and Nutrition Examination Survey, who reported on their lifetime use of cocaine or street drugs, employment status, occupation type, and socio- demographic characteristics. Results: The overall lifetime prevalence of cocaine or street drug use among U.S. young adults was 21.7%±3.4; highest among males (12.7±1.9), non-Hispanic whites (13.7±2.9), those with a high school diploma or GED (7.9±1.4), unmarried (13.7±2.6), those with an annual household income of less than $20,000 (8.1±2.5); those employed as blue-collar workers (8.1±1.8, and those with a job (14.7±3.1). Among employed young adults, those in Construction trade (3.7±1.2) and Health service occupations (2.3±1.4) had the highest proportion of workers reporting a high lifetime prevalence of cocaine or street drug use. Employed young adults were significantly more likely 1.32 [1.01-1.98] (adjusted odds ratio [95% Confidence Interval]) to report a lifetime use of cocaine or street drugs even after controlling for gender, race/ethnicity, education, marital status, and annual household income as compared to unemployed young adults. Conclusions: Knowledge of rates of substance use among both employed and unemployed young adults will offer support towards building better prevention programs for younger members of the workforce, thereby offering protection against continued or accelerated use and abuse. The workplace may be a useful venue in which to target tailored drug abuse educational interventions at high risk employed young adults. ABSTRACT National Health and Nutrition Examination Survey (NHANES) is a population-based health survey of non-institutionalized U.S. residents conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention NHANES uses a complex, multistage probability sampling design, with oversampling of minority populations. All participants completed household surveys conducted by trained study staff that included questions on demographics and health history. Data obtained from 1,009 young U.S. adults age 20-25 years old participating in the 2001- 2004 NHANES, who reported on their lifetime use of cocaine or street drugs (using computer- assisted [CASI] technology), employment status, occupation type, and socio- demographic characteristics. Analyses completed with the PASW Statistics 18 and PASW Complex Sample package (IBM, Inc.) to take into account sample weights, design effects and aggregation of data over multiple survey years. METHODS epidemiological studies in the last decade, up to 50% of adolescents have used cannabis at least once Epidemiological studies, suggest that up to 50% of U.S. adolescents have used cocaine or street drugs at least once during their life-time. Longitudinal studies that have examined risk and vulnerability factors for onset of cocaine and street drug use, have also identified potential negative consequences of regular drug use, abuse and dependence. Employment experiences in young adulthood often forecast later occupational attainment patterns, therefore understanding factors associated with job type and drug use remains of major public health importance. INTRODUCTION Examine the association between employment status, occupation type and drug use among U.S. young adults. Describe the lifetime prevalence of cocaine or street drug use among U.S. young adults. List, in rank order, young adult occupations that report high levels of cocaine or street drug use. OBJECTIVE Table 1. Proportion of Young Adults (20-25 years old) by socio-demographic characteristics who reported on ever using cocaine or street drugs: National Health and Nutrition Examination Survey 2001-2004 (n=1,009) Occupation Title % Ever used Cocaine or Street Drug (n=118) Other transportation and material moving occupations66.7 Extractive and precision production occupations50.0 Other mechanics and repairers40.0 Construction trades36.6 Writers, artists, entertainers, and athletes33.3 Material recording, scheduling, and distributing clerks33.3 Related agricultural, forestry, and fishing occupations33.3 Records processing occupations26.7 Miscellaneous food preparation and service occupations26.1 Technicians and related support occupations25.0 Waiters and waitresses25.0 Health service occupations21.9 Cooks21.7 Management related occupations20.0 Secretaries, stenographers, and typists20.0 Vehicle and mobile equipment mechanics and repairers20.0 Fabricators, assemblers, inspectors, and samplers20.0 Motor vehicle operators18.8 Executive, administrators, and managers18.5 Construction laborers18.2 Cleaning and building service occupations14.3 Sales workers, retail and personal services13.0 Laborers, except construction12.5 Miscellaneous administrative support occupations11.1 Personal service occupations11.1 Health diagnosing, assessing and treating occupations10.0 Sales representatives, finance, business, & commodities ex. retail9.1 Other helpers, equipment cleaners, hand packagers and laborers9.1 Protective service occupations7.1 Other professional specialty occupations6.7 Freight, stock, and material movers, hand5.9 Engineers, architects and scientists5.0 Teachers3.7 Supervisors and proprietors, sales occupations0.0 Secretaries, stenographers, and typists0.0 Private household occupations0.0 Personal service occupations0.0 Farm and nursery workers0.0 Textile, apparel, and furnishings machine operators0.0 Knowledge of rates of substance use among both employed and unemployed young adults will offer support towards building better prevention programs for younger personnel, thereby offering protection against continued or accelerated use and abuse. The workplace may be a useful venue in which to target tailored drug abuse educational interventions at high risk employed young adults. CONCLUSIONS Lifetime prevalence of cocaine or street drug use among U.S. young adults was 21.7% ± 3.4. Among employed young adults, those in Construction trade (3.7±1.2) and Health service occupations (2.3±1.4) reported the highest proportion of workers with drug use. Employed young adults were significantly more likely 1.32 [1.01-1.98] to report a lifetime use of drug use compared to those unemployed. RESULTS