Guidance on Drug & Alcohol Policies and Testing

Transcription

1 Guidance on Drug & Alcohol Policies and Testing IMCA SEL 040 June 2016

2 AB The International Marine Contractors Association (IMCA) is the international trade association representing offshore, marine and underwater engineering companies. IMCA promotes improvements in quality, health, safety, environmental and technical standards through the publication of information notes, codes of practice and by other appropriate means. Members are self-regulating through the adoption of IMCA guidelines as appropriate. They commit to act as responsible members by following relevant guidelines and being willing to be audited against compliance with them by their clients. There are two core activities that relate to all members: Competence & Training Safety, Environment & Legislation The Association is organised through four distinct divisions, each covering a specific area of members interests: Diving, Marine, Offshore Survey, Remote Systems & ROV. There are also five regional sections which facilitate work on issues affecting members in their local geographic area Asia-Pacific, Central & North America, Europe & Africa, Middle East & India and South America. IMCA SEL 040 This guidance document replaces IMCA SEL 008 Guidance on drug and alcohol policies: The collection of samples (published in 2003) and IMCA SEL 011 Guidance on drug and alcohol policies: breath testing (published in 2004). The new document is a merge and revision of the two older documents, and was prepared by members of the SEL Core Committee, assisted by other experts from the industry. If you have any comments on this document, please click the feedback button below: feedback@imca-int.com Date Reason Revision April 2003 Initial publication of IMCA SEL 008 February 2004 Initial publication of IMCA SEL 011 June 2016 Merge and revision of original two documents IMCA SEL 040 The information contained herein is given for guidance only and endeavours to reflect best industry practice. For the avoidance of doubt no legal liability shall attach to any guidance and/or recommendation and/or statement herein contained IMCA International Marine Contractors Association

3 Guidance on Drug & Alcohol Policies and Testing IMCA SEL 040 June Glossary of Terms and Abbreviations Introduction Personnel Involved in Testing Process Prevention Rights of the Individual Prohibition Definition Under the Influence of a Prohibited Substance Testing or Sample Collection Tampering Who Should be Tested? Reasons for Testing Pre-Employment Testing Routine Testing Testing Following Incidents and Accidents Reasonable Cause Testing Testing Following a Positive Test Result Tests for Drug and Alcohol Abuse Urine Testing Breath Testing Blood Testing Oral Fluid (Saliva Testing) Hair Testing Sweat Testing Urine Testing Collection Site Collection Kit Collection Shipment Laboratory Selection Laboratory Procedures Subject Request for an Independent Test of a Split Specimen Breath Testing Record Keeping Documents Record Keeping Procedures Retention of Records Confidentiality and Release of Information... 23

4 8 Problems with Testing Refusal to Test Insufficiency of Sample Amount Receiving Report of a Dilute Sample Cut-Off Levels Further Information... 28

5 1 Glossary of Terms and Abbreviations Form See section Log See section BAC DER DOC MRO OIC Breath Alcohol Calibration Designated Employer Representative Directly Observed Collections Medical Review Officer Officer in Charge IMCA SEL 040 1

