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Safeguard OSH Solutions - Thomson Reuters

Safeguard OSH Solutions - Thomson Reuters



Safeguard Magazine

Drug testing: Testing times

Workplace drug testing in New Zealand is more than 20 years old. SUE NOLAN reviews the history, critically examines current issues, and takes a peek into the future.

The introduction of workplace drug testing as part of an organisation’s Drug and Alcohol Free Workplace Programme (DAFWP) commenced in the early 1990s. Initially this was in response to US-based companies requiring their global subsidiaries to adopt policies and procedures mirroring the US programmes. In 1992 the Royal NZ Navy introduced drug testing programmes and the other elements of the Defence Force followed.

During the mid to late 1990s the pioneers were in the forestry, fishing, mining and aluminium manufacturing sectors. Since 2000 many organisations in other high risk industry sectors have put comprehensive programmes in place, and even some sectors not regarded as safety-critical now embrace some drug testing options. Sectors include oil/gas/energy, dairy, transport, construction (vertical and horizontal), meat/poultry, agriculture, tourism and hospitality, manufacturing, personnel consulting, banks, and some local and central government agencies including NZ Customs and the departments of Corrections and Conservation.

Around 8000 tests were conducted nationwide in 2000; by 2006 this had increased to 60,000, and it is estimated that the figure for 2014 will exceed 200,000. In 2006, the majority of tests being conducted were pre-employment (74%), with post accident/reasonable cause tests representing 3% and random testing 15%. In the past five years random testing has increased significantly, with an estimated 50% of company policies now including this option.

There is wide variation in the quality and robustness of company policies, procedures and testing programmes, but the model initially designed by ESR and Instep Ltd in 1995 (see page 19) continues to be supported and endorsed by many companies and stakeholders (eg unions). The DAFWP model has four critical components. Each one will be summarised, with issues currently being faced highlighted at the end.

DEVELOPING POLICY AND PROCEDURES

These must be legally robust, updated regularly, implemented via full consultation with employees and stakeholders, and compliant with the most recent technical standards relevant to workplace testing. The procedures should cover testing options and protocols/flowcharts which can be readily followed by managers, eg:

  • • 
    Testing options (pre-employment, post incident, reasonable cause, random, follow-up).
  • • 
    Informed consent for each testing occasion (managers’ responsibility).
  • • 
    Verification of ID of donor for collector (photo and signature).
  • • 
    Consequences of refusing to consent.
  • • 
    Close supervision from time of notification until delivery to collector (ensuring no opportunity for overhydrating, sample tampering, substitution with artificial urine, etc).
  • • 
    Unwitnessed urine specimen collection.
  • • 
    Stand down conditions if screen is not negative while awaiting laboratory confirmation.
  • • 
    Rehabilitation offer.
  • • 
    Confidentiality of information.
  • • 
    Testing procedures to comply with latest International Standards.

CURRENT ISSUES:

  • • 
    Many policies/procedures are not updated sufficiently regularly and are currently out of date. With the rapid changes in drugs of abuse trends, and employees being aware of the drugs which will not be tested for in an out-of-date policy, some workers deliberately use substances which will “beat the test.”
  • • 
    Gaps in minimising opportunities to interfere with specimen integrity (eg tampering, substitution). Main causes are lack of supervision from time of notification, and employees/contractors being aware that the collecting agent has turned up for random testing.
  • • 
    Inexperienced people are given the task of writing or updating the company policy. The documents are frequently ambiguous, incoherent, full of gaps, technically and legally unsound and procedurally difficult to comply with. An expert in the field should be engaged at an early stage to facilitate this process efficiently and draft the templates.
  • • 
    A “not robust, technically and legally unsound” set of policy and procedures is challengeable in employment courts.

EDUCATION AND TRAINING

One of the key determinants for a successful DAFWP is educating managers and staff. Staff should undergo drug and alcohol awareness training which provides updated and relevant information to help make ongoing informed decisions. Managers/supervisor require upskilling in identifying signs and symptoms of a substance impaired person and effectively managing the company DAFWP. Such training should be ongoing for new recruits and new managers, with refresher training programmed at intervals of three to four years.

CURRENT ISSUES:

  • • 
    Some companies do minimal or no training.
  • • 
    Some companies will initially invest in training as part of the implementation strategy but fail to commit to ongoing training.
  • • 
    Some training programmes, provided either by an outside service provider or an in-house person, are inadequate both in content and the expert knowledge required for this specialist topic.
  • • 
    Many managers/supervisors have not been provided with the knowledge and skills to follow procedures correctly. There are now a number of cases where this inadequacy has been exposed in the Employment Courts.

TESTING - URINE

Drug testing in New Zealand is primarily based on urinalysis. Urine testing must be conducted in compliance with AS/NZ 4308:2008 Procedures for specimen collection and the detection and quantitation of drugs of abuse in urine. This requires collectors and those providing screening services to have two NZQA unit standards: US 25458 and 25511.

The testing starts with an initial screen for drug classes and specimen integrity conducted either by the collector (referred to as “on site” screening) or by an accredited laboratory (ESR or Canterbury Health Lab). If “on site” screening is used the qualified collector must use a device which is verified as complying with AS/NZS 4308, run daily positive and negative controls, and belong to a recognised proficiency testing programme. IANZ accreditation should also be sought by the collecting agent.

Specimens screening “not negative” must be forwarded to the laboratory for mass spectrometry confirmatory testing to determine whether a specific drug of abuse is present and at or above the relevant cut-off concentration. This can then be re-pointed as a positive result. Confirmatory testing is crucial to eliminate interference from legitimate medications, foodstuffs (eg poppy seeds) and other artefacts. Also the collector should only advise the client that the urine has been dispatched to the laboratory for confirmatory testing and not indicate what the “not negative” actually was.

