|Risk Levels||Intervention||AUDIT Score|
|Zone I||Alcohol education||0 - 7|
|Zone II||Simple advice||8 - 15|
|Zone III||Simple advice plus brief counseling, And continued monitoring||16 - 19|
|Zone IV||Refer for diagnostic evaluation and treatment||20 - 40|
Risk Zone I – AUDIT scores between 0 and 7
This score generally indicates low-risk drinking. Although no formal intervention is required, alcohol education is appropriate for the following reasons:
- It contributes to the general awareness of alcohol risks and the relevance to safety critical work.
- It may be effective for workers who have experienced alcohol problems but who have already reduced their drinking levels; or whose circumstances may change.
- It could be effective for those workers who have minimized the extent of their drinking on the AUDIT questions.
Scores in this zone are likely to be recorded by a significant proportion of workers. They indicate alcohol use in excess of the low-risk guidelines. Persons in Zone II generally would be drinking at risky or hazardous levels and would be at moderate risk of alcohol-related harm. This zone however may also include workers experiencing actual harm and low levels of dependence. Generally, simple advice and information on the alcohol guidelines and risk factors, and the importance of attentiveness for safety critical work would be an appropriate intervention. The examining health professional may assess the worker as Fit Subject to Review in order to flag the issue for attention at subsequent assessments. The period of review may be earlier than or in line with normal periodic frequencies, depending on the clinical assessment and other indicators.
Risk Zone III – AUDIT scores between 16 and 19
This zone indicates risky drinking and problems related to higher levels of consumption. This score indicates a pattern of consumption that is already causing harm to the drinker who may also have symptoms of dependence. Workers in this zone should be managed by a combination of simple advice, brief counseling, and continued monitoring. Follow-up and referral to the worker’s general practitioner is necessary. The examining health professional should assess the worker as Fit Subject to Review and should refer for external assessment via the worker’s GP. They may also classify Temporarily Unfit, if there are immediate concerns for the safe conduct of rail safety work.
Risk Zone IV – AUDIT scores in excess of 20 and where combined scores on questions 4, 5 and 6 are equal or greater than 4
Scores in this zone indicate that the person falls into the high-risk category of alcohol-related harm. Workers in this zone are likely to be alcohol dependent and require more intensive intervention. Health professionals should note that dependence varies along a continuum of severity and might be clinically significant at lower AUDIT scores. Workers in this zone should be referred to specialist services to consider withdrawal, pharmacotherapy and other more intensive treatments. They should be assessed as Temporarily Unfit for Duty pending further assessment and referred in the first instance to their general practitioner.