What is a shy bladder in DOT drug testing?

Shy Bladder in DOT Drug Testing


US DOT has provided specific procedures for dealing with applicants or employees who present for a DOT urine test, but are unable to provide an adequate urine specimen.  The procedures are included in 49 CFR part 40, at paragraph 40 .193. 

When an individual is unable to produce a urine specimen or provides a specimen that is less than 45 mL, the “shy bladder” procedures are initiated.  If the individual does not produce any urine, the collector explains that the individual will have up to three hours to provide an adequate specimen and encourage the individual to drink up to 40 oz. of fluids while remaining at the collection site. The collector should note the time of the first attempt to obtain a urine specimen on the CCF.  If the individual refuses to   remain at the collection site until he/she has provided an adequate specimen or until the three hours have   elapsed, it is a “Refusal to Test”. 

A urine specimen collector should always use a shy bladder log to document the shy bladder process.

If the individual provides a specimen less than 45 mL, the collector should examine the specimen for obvious signs of adulteration and obtain a temperature reading, if possible.  If the specimen shows no indications of possible adulteration or substitution, the collector should discard the specimen and record on the CCF the time of the attempt and that the specimen was insufficient quantity.  The individual should be encouraged to drink fluids up to 40 oz. and try again before the three hour time limit elapses.  If the specimen temperature is out of range or the specimen appears to have been tampered with, the collector should prepare the partial specimen for shipment to the laboratory and commence to conduct another specimen collection under direct observation. 

DOT rules do not permit the combining of two or more partial specimens to achieve the 45 mL. minimum volume. If three hours elapse and the individual has not provided an adequate specimen, the collector should discontinue the collection process.  The collector should ensure that the 3 hour time period is recorded and that the “None Provided” box is checked on the CCF.  The collector notifies the employer that the collection was discontinued.  At this point, the employer directs the individual to obtain, as soon as possible, from a licensed physician who is acceptable to the employer, an evaluation concerning the individual’s ability to provide an adequate amount of urine.  A written report of the examining physician’s findings is provided to the MRO for review and final determination.  If the MRO finds no documentation of a medical condition or illness that explains the individual’s inability to provide an adequate specimen, it is deemed a “Refusal to Test”.     

According to DOT rules, collectors may not discontinue a “shy bladder” collection prior to three hours elapsing or the successful completion of the specimen collection.  Collectors may not allow individuals to leave the collection site and return at a later time or date.  These “shy bladder” procedures apply to applicants for DOT covered positions as well as current employees.