6 2 Introduction This document, published in 2016, replaces two earlier IMCA documents which have been revised and merged. The two earlier documents, now withdrawn, were IMCA SEL 008 Guidance on drug and alcohol policies: the collection of samples, published in 2003 and IMCA SEL 011 Guidance on drug and alcohol policies: breath testing, published in IMCA members may decide to implement policies covering the prohibition of the illicit use, possession, distribution or sale of drugs and alcohol by any persons involved their operations. They may also put in place policies and procedures for testing for the use of drugs or alcohol. This is in order to ensure that working practices are conducted in such a manner to minimise risks to human beings, the environment, equipment and assets. The guidance sets out some points for consideration in establishing such policies and procedures. It is not an exhaustive guidance. IMCA membership is global, which means that a wide range of legal and cultural issues will affect such a process. It is intended as a useful reference to highlight issues that might arise and indicate where particular care might be required. In developing procedures, each company should examine the cultural and legal background in the areas in which they operate, and should adapt local company procedure as appropriate. The taking of samples, whether they are urine samples, breath samples or any other samples, should be done with the utmost care and rigid attention to procedure. The procedures should be carefully drafted. This guidance is intended to aid that process, but has not been prepared by medically qualified personnel and legal experts in this field. Wherever medical or legal guidance is required, the reader should consult an appropriate medical or legal adviser. Although the term employee is used throughout this guidance, it is not intended to be a restrictive term and can apply to all workers in a workforce, irrespective of their contractual relationship to the company. Such workers could include contractors and subcontractors working for the company. Compliance with the company drug and alcohol policy or a requirement to have an equivalent policy in place could be made a contractual requirement between the company and such parties. The focus of a drug and alcohol policy should be on prevention. Education of the workforce is of the essence. The workforce should understand the reasons for this policy and how abuse of drugs or alcohol affects their health. Education and training will help them buy into the process, making it much easier to implement the policies and procedures relating to drug and alcohol testing. Those involved in implementing the drug and alcohol policy, e.g. deck officers, should as far as is possible be properly trained to international standards; alternatively, consideration may be given to using an outside contractor who has all the training and support processes already in place. In many companies the development of a legally defensible drug and alcohol policy will require a multi-disciplinary approach, with the involvement of different departments, including, for example, Occupational Health, Human Resources, and Legal as well as operations departments. When establishing procedures for the taking of samples, there are a number of issues that should be addressed, which are dealt with below. 2.1 Personnel Involved in Testing Process Procedures and policies may differ between companies, and different personnel at different levels of seniority and experience could be tasked with varying ranges of responsibilities. This guidance assigns tasks to particular named roles. It is not intended to suggest that companies should have these particular personnel designations, or that only those personnel should be involved with any particular responsibility or task. Some companies might employ contractors for the taking of sample collections anyway. The designations are created for the sake of simplicity in this guidance, as a means to clarify the various duties arising from the taking of samples. If a company is using an outside agency for sample collection, the guidance could still be of assistance in indicating or checking the necessary operational requirements. If litigation or any other formal action arises out of the results of a collection, it could be necessary to demonstrate that the personnel involved were competent to carry out their activities. 2 IMCA SEL 040

7 Consideration would probably need to be given to other categories of personnel than those listed below, who could be involved in the collection process. This may become evident as each company develops its procedures. Personnel involved in a collection process are referred to in this guidance as: Collector(s); Site Supervisor a person in overall control of a collection, particularly when a number of collections are being done at the same time; Designated Employer Representative (DER) a company official tasked with taking immediate action to remove employees from safety sensitive duties, or cause them to be so removed, and to make necessary decisions in respect of testing and evaluation purposes; Medical Review Officer (MRO) it is suggested that such a person would be a qualified physician responsible for receiving and reviewing laboratory results and evaluating medical explanations for certain test results. Some companies might have doctors on their staff who are able to assist in this regard, whereas some might use outside agencies; Officer in Charge (OIC) an officer of the company that is tasked with any aspect of control of the collection process, who may or may not be the collector; Subject the person being tested. A broad overview of two of the principal personnel and their qualifications is provided here Medical Review Officer (MRO) Skills, qualifications and experience required are likely to depend upon the relevant jurisdiction and the company policy, but to be sufficient for the tasks envisaged, the following points should be considered in respect of the MRO (who may or may not be a company employee): A suitably qualified physician, such as a doctor of medicine with a qualification that is recognised and accepted in the relevant jurisdiction; The MRO should have clinical experience of and be knowledgeable of controlled substance abuse disorders and alternative medical explanations for confirmed drug test results; The MRO should know about issues relating to adulterated and substituted specimens as well as the possible medical causes of specimens having an invalid result; A need to be aware of the current appropriate government/company/local guidance; The company could require the MRO to receive training in respect of its procedures, such as: Collector(s) collection process chain of custody, reporting and record keeping interpretation of drug and validity test results role and responsibilities of the MRO interaction with other participants (e.g. DERs, collectors etc.) some governments might have continuing education schemes that could be relevant. The collector(s) might or might not be a company employee and the training and qualifications held would depend upon relevant jurisdictional requirements and company policy. However, the following points could be considered: Knowledge of relevant and current jurisdictional requirements/guidelines; Knowledge of all steps needed to conduct a collection; How to deal with problem collections (see section 7.1); How to correct minor flaws in the collection process (see for example the missing signature aspect in Correctable Flaws in section 5.6.2); Responsibility for maintaining integrity of collection process; IMCA SEL 040 3

