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

DRUG TESTING IN INDUSTRY- 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-to-duty

recommendation

• Ensure decision-to-hire or return-to-duty

requirements are accomplished

Cont ……

DRUG TESTING IN INDUSTRY- OMP ROLE: SUMMARY

• All eleven steps!

• Nothing else!

• Provide a MEDICAL service –

NOTHING ELSE!

DRUG TESTING IN INDUSTRY

But Doc, he’s my best (driller/driver/digger/etc)!

AVOID THIS TRAP AT ALL COSTS!

DRUG TESTING IN INDUSTRY- POLICY DECISIONS

• Are taken in the boardroom, not the medical centre!

• Fall within overall A & D policy• Concern:

• 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)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (3)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (4)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (5)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (6)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (7)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (7a)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (8)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (9)

DRUG TESTING IN INDUSTRY-SAMPLING PROCEDURE (10)

DRUG TESTING IN INDUSTRY-PITFALLS

DRUG TESTING IN INDUSTRY- 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!