In best-practice policies and procedures it is now recommended that, for a post incident or reasonable cause event, every on-site specimen which screens negative is automatically sent to the laboratory with instructions to test for an extended range of drugs (eg synthetic cannabinoids, bathsalts, other legal highs, other designer drugs) which will not be detected in the initial screening test. Extended testing should also be conducted for some random events.

This is because an on-site screening kit only tests for the traditional panel of drugs (cannabinoids, opiates, cocaine metabolites, amphetamine-type substances, benzodiazepines). Where a company also wants to test for the new drugs – particularly post-incident or reasonable cause – then a negative standard screen cannot be accepted as a final result. Only laboratories have the capability to test for the extended range of drugs.

CURRENT ISSUES:

  • • 
    Many urine collectors and “on site” screeners are not NZQA qualified.
  • • 
    Some “on site” screening devices are not verified as compliant with AS/NZS 4308:2008.
  • • 
    Many “on site” screeners are not doing daily controls and do not belong to a proficiency testing programme.
  • • 
    Some “on site” screeners do not send urine screening “not negatives” to laboratory for confirmatory testing and act on the screen result only.
  • • 
    Many screening reports are providing inappropriate information to the client (eg confidential medication data, details of the “not negative” drug class or integrity failure).
  • • 
    Most companies are not requesting that specimens screening negative get forwarded to the laboratory for “extended” testing.

TESTING – ORAL FLUID

In 2006 Standards Australia introduced an Oral Fluid drug testing standard AS4760:2006 Procedures for specimen collection & the detection & quantitation of drugs in oral fluid. There have been ongoing issues with the standard, particularly with respect to testing for cannabinoids, since both the target concentration and the “on site” screening devices are inadequate for testing for this drug, both from a reliability and sensitivity perspective. Hence NATA (Australian equivalent of IANZ) released a statement in July 2013 stating that it is not able to accredit facilities to cover on site initial drug testing of oral fluid due to a number of significant technical issues which are unable to be resolved.

The current status is that, in August 2014, Standards Australia agreed to the revision and updating of the current AS4760. It also agreed that the Standard will be a joint standard with New Zealand. Such reviews take a minimum of 18 months to be completed so the earliest a revised/updated joint standard would be released would be early 2016.

CURRENT ISSUES:

  • • 
    Companies should be advised not to consider oral fluid testing until there is a Joint AS/NZS Standard which is technically robust and can be complied with.
  • • 
    Then there needs to be manufactured screening devices, controls and transportation devices that are reliable and sensitive enough to comply with the revised standard.

TESTING – ALCOHOL

A company policy must decide if it has a zero alcohol tolerance (becoming the most popular model) or will test at the latest “drink driving” level (from 1 December 2014, 250 micrograms per litre (µg/L) of alcohol in breath for over 20 year olds). Even for a zero tolerance policy, the testing is usually conducted to determine whether the level is at or above 100µg/L. The breath-alyser should comply with AS3547:1997/Amendment 1-2000 (type 2) Breath alcohol testing devices for personal use and be calibrated within the specified time period (often every six months).

REHABILITATION

Many policies offer rehabilitation to those who voluntarily seek help or who test positive for the first time. The latter decision is normally at the discretion of the company and is based on the employee’s previous history as a “valued” employee. However there are strict criteria regarding return to work decisions and monitoring for ongoing abuse via follow-up testing for up to two years. The policy should dictate what proportion (if any) of the treatment the company is prepared to fund.

CURRENT ISSUES:

  • • 
    Some companies have moved to a one-strike policy with no rehabilitation offer.
  • • 
    Many rehabilitation programmes are not appropriately managed or monitored.
  • • 
    Follow-up testing should cover laboratory testing for drugs including the “extended.” panel and not rely on the “on site” screen only. This is seldom done.

THE FUTURE

Workplace drug testing will continue to grow, with some of the minimal or non-participating sectors (eg Health) hopefully also introducing robust policies. Alternative methods for different types of testing will become more common as these become reliable and standards are introduced, for example:

  • • 
    Oral fluid testing (once AS4760 is updated).
  • • 
    Hair testing – tests for historical use of drugs but not recent use. It is ideal for follow-up rehabilitation testing and some legal testing eg child custody cases. Some companies overseas (eg casinos) use pre-employment hair testing to ensure the applicant has had no exposure to drug use for a significant period.
  • • 
    Breath testing for drugs of abuse: research is already under way but the methodology is in its infancy for medico-legal testing criteria.

“On Site” screening may decline with updated policies and procedures, focused on ensuring that testing is covering as many of the “modern” drugs of abuse as possible, choosing to send all samples to the laboratory for “extended” testing. For this to occur, laboratories would be required to offer a rapid turnaround for reporting results and be using sophisticated Liquid Chromatography/Mass Spectrometry/Mass Spectrometry (LCMSMS) for their screening methodology. Prices would also need to be competitive.

There is likely to be an increase in legal challenges to company policies and procedures which are inadequate, out of date or not being adhered to by managers.

As an increasing number of collecting agent service providers from a myriad of backgrounds are moving into this space, it will be even more important for a company to continue to audit the quality of the services they are providing and ensure they are fully complying with the technical standards.

A final strong message is to continue to focus on the importance of using policy advisors who are subject matter experts, and ensure adequate ongoing training for staff and managers.

Auckland-based Sue Nolan is director of consultancy firm DrugFree Sites.

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