What is Impairment?

What is Impairment?

“Impairment: noun. Definition: the act of impairing something or the state or condition of being impaired; diminishment or loss of function or ability.”

When we think of impairment our minds often go immediately to drug or alcohol use. However, impairment can come from a wide variety of situations as life happens. 

None of us are above the struggles of difficult family situations, medical problems or other traumatic events. Some examples of things that might cause impairment are: fatigue, illness or treatment of illness or pain, antibiotics or cold medications, chronic or acute pain or any number of therapy treatments. Along with these, there is a gamut of other causes of impairment; preparing for a large event like a wedding, an exam or a change in work duties can cause a worker to lose focus on their work. Unresolved conflict either at the workplace or at home, extreme weather (heat or cold), having a child or assisting with a family member is turmoil, experiencing a traumatic event like a fire or a robbery, even side effects of shift work like disruption of a worker’s circadian rhythm can cause noticeable impairment similar to the symptoms of substance use. 

The Canadian Human Rights Commission describes the appearance of impairment as “odor of alcohol or drugs, glassy or red eyes, unsteady gait, slurring speech, poor coordination.” The definition might be short-sighted. With the exception of the odor of drugs and alcohol, these symptoms could be brought on by any or all the symptoms listed above or even a lack of sleep. 

So how do you proceed? Knowing your workers is a great first step when it comes to engaging the reasonable suspicion or the fitness-for-duty procedures your organization has in place. The Atlantic Canada Council on Addiction (ACCA) has published a table which can be used to help determine impairment in general. The ACCA recognizes that the symptoms of impairment do not necessarily mean that an employee has a substance use problem, however they can indicate that a worker is in distress and needs some help. To assist sort through this the table below can assist in determining which is which.

Table 1
(not specific to any causal agent)
  • deterioration in appearance and/or personal hygiene
  • unexplained bruises
  • sweating
  • complaints of headaches
  • tremors
  • diarrhea and vomiting
  • abdominal/muscle cramps
  • restlessness
  • frequent use of breath mints/gum or mouthwash
  • odour of alcohol on breath
  • slurred speech
  • unsteady gait
Psychosocial impacts
  • family disharmony (e.g., how the colleagues speak of family members)
  • mood fluctuations (e.g., swinging from being extremely fatigued to ‘perkiness’ in a short period of time)
  • inappropriate verbal or emotional response
  • irritability
  • confusing or memory lapses
  • inappropriate responses/behaviours
  • isolation from colleagues
  • lack of focus/concentration and forgetfulness
  • lying and/or providing implausible excuses for behaviour
Workplace performance and professional image
  • calling in sick frequently (may work overtime)
  • moving to a position where there is less visibility or supervision
  • arriving late for work, leaving early
  • extended breaks; sometimes without telling colleagues they are leaving
  • forgetfulness
  • errors in judgement
  • deterioration in performance
  • excessive number of incidents/mistakes
  • non-compliance with policies
  • doing enough work to just ‘get by’
  • sloppy, illegible or incorrect work (e.g., writing, reports, etc.)
  • changes in work quality


Even though a worker might not be under the influence of recreational drugs or alcohol, they may still be impaired and a danger to themselves or others. Fitness for duty procedures can be enacted even though there is no reasonable suspicion of substance misuse. A properly trained person will be able to recognize the difference, and ask the appropriate questions in order to engage the fitness for duty or reasonable suspicion policies an organization has put in place. The policy is the framework to guide your Fit-for-Duty process so that potential impairment is handled in a way that benefits safety for everyone involved.  Not sure how to proceed? We can help you with that. 


Daniel Hearn, ACC

2BSure Substance Abuse Professionals

January 2, 2021


Canadian Centre for Occupational Health and Safety (The), (2020). Impairment at work. Retrieved from,


Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/impairment.