National Drug Screening, Inc (NDS) is excited to sponsor the Inside Drug Screening column in The Background Buzz for 2024. It is our intent to educate the background screening industry on important news, information and trends about drug screening. Our focus will be on workplace drug testing and each month we will feature a specific drug testing topic followed by any recent news, information and trends. These back to the basics drug testing topics will help your teams better understand drug testing and to help grow your drug testing revenue.
Understanding problems that may occur in the drug & alcohol testing program is essential to managing an effective program. Learn the most common specimen collection issues.
Employment drug testing always involves the collection of a specimen to be tested with an instant testing device or shipped out to a laboratory for lab initial testing and confirmation testing when necessary. This article will discuss some of the common problems associated with a drug screen specimen collection at the point of collection.
Understanding problems that may occur in the drug & alcohol testing program is essential to managing an effective program. Learn the most common specimen collection issues.
- Shy Bladder in a Urine Collection
- Temperature out of Range – Urine Collection
- Direct Observation – Urine Collection
- Insufficient Quantiey – Hair Collection
- Insufficient Quantiey – Oral Fluid Collection
- Shy Lung – Breath Alcohol Test
- Refusal at the Point of Collection
Shy Bladder – Urine Collection
In a DOT collection, the donor is always required to make an attempt to void a specimen. If they say they cannot go right now, they are required to try anyway. Once an unsuccessful attempt is made this starts the shy bladder process. An unsuccessful attempt would be less than 45 mL of urine for a DOT specimen or less than 30 mL for a Non-DOT specimen.
A log sometimes called a shy bladder log should document the shy bladder process. The donor will have up to 3 hours to produce a sufficient specimen, usually this is completed much sooner. The donor is entitled to be provided up to 40 ounces for water reasonably distributed over the 3 hours. Refusal to drink fluids is not a refusal to test. Once a successful quantity of specimen is collected, the specimen collection process can be completed, and specimen sent to lab.
If the 3 hours expires and the donor still cannot provide the appropriate quantity of urine this is generally considered a refusal to test. EXCEPT when a medical examination determines there is a medical explanation for the inability to produce urine withing 3 hours. The physician for the medical examination is determined by the employer in conjunction with the Medical Review Officer (MRO). Best practices and more on Shy Bladder >
Temperature out of Range – Urine Collection
During a urine drug screen collection, when the donor comes out of the bathroom with the urine specimen, the collector takes the collection container from the donor and immediately views to see if the temperature is in range. There is a temperature strip on the specimen collection cup. If the temperature of a urine specimen is outside the range of 90-100F (32-38C), there is reason to believe that the donor may have altered or substituted the specimen.
A second collection should be initiated and for DOT drug testing this second test must be conducted under direct observation. If the donor does not want to proceed with the second collection, follow the steps to document this as it is considered a refusal to test. In this case nothing is sent to the Lab, complete documentation is required. If the donor proceeds with the direct observed collection, the results of the second specimen collection would always be the result of record unless the result of the first specimen collected is positive.
Direct Observation – Urine Collection
For DOT testing only, some situations require a direct observation of the urine specimen collection. The observed collection must be gender specific (same gender) – no exceptions. The same gender observer goes into the restroom with the donor to observe the donor void into the specimen cup. DOT provides very clear Direct Observation Procedures and these include the situations of when to conduct a direct observation. A common reason for the direct observation would be when the urine specimen temperature is out of range.
Insufficient Quantity – Hair Collection
Hair collections are fairly easy except when the donor does not have hair on the head, or the collector does not collect enough hair. Often laboratories reject hair specimens because of insufficient quantity. A hair drug test requires 100-milligrams of hair (90 to 120 strands). This can be from the head, chest, face, underarms, arms or legs but do not combine head hair with body hair. When using head hair 1.5 inches is necessary with about the thickness of a pencil. Laboratories will have specific instructions for the hair collection for hair specimens going back to their lab.
Insufficient Quantity – Oral Fluid Collection
Specimens collected for oral fluid drug testing are most often collected on a device that resembles a sponge on a stick. 1 milliliter (mL) plus or minus 10% of oral fluid is required to perform drug testing. The good news is that most commonly, samples for oral fluid drug testing are gathered using a tool that looks like a sponge attached to a stick. Drug testing requires approximately 1 milliliter (mL) of oral fluid, with a tolerance of plus or minus 10%. Fortunately, the majority of oral fluid collection devices come with a volume adequacy indicator. This indicator guarantees that enough saliva (1 mL) is collected to avoid potential false negative outcomes caused by inadequate sample size, and to produce a significant quantitative result. Typically, the indicator turns blue when sufficient quantity of oral fluid is collected.
Shy Lung – Breath Alcohol Test
Shy lung refers to a situation when a donor is unable to provide an adequate amount of breath for an alcohol breathalyzer test. The donor can then be sent for a medical evaluation by a physician which is selected by the employer and MRO. If the physician determines that there is no medical explanation for the donor’s failure to provide sufficient breath, it’s considered a refusal to test. If the donor refuses the medical examinations, it’s considered a refusal to test.
Refusal at the Point of Collection
Many times, there is a refusal to test at the collection site or point of collection. The specimen collector documents what happened during the collection and also stating “this is considered a refusal.” The actual official determination of the refusal should be a decision made by the employer’s designated employer representative (DER); the person in charge of the drug testing program.
Donor actions causing a refusal to test:
- Donor fails to appear for any test (except a pre-employment) within a reasonable amount of time
- Donor fails to remain at the testing site until the testing process is complete (pre-employment exception)
- Donor fails to provide a urine specimen for any drug test required by DOT agency regulations; without documented medical explanation obtained after the collection
- In the case of a directly observed drug test – failure to permit the observation of the provision of a specimen or failure to raise the donor’s shirt, blouse or dress/skirt above the waist and lowering clothing and underpants to show the collector that the donor does not have a prosthetic device
- Donor fails to cooperate with any part of the testing process (e.g., refuse to empty pockets, behave in a confrontational way, donor fails to wash hands after being directed to do so)
- Donor is found to possess or wear a prosthetic device that could be used to interfere with the collection process
- Donor admits to the collector or MRO that he/she attempted to adulterate or substitute the specimen
A refusal to test is very serious, it is a violation of the drug & alcohol testing program and there should be no second bite of the apple.
About the Author
Joe Reilly entered the world of drug testing in 1993 and over the last 25+ years has become a leading national expert on workplace drug testing, drug free workplace programs and specimen collections for drug tests. Joe is the President of a nationwide drug testing industry consulting firm – Joe Reilly & Associates. He is also President of National Drug Screening and is the Senior Director of Compliance for USA Mobile Drug Testing Inc.
Joe served for twelve years on the board of directors of DATIA the Drug & Alcohol Testing Industry Association (now NDASA) and for four of those years as the Chairman of the Board.
Joe Reilly, President, National Drug Screening, has been involved in the drug testing industry since 1993 and is a national expert in workplace drug testing. Joe is a former board member and former chairman of the board of DATIA (now NDASA). Working with employers, third party administrators, and background screening companies, Reilly is always available for assistance and questions.
