Page 38 - OHS, June 2022
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EMPLOYEE HEALTH SCREENING
proper instrumentation and staff to analyze the specimen and to conduct additional testing, if necessary.
Lab-based oral fluid drug testing for the workplace has been a valuable service available since the 2000s. However, there are important differences between oral fluid testing and testing using urine, hair or blood sampling.
How is Oral Fluid Different? To start with, in comparison with urine, hair and blood sampling, oral fluid is a less-intrusive option. For example:
■ Unlike urine, the donor doesn’t need to be given privacy in a bathroom, which also gives donors an opportunity to cheat the testing process.
■ Unlike hair, oral fluid helps avoid complications associated with insufficient hair being available to collect.
■ Unlike blood, oral fluid doesn’t require use of syringe and needle by a trained phlebotomist to draw blood from a donor’s arm.
How is Oral Fluid Similar? Oral fluid testing is very similar to traditional urine sampling in several ways:
■ Oral fluid testing is scientifically accurate and legally defensible.
■ Chain of custody and specimen retention by the lab is modeled after federal guidelines.
■ Oral fluid testing can be used for detecting the most commonly-abused drugs tested today, including marijuana, cocaine, opiates, amphetamine, methamphetamine, phencyclidine (PCP), ecstasy (MDMA), oxycodone, barbiturates, benzodiazepines and methadone.
■ Result turnaround is very comparable to urine testing.
Lab-based oral fluid drug testing for the workplace has been a valuable service available since the 2000s.
■ Testing cost is comparable to urine, and even less expensive if the employer performs the specimen collection directly. Hair and blood testing are significantly more expensive than oral fluid and urine testing.
Advantages of Oral Fluid Testing
There are also several unique advantages to oral fluid testing:
■ Depending on the substance ingested, oral fluid can detect more recent use than is the case with urine, as soon as within one
hour of ingestion.
■ Oral fluid has shown to be more sensitive in detecting
marijuana use.
■ An oral fluid collection can easily be performed directly by
the employer, thereby avoiding lost employee time traveling to a collection site.
■ An oral fluid collection is performed with the donor under continuous supervision and observation of the collector (or employer), thereby essentially eliminating donor ability to tamper with the specimen.
■ An oral fluid collection will not be interrupted or delayed due to a donor’s inability to provide sufficient specimen, as may be the case with urine.
Possible Disadvantages of Oral Fluid Testing
There are some attributes of oral fluid testing that some could possibly view as a disadvantage, including:
Federally-mandated testing. As is currently the case with the Department of Transportation testing, lab-based urine testing is required for federally-mandated testing. However, the Substance
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32 Occupational Health & Safety | JUNE 2022
www.ohsonline.com
published guidelines in October of 2019 authorizing lab-based oral fluid drug testing that will eventually make it possible for federally-regulated workplaces to begin using lab-based oral fluid testing as an alternative to lab-based urine testing.
Shorter detection window. Depending on the substance ingested, amount of ingestion and an individual’s metabolism, most substances can generally be detected in oral fluid within a one–48-hour period following use.
■ Detection in urine generally falls into a one-to-seven-day period following use (or longer for chronic users).
■ Detection in hair generally falls into a seven-to-90-day period following use provided an inch-and-a-half of hair length is available to be collected (essentially every half-inch of hair from the skin can provide a 30-day window of detection).
U.S. state restrictions. All states permit the use of lab- based urine drug testing for all testing scenarios. In the case of lab-based oral fluid testing, most states have no restriction for use, but there are a handful that require lab-based urine testing in certain scenarios, or to qualify for workers’ compensation premium discounts.
Oral Fluid testing is also increasing in popularity among employers interested in obtaining an “instant” or “rapid” screening result. Since oral fluid testing is a point-of-collection test, an employer can directly collect a specimen for immediate screening rather than send an employee to a collection site, which may take two or more hours before the employee can return to work. Generally speaking, at least 90 percent of the time, employers will
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