Transcript drug testing in industry

DRUG TESTING IN INDUSTRY
THE OCCUPATIONAL MEDICINE
PRACTITIONER’S ROLE
Acknowledgement: Dr Peter Boogaard, Chief Toxicologist,
Shell Health Services, SIPC, The Hague, Netherlands:
Medical Review Officer Course
DRUG TESTING IN INDUSTRY
Why test?
• Judgement errors
• HSE consequences
• Financial & reputational
consequences
• OHS requirement
DRUG TESTING IN INDUSTRY
Who to test?
• HSE-sensitive positions
• Heavy Plant Operators (vehicles,
machinery etc)
• Maintenance staff
• Security staff
• Chauffeurs
• Company representatives
• Senior management
DRUG TESTING IN INDUSTRY
When to test?
• Periodic medical surveillance
examinations
• Post-illness
• Random
• Pre-employment/placement
• For-cause
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- OMP ROLE
• Receive test results from lab.
• Notify employee of confirmed pos.
test result
• Review & interpret each confirmed
pos. test result
• Provide opportunity for employee to
discuss pos. test result
Cont …….
DRUG TESTING IN INDUSTRY
- OMP ROLE (2)
• Review employee’s medical history
as appropriate
• Review medical records as
appropriate
• Verify laboratory results
• Notify employer of verified positive
result
Cont …….
DRUG TESTING IN INDUSTRY
- OMP ROLE (3)
• Process employee request for re-test
• Make decision-to-hire or return-toduty recommendation
• Ensure decision-to-hire or return-toduty requirements are accomplished
Cont ……
DRUG TESTING IN INDUSTRY
- OMP ROLE: SUMMARY
• All eleven steps!
• Nothing else!
• Provide a MEDICAL service –
NOTHING ELSE!
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But Doc, he’s my
best (driller/driver/
digger/etc)!
AVOID THIS TRAP AT ALL COSTS!
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- POLICY DECISIONS
• Are taken in the boardroom, not the
medical centre!
• Fall within overall A & D policy
• Concern:
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When to test
Whom to test
Outcome of positive test results
Disciplinary and other decisions
Confidentiality measures
• Must have no comeback on the OMP
DRUG TESTING IN INDUSTRY
-SAMPLING PROCEDURE (1)
DRUG TESTING IN INDUSTRY
-SAMPLING PROCEDURE (2)
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-SAMPLING PROCEDURE (3)
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-SAMPLING PROCEDURE (4)
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-SAMPLING PROCEDURE (5)
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-SAMPLING PROCEDURE (6)
DRUG TESTING IN INDUSTRY
-SAMPLING PROCEDURE (7)
DRUG TESTING IN INDUSTRY
-SAMPLING PROCEDURE (7a)
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-SAMPLING PROCEDURE (8)
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-SAMPLING PROCEDURE (9)
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-SAMPLING PROCEDURE (10)
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-PITFALLS
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- the last word?
If you can’t do it properly, don’t
do it at all!
DRUG TESTING IN INDUSTRY
OTHER:
• Laboratory accreditation
• Screening vs confirmatory tests
OVER TO PATHCARE!