Mental Health Impacts due to Occupational Exposure of Second-hand Drug Smoke Among Pacific Northwest Transit Operators

Abstract

Illicit usage of Fentanyl (FTY) and Methamphetamine (MTH) has been occurring on public buses and trains as people who use drugs transition from injection to smoking use preferences which has led to the occupational exposure of public transit operators to second-hand drug smoke (SDS). There is little known concerning the potential physical and mental health impacts of SDS exposures, however, common misconceptions regarding the danger of drugs like FTY have created the public perception that these exposures are extremely dangerous, even fatal. Using quantitative data from the Amalgamated Transit Union Survey, we performed a retrospective, cross-sectional study to investigate the association between SDS exposures via observing drug use on transit and mental health screening scores, and between operators’ risk perception (RP) and self-reported symptom burden. We found that operators who were exposed more than 10 times per week had ~16 times higher odds of reporting a PHQ score >/= 10, consistent with moderate depression (OR = 15.7, 95% CI: 2.68 – 302, p = .0057) and ~6 times higher odds of reporting a GAD score >/= 10, consistent with moderate anxiety (OR = 5.56, 95% CI: 1.25 - 39.4, p = 0.041) when compared to operators who were not exposed at all. We also found that increasing operators’ RP level was associated with the higher amounts of symptoms reported after exposure (regression coefficient = 0.337, 95% CI: (0.248 - 0.431), p = 1.62 x10-11). Furthermore, we demonstrated a significant multivariate effect that operators with higher RP levels reported more severe symptoms than lower risk groups (Pillai’s Trace = .183, F(6, 448) = 7.52, p = 1.064 x 10-7). This thesis highlights the mental health impacts and burden of disease among transit operators that are associated with exposure to SDS and witnessed drug use and therefore may help direct protective policies and control measures to keep workers safe and allow employers to plan for the expanded medical needs of their workforce.