The Department of Transportation (DOT) has approved use of non-urine specimens for occupational drug testing. There are benefits and disadvantages to each specimen type.
Reasons for requesting drug testing:
(1) pre-employment
(2) random testing according to company policies
(3) return to duty
(4) follow-up (making sure the patient remains drug free after return to duty)
(5) reasonable suspicion (for cause)
(6) post-accident
Situation |
Hair |
Oral Fluid |
Sweat |
Urine |
---|---|---|---|---|
pre-employment |
Y |
Y |
N |
Y |
random testing |
Y |
Y |
N |
Y |
return to duty |
Y |
N |
Y |
Y |
follow-up |
Y |
N |
Y |
Y |
reasonable suspicion |
N |
Y |
N |
Y |
post-accident |
N |
Y |
N |
Y |
One consideration of the choice deals with the need to collect the specimen under direct observation (for reasonable suspicion, others). An alternative specimen may be desirable if:
(1) there is no person of the donor's gender available to observe the collection.
(2) a significant delay may occur before the urine specimen can be collected (transporting the person to a testing site, etc.).
If a problem occurred with a previous specimen (adulterated, substituted, invalid, etc.) then consider:
(1) urine specimen collection under direct observation
(2) hair testing, since this allows retrospective evidence of drug use while the hair has been growing
Purpose: To select an appropriate specimen for drug testing.
Specialty: Toxicology, Emergency Medicine, Critical Care
Objective: laboratory tests
ICD-10: Z86.4,