Abstract:
Drug misuse, specifically of synthetic opioids and methamphetamines, has increased in the United States, often occurring on public transit, creating potential for secondhand exposure for transit operators. These exposures could result in physical or mental health impacts. Here, we characterize drug use incidents on transit vehicles and its impacts on transit operators. Using a quantitative survey of transit operators in the Pacific Northwest, we fit ordinal logistic regression models to investigate transit operators’ perceived risk of workplace exposure to drug use incidents, occupational stress, and job satisfaction, and their association with intent to leave their job. We found that higher perceived risk scores were significantly positively associated with greater intent to leave (OR: 1.08; 95% CI: 1.02, 1.14), but occupational stress and job satisfaction, which were significantly associated with greater intent to leave, attenuated this relationship. We subsequently conducted qualitative interviews of transit operators to explore their experiences with passenger drug use, risk perceptions, impacts, availability and effectiveness of existing supports and guidance pertaining to passenger drug use, and whether there are unfulfilled needs in these supports. Interviewees reported physical health effects, mental health outcomes, and emotional impacts. Risk perceptions of passenger drug use were prevalent and may be exacerbated by outrage factors. Operators reported a lack of support from their agencies, and highlighted engineering controls as an effective intervention that is currently unfulfilled. We then examined temporal and weather-related trends in drug use on transit, based on previous transit operator concerns that people who use drugs (PWUD) seek transit vehicles as shelter to escape from inclement weather. Using a dataset of drug use incidents reported by transit operators in King County, Washington, in 2022, we fit a Poisson regression model to understand the association between daily incident count and daily weather patterns. Reported drug use incidents showed clear temporal trends, with a higher frequency of incidents in winter and spring than in summer; April had the highest mean daily incident count of 7.3 incidents/day. Higher temperature was significantly associated with lower incident count (IRR: 0.96; 95% CI: 0.95, 0.97). The work presented here highlights the impacts of drug use incidents on transit operators, and can help guide the development and timely deployment of interventions that can improve the work experiences of transit operators.