Two Decades After Research, Collection Sites Still Weakest Link in DOT Testing Process

The Opioid Abuse In Transportation Act in Congress would, if enacted, would have great potential to save lives and avoid injuries by including a broader approach to drug testing programs and better reporting of drug testing data for the Department of Transportation’s (DOT) drug and alcohol testing program.

CleanFleet supports the Opioid Abuse In Transportation Act, but more needs to be done for more accountability on collection sites.

Over 20 years ago, the DOT identified the collection process as the weakest link in the drug testing process. To be effective, every element of the testing process must be considered reliable and must provide reasonable defense against attempts to tamper with the process.

Let’s look at how collection sites are still the weakest link in the DOT testing process.

History of the Testing Process Weakest Link

Many flaws were first researched of collection sites performing DOT drug testing collections in 2007 by the Government Accountability Office (GAO) testimony to Congress. A DATIA article in the Summer 2014 Issue summarized the GAO research, by finding:

• 75% of collection sites failed to restrict access to items that could be used to adulterate or dilute the urine specimen; individuals had access to soap, air freshener, and other potential adulterants in the privacy enclosure
• 67% of collection sites had access to running water in the privacy enclosure
• 42% of collection sites failed to ask the employee to empty his/her pockets and display items to ensure no items were present that could be used to adulterate the specimen
• 19% of collection sites failed to check the temperature of the specimen
• 17% failed to add bluing agent in the toilet water or secure the tank with tape

Since then, many TPAs performing audits on collection sites in their consortiums have found:

• Procedures for direct observation are not followed properly or performed the same way every time with every donor
• Collectors are not altering forms or altering forms incorrectly, when needed
• Pre-filling the CCF, pre-date the specimen security seals, preprint the collector name, date and time on Step 4; and in some cases pre-sign on Step 4
• Alcohol testing collection sites did not have an evidential breath alcohol testing device on hand

If you disregard the fact that the donors giving their specimen at a collection site are uneducated on the process, procedures, or keen to look for warning signs, there is an even longer list of issues found when auditing collection sites.

Direct observation collections can only be made with same gender

There are certain situations during the collection process in which requires someone to observe the donor void into the cup in order to ensure the sample is not tampered with and is valid. When these situations arise, the person observing must be of the same gender.

The issue that arises is that most collection sites are a 1 or 2 person operation and usually don’t staff both genders.

There have been situations where a physician or a nurse of the opposite sex has stated that “they are a doctor” and can observe the collection. This is not true. Instead, the donor will need to go to a more inconvenient site because they do not have anyone to perform the observed test.

Shy Bladder Procedure and Refusal to Test

The collector must specifically tell the employee that he or she is not permitted to leave the collection site and if they do so, that it will be considered a refusal to test. In many cases, we have witnessed collectors complaining to a donor for leaving the collection site to smoke or get a drink nearby.

In another case, a collector threw away the first temperature out-of-range specimen and all paperwork when a frustrated donor leaves during the Shy Bladder process.

We have even heard stories of a shy bladder process that went over the three hours. The collector asks the manager what should be done at that point. The decision made was to send the Laboratory Copy of the Custody and Control Form (CCF) sealed in the bag without a specimen to the laboratory.  Of course, the lab canceled the test due to no specimen.

Regarding refusals, some collectors have been known to send the specimen into the lab after the employee refuses to continue the testing process or admits to tampering with or adulterating their specimen.

Some Donors Offer Bribes for Clean Urine Sample

At any collection site, a donor will get nervous when a cheating device is found, an out of temperature specimen is presented, or shy bladder process is started.

At CleanFleet, one donor offered one of our staff $1,000 to “make this all go away”. After refusing to fix the paperwork, the donor asked if the staff member would just pee for him and fix it that way. Again, our staff member refused, stating that there was no way I was going to break the law.

The donor then broke down and admitted that he would not pass the test. He stated that he had been talking with his boss who was directing him to wait the 3 hours and not test, then go on vacation and wait 30 days.

What worries us about this story was what the donor’s boss advised the driver. Not only is what was advised against the law, but devastating to a driver seeking help and found none.

Why is all of this important? 

Mistakes in the collection process can lead to issues with DOT regulators and the employer might be out of compliance facing fines and other sanctions.

For congress, it’s time to take action, hold collection sites accountable, and require changes to improve the DOT collection process. We will address what changes Congress can require in a following article.

For companies, be sure your drug and alcohol tests are handled by a reputable drug testing vendor. The wrong choice in a service agent for your drug testing services may or may not cause ongoing problems, but it only takes one test to go bad for devastating consequences to occur.

Lastly, for donors who might have an erroneous test result reported due to an error, collection sites might face issues from a plaintiff’s attorney on any challenge or law suit from a donor who tested positive and lost his or her job.