On November 9, 2004 the Department of Transportation amended certain provisions of its drug and alcohol testing procedures to change instructions to laboratories and medical review officers (MRO) with respect to adulterated, substituted, and diluted specimen results. This change is intended to avoid inconsistency with new requirements established by the U.S. Department of Health and Human Services (HHS) that went into effect on November 1, 2004.
The interim rule specifically requires MROs to provide medical review and verification for all laboratory-reported substituted specimen results. This change is necessary because, under the HHS Mandatory Guidelines, there will be no specimens with creatinine levels greater than or equal to 2 mg/dL that will be considered substituted. Prior to this rule change MROs were allowed to do a medical review for some and direct observation recollection for others.
Also, DOT now considers a urine specimen to be dilute when the creatinine concentration is greater than or equal to 2 mg/dL but less than 20 mg/dL and the specific gravity is greater than 1.0010 but less than 1.0030. Previously, urine specimens had been considered dilute when the creatinine concentration was above 5 mg/dL but less than 20 mg/dL and the specific gravity was greater than 1.001 but less than 1.003. If the sample is found to be within the new range, DOT will require MROs to treat laboratory reported negative-dilute results with creatinine levels greater than or equal to 2 mg/dL but equal to or less than 5 mg/dL as negative-dilutes that require immediate recollections under direct observation.
The rule also direct laboratories to perform validity tests for oxidizing adulterants and additional validity tests when certain conditions (e.g., abnormal physical characteristics) are observed.
For more information contact Jim L. Swart, Deputy Director (S-1), Office of Drug and Alcohol Policy and Compliance, 400 Seventh Street, SW., Washington, DC 20590; telephone number (202) 366-3784 (voice), (202) 366-3897 (fax) , or email@example.com (e-mail).
The entire Federal Register Article can be downloaded from RCP’s website here through the DOT Gateway..