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Managing Risk Through Cognitive Impairment Testing

Editor’s Note: Incident Prevention does not condone, promote or recommend manufacturers’ products mentioned in technical articles. The magazine’s editorial advisory board will make exceptions for devices, technology or equipment that is unique in its design or application. The board has found that AlertMeter, mentioned in this article, meets the exception as their research could not find a competitor that offered a similar device. Incident Prevention believes the information provided in this article to be an evolving application in risk prevention and therefore of interest to readers. Incident Prevention and its editorial advisory board make no warranties, express or implied, about the efficacy or testing described.

Utility safety professionals have the duty to ensure a safe workplace for all employees. If that due diligence pays off, the result is consistently having few or no injuries on OSHA 300 forms year after year.

But no matter how well a safety program functions, incidents never completely stop occurring. Often after an incident, in the quest to determine a root cause, we find that there were adequate written procedures in place and effective training was completed. So, what does that mean? It means that consideration of human factors must be part of the incident analysis. Cognitive impairment in particular has a profound effect on the way employees reason through safety risks associated with their jobs, especially in the high-hazard electric utility industry.

Let’s take a look at an example of what many utility companies do to provide a safe working environment for their personnel. The workforce at ABC Utility Co. is proud to have a top-shelf operational risk management program with the best safety team available. The team has done some great work, including the following:

  • Developed sound written policies, programs and procedures based on OSHA and applicable consensus standards.
  • Hired valuable employees with the right frame of mind who are tested to be physically fit to do the job.
  • Implemented top training programs consisting of over 50 topics to help ensure employees have a full understanding of safe work practices that pertain to their job assignments.
  • Every new employee goes through days of orientation training based on their position and demonstrates an understanding of safe work practices before working in the field.
  • Encouraged reporting and investigating every near-miss incident.
  • Where deficiencies were identified, an effective, positive corrective action policy was implemented to the extent possible, although sometimes a negative approach was required.
  • Job briefings are effectively performed before each job.
  • Regular field observations of employees and contractors are performed and scored to measure the effectiveness of work practices, training and education.
  • Assembled an effective safety committee made up of all disciplines within the organization and maintained an apprenticeship committee to oversee technical training.
  • Chose and purchased the best and safest tools and equipment based on assessments by the safety committee as well as outside experts as needed.

All of these operational risk management tools provide the foundation of ABC Utility Co.’s Safety, Training & Empowerment Program pyramid shown below. You’ll note that people-focused safety, which targets the value of the company’s employees, is at the top of the pyramid. But while ABC Utility Co. has implemented behavioral safety models – including regularly providing workers with positive, immediate feedback and ensuring they actively participate in decision-making activities – the company has little ability to determine activities or events in employees’ personal lives that impact performance at work.

This is where the value of cognitive impairment testing comes in.

A Transformational Tool
Occasionally, a concept is introduced to the utility industry that has enormous potential to transform and elevate existing safety programs. Many investigations of utility injuries and fatalities have revealed that one common causal factor is the state of mind of the individual who was injured or killed. Their cognitive ability to choose the right path forward during a risky job may have been impaired, but typically we don’t know that until it’s too late.

The most disastrous accidents typically involve a combination of risk factors that are aggravated by a cognitively impaired worker’s inability to manage them. Imagine a storm scenario in which a lineman has been physically working hard for 15 hours. The storm restoration efforts are understaffed because of the magnitude of the storm, so the lineman is overworked. On top of that, he’s had a serious issue arise with his family that kept him up the night before.

A storm, physical and mental fatigue, and emotional distress. Even the most experienced worker would struggle under these circumstances.

Enter the 60-second cognitive impairment test.

In a company that uses such testing, the lineman would take a cognitive impairment test before he gets put to work on high-voltage power lines. If the fatigue and emotional distress that this worker is experiencing are profound enough to impair his vigilance, reaction time, short-term memory or judgment, the test would tag him as outside the normal range of alertness. Then, his supervisor would instantly be notified and prompted to speak with the worker to determine the safest path forward. At the end of the shift, the lineman would return home safely.

Not a New Concept
Cognitive impairment testing as a workplace safety measure is not a new concept. It has roots in the late 1980s and early 1990s, soon after the mandate for drug testing was introduced for federal employees.

More recent social changes, however – such as increasing mental health awareness and fatigue awareness – have further thrust cognitive impairment tests into the spotlight.

And thanks to a slew of new technologies sweeping the marketplace, these tests have recently become a lot more accessible, flexible and affordable. They take the form of mobile and tablet apps, wearable devices and eye-tracking devices.

According to one NIOSH-funded study, a successful cognitive impairment test needs to check the following boxes:

  • Valid and reliable in detecting impairment.
  • Quick enough not to disrupt productivity (around two minutes per day per worker maximum).
  • Not dependent on language skill.
  • Easy enough for all workers to take the test regardless of educational/technological background.

Even if a test checks all of those boxes, most safety professionals and supervisors still wonder, what do workers think about these tests? According to research by the National Workrights Institute:

  • 100% of employers who used impairment testing considered their experience successful.
  • 90% of employees accepted impairment testing.
  • 87% of employers found impairment testing superior to urine testing.
  • 82% of employers found that impairment testing improved safety.

Further qualitative feedback has revealed how cognitive impairment testing receives more than a shrug or nod of approval from workers. They use it to influence their lives. For example, following are statements from companies that use AlertMeter (, a game that detects cognitive impairment in 60 seconds:

  • “Employees have told me that they’re taking better care of themselves now, such as getting more sleep. One employee said his family traditionally had a barbecue every Sunday night with a fair amount of partying. They’ve changed it to Saturday night so he’s better rested for work.” (Triple-S Steel)
  • “Our initial concern was twofold: workers reporting without an adequate amount of sleep as well as a defense against substance impairment. We found [cognitive impairment testing] to satisfy both of our needs. An added benefit has been that since employees know that they will be tested daily, they are reporting to work in a better condition and ready to go to work.” (Prudential Stainless & Alloys)
  • “The trucking personnel now realize that we want them to be healthy, able to do their job while also having a life outside of work. There is an expectation that they are following sleep guidelines, maintaining healthy eating habits and generally taking care of themselves. They’re not just workers with a pulse. We want them to be healthy and strong, have a lengthy career, and be able to spend time with their families outside of work.” (Savage Services)

In closing, cognitive impairment testing could be a game-changer for your organization, offering a fast, simple way to exercise influence over worker safety and health. If you haven’t yet looked into it, now may be the time.

About the Authors: Lee Marchessault, CUSP, is the president of Workplace Safety Solutions. He started his career in the electric utility industry 43 years ago and has been working in safety and risk management for 25 years. Reach him at

Peri Eryigit is the marketing and communications manager for Predictive Safety SRP Inc. She works to increase awareness of workplace cognitive impairment and relevant scientific and technological solutions. Reach her at

Safety Management