Original Communication
Urinalysis and hair analysis for illicit drugs of driver applicants and drivers in the trucking industry

https://doi.org/10.1016/j.jflm.2010.02.014Get rights and content

Abstract

The purpose of this article is to compare the differential rate of detection of illicit drugs when using two distinct sample types, hair and urine specimens. The specimens were collected from persons who applied for employment as a truck driver, or were collected from randomly selected currently employed truck drivers. The data is examined for job applicants and employees to determine if any differences in outcomes are associated with employment status or specimen type. The data is also assessed for specific patterns associated with particular drugs and their assay outcomes. Overall, it was determined that drug positive cases are relatively rare. Job applicants are more likely to test positive for an illicit drug than a currently employed driver. Applicants are more frequently positive for a drug by a factor of 3 for both urinalysis and hair analysis when compared to currently employed drivers. Approximately 2% of applicants were urine positive and 9% hair positive for an illegal drug. Considering employed truck drivers 0.6% were drug positive by urinalysis and 3% when using hair analysis. It is concluded that hair assays detect more drug use than urinalysis. It is also concluded that when urine and hair assay outcomes are non-concordant the typical case is a positive hair analysis with a negative urinalysis.

Introduction

Among the duties of the medical examiner is the necessity to evaluate the circumstances of injurious or fatal vehicle accidents, typically by the examination of the physical evidence presented at the scene of the event, including toxicological reports. This paper examines one specific element related to these duties, the evaluation of drug intoxication by commercial truck drivers and those who seek employment as commercial truck drivers. Safety concerns within the transportation industry and the potential use of drugs by employee involves both economic liability and public safety concerns.1 Transportation employees engaged in drug use present an enhanced risk to safe vehicular operation as well as being perceived as less productive in the work environment. The truck drivers we are considering here are the operators of very large commercial articulated trucks of 12–16 wheels and weight up to 150,000 pounds when fully laden. These vehicles are colloquially referred to as “semi’s” in the United States

Drug testing in the workforce is a well-established practice in the United States and as a consequence there have been a number of different assessments of technology and sample types as they may be applied to employee or pre-employment drug testing.2 For the commercial trucking industry drug and alcohol intoxication is an especially important legal matter. The issue of public safety in the operation of these large mechanical entities is an important public health concern. In 2002 a field operation by law enforcement officers targeting large commercial trucks reported that of 1079 drivers checked by urinalysis 9.5% were positive for a CNS stimulant (amphetamines, methamphetamine, ephedrine, or cocaine) and 4.3% were positive for cannabinoids.3 A recent United States Federal Motor Carrier Safety Administration study of accidents involving large commercial trucks reported approximately 13,091 fatal crashes nationwide over a three-year period 2005–2007.4 A 2005 study of drug use by drivers of large trucks determined that 1.7% of a randomly selected sample provided by commercial trucking companies (representing approximately 420,000 drivers) were positive for a controlled substance.5 When alcohol use was assessed the result showed an average of 0.225% positive over the same time interval. Thus truck drivers were more than 7 times more likely to be positive for a controlled substance than alcohol. There is also data, albeit limited, for pre-employment drug screening of persons applying to be truck drivers. These findings reported that in the year 2005 approximately 2.1% of truck driver job applicants tested urine positive for a controlled substance. These are substantial numbers, and therefore the evaluation of the potential intoxication of these workers does have a legitimate basis. Especially in the case of an accident an assessment of possible legal actions – both criminal and civil – depend in part on forensic examination of biological evidence, including the toxicological status of the truck driver.

Section snippets

Mandatory drug testing of drivers and applicants

In consideration of this, the United States government in 1989 mandated that commercial trucking companies must conduct random drug and alcohol surveillance of their truck drivers and screen all applicants for driving positions for drug use at the time of application for employment. This is required under the United States Federal Department of Transportation’s (DOT) rule 49 CFR Part 40. This regulation also delineates the specific procedures for conducting the testing, the specimen types which

Purpose of the current study

The current study examines the differential outcome in a large-scale drug monitoring program which utilized both scalp hair and urinalysis for the purposes of detecting illicit drug use. The testing was performed on samples collected by large and well-established commercial trucking companies to assure that their drivers met federal and state requirements. The purpose of this article is to compare the differential in detection of illicit drugs when using two distinct sample types, hair and

The drug assay data

The data set used in this analysis consists of 11,242 urine and hair samples collected from persons applying for employment in the trucking industry. Job applicants were all tested, and they account 9784 cases or approximately 87% of the cases considered here. Active truck drivers were selected at random and there are 1458 cases of this type accounting for approximately 13% of the data. As noted, the urine and hair samples were tested for a 5-drug panel. These were opiates, cannabinoids,

Hypotheses

Because of its differential retrospective capacities, the use of hair analysis, in comparison to urinalysis, infers certain expected outcomes in the relative rates of detecting the illicit drugs. The most commonly used illicit substances are relatively rapidly excreted via the urine – for example the opiates, amphetamines, and cocaine. Urine samples, even after episodes of substantial use, are usually clear of these drugs and their metabolites in 48–72 h. Essentially, urine specimens are good

Urinalysis

The percentage of persons who were urine positive for an illicit drug was relatively small – only 1.9% out of the nearly 10,000 applicants tested positive for some drug. The complete urinalysis results for pre-employment testing are reported in Table 1.

Of the 164 persons who tested positive, the most frequently detected drug in urine was marijuana. Eighty-nine applicants (54.3%) were positive for either marijuana alone (81 cases) or marijuana in combination with one additional drug (8 cases).

Results: random screening of employed drivers

As explained in the introductory section, trucking companies are required by law to use a randomized selection process to conduct drug tests on currently employed drivers. In the data analyzed here there are 1458 cases of randomly screened active drivers. The results of the urinalyses for these drivers are shown in Table 4. Nearly all of these drivers tested negatively. Of all urinalyses performed (and excluding refusals or test not performed), 99.4% were drug negative.

Table 4 indicates that of

Evaluating the hypotheses

Four hypotheses were stipulated for this analysis. They, in brief, are summarized as follows:

  • 1.

    Hair analysis should, on aggregate, show higher levels of drug consumption than would urinalysis.

  • 2.

    It is more likely that a person who has a positive urine sample for a specific drug will have a positive hair analysis.

  • 3.

    It is more likely that a person who has a negative hair analysis will have a negative urine outcome.

  • 4.

    It is likely that when a drug is detected in urine and not recovered in hair it is most

Summary

This article has evaluated the outcome of drug testing of two groups in the trucking industry – those who apply for employment as truck drivers and those who are active truck drivers. Presenting this data has several purposes. First we wish to simply establish a baseline of data in this important and critical industry. We can reasonably surmise that the occurrence of drug positive applicants and drivers is relatively rare, whether measured by either urinalysis or hair analysis. The use of

References (16)

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