8 Ensuring proper collection methods and correct conduct with subjects; Certain states might have established training and qualification structures; Some way devised of demonstrating proficiency, e.g. as in mock collections with various scenarios enacted; Any need for refresher training; Documented evidence of training and qualification Involvement of Company Medical Personnel There should be careful consideration of in what circumstances a company s medical personnel (for example a medic on board the vessel) could be involved in the testing, particularly where such medical personnel have a role as counsellor or are bound by a confidentiality obligation. 2.2 Prevention Prevention of misuse of drugs and alcohol is preferred to the discovery of such misuse amongst employees. The following preventive measures may be used: Providing information for personnel on drug and alcohol abuse. For example a brochure with information on the effects of drugs and alcohol use on personal health, safety, and the work environment, and the behavioural indications of drug and alcohol abuse; Availability of competent persons for consultation on drug and alcohol abuse. Such competent persons could be the company s medical doctor or adviser, or the medic on board the vessel; Addressing the dangers of drug and alcohol abuse during safety training and vessel inductions. 2.3 Rights of the Individual Any drug or alcohol screening programme should respect the dignity, privacy, confidentiality and fundamental legal rights of the individuals concerned (STCW, Section B-VIII/1 (2)). Different countries and cultures have different approaches to testing; there are also differing legal issues in various coastal or company states. Individual companies also have their own contractual relationships with their workforces. Lack of care could result in legal action against the company and/or personnel carrying out such tests. Even if this did not happen, unnecessary disputes or bad feeling could result between employers and their workforce if this issue is not treated with utmost caution. 2.4 Prohibition Any policy should be clearly defined and unambiguous about what is prohibited. For example the company could prohibit its employees and all others to whom the policy applies, from being under the influence of a prohibited substance whilst on company property (and elsewhere as specified). The company could prohibit the use, possession, sale, manufacture, distribution, concealment or transportation of any prohibited substance, illicit drug equipment or paraphernalia. The use of the term any prohibited substance gives the opportunity to be specific as to exactly what is prohibited. In general the term includes illegal drugs and alcohol. But it could also include prescription drugs or over-thecounter medication that may cause impairment. A typical exception in such cases is when all of the following conditions are met: Prescription drugs have been prescribed by a licensed physician for the person in possession of the drugs; The prescription was filled by a licensed pharmacist for the person possessing the drugs; The individual notifies the individual s supervisor, or the medic on board, if he or she will be in possession of, or using, any prescription drugs or over-the-counter medication; Appropriate steps are taken to accommodate the possibility of impairment. Note 1: In some regions certain prescription-strength drugs could be readily available over-the-counter without need for a prescription. 4 IMCA SEL 040

9 Note 2: Where testing for drugs is part of a medical examination the use of any drugs for medication should be declared to the doctor doing the examination. 2.5 Definition Under the Influence of a Prohibited Substance The outcome result of any testing should be clear and legally defensible. When establishing if a person is under the influence of a prohibited substance the following should be clearly defined: Exactly which prohibited substances are referred to, e.g. typical drugs or alcohol; The presence of a prohibited substance, or metabolites of a prohibited substance in body fluids above an accepted or legally specified cut-off level. Examples of cut-off levels used in industry can be found in section 8 of this guidance. 2.6 Testing or Sample Collection It is essential for proper procedures to ensure that whenever any tests are taken or samples are collected, the process is carried out efficiently, securely, and in a medically safe and hygienic manner. 2.7 Tampering A test of the effectiveness of the security of the forensic trail (commonly called the chain of custody) from the collection process to the testing laboratory is that it has to be impregnable to litigant attack. The smallest gap in the defence of this trail could make the whole process worthless in any subsequent litigation. There is a small industry existing to provide ways of subverting the validity of drug and alcohol tests. Awareness of what is available and how it may be detected is important. Constant vigilance on site is needed to maintain the integrity and effectiveness of testing procedures. IMCA SEL 040 5

