Workplace Drug Testing

Cover......Page 1
Title page......Page 4
Copyright......Page 5
Contents......Page 6
Preface......Page 12
About the editor......Page 16
Contributors......Page 18
Abbreviations......Page 20
1 - Epidemiology of drug use in the working population......Page 24
Drug use on a global scale......Page 25
Use of cannabis in Europe......Page 26
Use of cocaine in Europe......Page 31
Use of opiates in Europe......Page 33
Employment status of respondents in drug use surveys......Page 34
Studies in prisoners......Page 36
Drug use in the chemical and petrochemical industries......Page 38
Airlines......Page 40
Trucking and road transport......Page 41
Drug use in the military......Page 42
Drug use in schools......Page 43
Drug use in university students......Page 44
Data from the United States......Page 46
Conclusion......Page 54
References......Page 55
2 - Effects of drugs on human performance......Page 58
Introduction......Page 59
Auditory and visual tests......Page 60
Cognitive tests......Page 61
Visual-motor coordination tests......Page 62
Self-assessment of some functions......Page 63
Epidemiological studies......Page 64
Amphetamine and MDMA (ecstasy) (Tables 2.1 and 2.2)......Page 65
Acute effects......Page 66
Ecstasy......Page 67
Chronic effects......Page 68
Cannabinoids (Table 2.3)......Page 69
Acute effects......Page 70
Duration of effects......Page 72
Chronic effects......Page 73
Workplace context......Page 74
Cocaine (Table 2.4)......Page 75
Acute effects......Page 76
Chronic effects......Page 77
Acute effects......Page 78
Chronic effects......Page 79
Acute effects......Page 80
Duration of effects......Page 81
Conclusion......Page 82
Conclusion......Page 83
References......Page 84
3 - The evidence base for workplace drug testing......Page 94
Introduction......Page 95
Does drug testing deter drug use in employees?......Page 96
What is the follow-up of employees who participate in treatment programmes after a positive workplace drug test?......Page 101
Does workplace drug testing reduce the number of accidents and injuries?......Page 102
Does drug testing improve productivity?......Page 108
Meta-analyses and Cochrane reviews......Page 116
References......Page 118
4 - Legal and regulatory aspects of workplace drug testing......Page 122
Introduction......Page 123
The challenge for transnational companies......Page 125
Workplace testing modalities......Page 126
The employment contract......Page 128
European Convention on Human Rights and Fundamental Freedoms......Page 130
Consent to being tested for intoxicants......Page 132
Privacy and bodily integrity......Page 133
EU data protection legislation......Page 135
Health and safety......Page 137
Occupational health and workplace drug testing......Page 138
Global background......Page 140
Specific workplace drug testing legislation in Europe......Page 142
Finland......Page 143
Recent Irish legislative initiatives......Page 144
Railway Safety Act 2005 (Ireland)......Page 146
Germany......Page 147
France......Page 148
Belgium......Page 149
Sweden......Page 150
United Kingdom......Page 151
Review of selected international case law......Page 152
European case law......Page 156
Conclusion......Page 165
References......Page 166
Introduction......Page 170
Background......Page 171
Where do you start?......Page 172
Human resources/occupational health/health and safety/security......Page 174
Line management and employee representatives......Page 175
Working group activities......Page 176
Policy document......Page 177
Education......Page 180
Employee Assistance Programme......Page 184
Treatment for employees with problems......Page 185
What does testing bring to a policy?......Page 186
Testing – the practicalities......Page 187
What will be the consequences of a positive result?......Page 188
Why and when will people be tested?......Page 189
Who will carry out the testing? (collection and analysis)......Page 192
What is a 'positive'
 result for drugs and alcohol?......Page 193
What records will be kept, by whom, and where? Who will have access to them?......Page 194
How will you handle 'late' disclosure of illegal or problem drug use during the test procedures?......Page 195
Sources of information......Page 196
References......Page 197
6 - Urine sample collection process......Page 198
Personnel......Page 199
Collection site......Page 200
Custody and control form (CCF)......Page 201
Specimen collection kit......Page 202
Collection process......Page 203
Directly observed collections......Page 205
Refusal to test......Page 206
Hair collection......Page 207
Further reading......Page 208
7 - Alternative matrices to urine......Page 210
Introduction......Page 211
Physiology......Page 212
Collection......Page 213
Analytical procedures......Page 214
Cocaine......Page 215
Cannabis......Page 217
Opiates......Page 218
Amphetamines......Page 219
Sweat collection......Page 220
Physiology of hair......Page 222
Collection of hair......Page 223
Analytical procedures......Page 224
Cocaine......Page 225
Opiates......Page 227
Amphetamines......Page 228
Sectional analysis......Page 229
Dose–concentration relationship......Page 230
Verification of history of drug use......Page 231
Alcohol abuse......Page 232
Recent trends in the use of alternative specimens for
workplace drug testing......Page 233
Conclusion......Page 234
References......Page 235
8 - Analytical techniques......Page 240
Introduction......Page 241
Enzyme multiplied immunoassay technique......Page 242
Fluorescence polarisation immunoassays......Page 243
Kinetic interaction of microparticles in solution......Page 244
Enzyme-linked immunosorbent assay......Page 246
Point-of-collection drug testing devices......Page 247
Chromatography: introductory theory......Page 248
Sample preparation......Page 251
Chromatographic separation......Page 252
Detection......Page 254
Mass spectrometry......Page 256
Ionisation in GC-MS......Page 257
Ionisation in LC-MS......Page 259
Mass analysis......Page 260
Tandem mass spectrometry......Page 262
Increase throughput......Page 264
Accuracy (bias)......Page 266
Stability......Page 267
Quality of results......Page 268
References......Page 269
Introduction......Page 272
In vitro adulteration......Page 274
In vivo adulteration......Page 275
Substitution......Page 276
Effect of adulterants on immunoassays......Page 277
KIMS......Page 278
RIA......Page 279
EIA......Page 280
RIA......Page 281
RIA......Page 282
FPIA......Page 283
EIA......Page 284
RIA......Page 285
FPIA......Page 286
Nitrite......Page 287
EIA......Page 288
EIA......Page 289
EIA......Page 290
FPIA......Page 291
RIA......Page 292
RIA......Page 293
EIA......Page 294
RIA......Page 295
Effect of adulterants on confirmatory techniques......Page 299
Laboratory detection of adulterants......Page 301
Confirmatory techniques......Page 303
Nitrite......Page 304
Confirmatory techniques......Page 305
Specimen adulteration and quality assurance......Page 306
Alternative matrices and adulteration......Page 309
Conclusion......Page 310
References......Page 311
Introduction......Page 316
Qualifications......Page 318
The medical review process......Page 320
Additional roles of the MRO......Page 323
Specimen validity testing......Page 324
Passive exposure......Page 326
Herbal teas......Page 327
Self-medication......Page 328
Medicinal use......Page 329
Metabolism......Page 330
Passive exposure......Page 331
Poppy seed food......Page 332
Medicinal use......Page 333
Passive exposure......Page 334
Herbal teas......Page 335
Medicinal use......Page 336
Metabolism......Page 337
Medicinal use......Page 338
Metabolism......Page 340
Drug-facilitated sexual assault......Page 341
Alcohol......Page 342
Metabolism......Page 343
Medicinal use......Page 344
Barbiturates......Page 345
Methadone......Page 346
Phencyclidine (PCP)......Page 347
Summary......Page 348
References......Page 349
History......Page 354
General principles of workplace drug testing guidelines......Page 355
Laboratory analysis procedure......Page 356
Conclusion......Page 357
References......Page 372
Introduction......Page 374
Introduction......Page 375
Employee awareness......Page 376
Changes to process......Page 377
Assistance for employees who declare a problem......Page 378
Germany: Degussa policy with respect to drug screening......Page 379
Indicative drug testing confined by limits......Page 380
Drug screening upon initial hiring......Page 381
Training management is necessary......Page 382
How it was implemented......Page 383
B Random testing......Page 384
Refusals......Page 385
Advice......Page 386
Introduction......Page 388
Background......Page 389
Drug use in the Australian workplace......Page 391
Laboratory interpretation......Page 392
On-site drug testing in Australia......Page 393
Alternative matrix testing in the workplace......Page 394
Conclusion......Page 395
References......Page 396
14 - Canadian perspectives......Page 398
Introduction......Page 399
Canadian Alcohol and Drug Use Monitoring Survey......Page 400
Substance use and gambling in the Alberta workplace (2002)......Page 401
Transportation sector......Page 403
Oil and gas sector......Page 404
Other sectors......Page 406
Legislation and guidelines......Page 407
Guidance from human rights commissions......Page 409
Policy components......Page 411
Introduction of alcohol and drug testing......Page 413
Testing technology......Page 414
Testing programme implementation......Page 415
Testing legality......Page 416
Conclusion......Page 417
Endnotes......Page 418
Introduction......Page 420
History......Page 421
Legislation and standards......Page 423
Drug and alcohol-free workplace model......Page 424
Develop policy and procedures......Page 425
Specialist medical advisor workshops......Page 426
Testing......Page 427
Testing options......Page 428
Pre-employment testing......Page 429
Follow-up/post-rehabilitation......Page 430
Amphetamine-type substances (ATS)......Page 431
Other party pills......Page 432
LSD, cocaine and benzodiazepines......Page 433
Australian/New Zealand Standard: AS/NZS 4308 : 2008......Page 434
Conclusion......Page 436
References......Page 437
Index......Page 440