10 3 Who Should be Tested? Reasons for Testing Each company is likely to have its own policy and requirements as to which personnel are subject to drug and alcohol testing. This could be dependent to some extent on the reasons for testing and will differ from company to company. The following gives some indication of the types of test that could be considered. 3.1 Pre-Employment Testing Dependent upon company policy and jurisdictional requirements, some points for consideration are: If, for instance, a company only tests employees who operate in safety sensitive areas and an employee moves from a position not requiring a test to a position where a test is required, then a pre-employment test could be necessary; This could also apply, for example, to an employee who has been employed outside of a random testing programme, either through absence or a move from a different area of operations; The company s acceptance of previous employers tests would also need consideration, whether for example all other employers tests were acceptable; Dependent upon company policy and jurisdictional requirements, pre-employment breath testing could be required, but breath tests are unlikely to be used under this heading; a urine test being more usual. Vessel masters however, might on occasion, for example, require breath testing of persons joining a vessel for the first time, or on returning to duty from leave. 3.2 Routine Testing Routine Testing Companies might require that routine regular checks of personnel are undertaken, perhaps on an annual basis. Company procedure could define: If and when such tests could be deferred when the other types of tests have already been satisfactorily taken; A period for testing to be calculated from an employment date or regularly on a particular day for a particular work site; Provisions for an employee to be tested at another time if absent from the work site at the required time; Policy regarding a failure test, or a refusal to submit to routine testing; Although it would be more usual for urine samples to be required for routine testing purposes, companies might require breath testing for routine regular checks of personnel Periodic Testing Periodic testing is a further method of testing which could be carried out as a supplement to the other tests. They could be carried out for example when an employee is required to have a physical examination, perhaps as a routine medical or as part of a procedure toward obtaining or updating a required work certification, licence or other type of professional qualification. Points to consider could include: Should the requirement for a periodic test be maintained if the subject can provide satisfactory evidence that they have passed an acceptable test, or complied satisfactorily with a random testing programme within a prescribed period before?; Expert medical advice might be required as to how long such period should be Random Testing Different views exist on random testing and the extent to which it should be carried out. Some companies might wish to cover a certain percentage of their workforce over the course of a year or conduct a certain number of tests over a prescribed time. If random tests are used, some points to consider are as follows: 6 IMCA SEL 040

11 Who should be subject to random testing everyone, or just those in safety critical positions?; For maximum effect, all relevant personnel could remain in the selection pool at all times, regardless of whether they have been previously selected for testing; A true random selection of site and/or personnel would be preferable, for example by use of a computer-based random number generator; For better effect, the test could be unannounced as well as random, for example notification being after employees have reported for duty on the day of the test; Consider how to blend the need to have a certain number of tests with the avoidance of a predictable pattern of testing (e.g. on a certain day of the week or month); A procedure could be established governing the time allowed between subjects being notified and having to turn up at the collection site; Commercial and practical considerations will have an effect. 3.3 Testing Following Incidents and Accidents Post-Accident Testing Company definitions of Accident and Serious Marine Incident might need to be included in an appropriate part of the procedures. Difficulties arise from the wide range of post-accident situations that can develop. Company procedures should have enough flexibility to cope with likely situations. Further points to consider include: Care should be taken that injured persons are treated for their injuries first; Medical treatment might affect the validity of a test; Testing might not be possible or might affect the proper care of the injured person; The injured person might or might not have contributed to the accident; There could be an interval of time from the accident to when a test is possible that would make it unlikely that any test would reveal whether the subject s performance was affected by drugs or alcohol. The person tasked with the responsibility for such tests (referred to in this document as the Officer in Charge (OIC)) would need guidance as to how the company wished to proceed in these circumstances. It might for example require the OIC to use the best information available at the relevant time to judge whether or not a test is practicable. If a test is practicable, the overall policy could be to ensure that all persons involved in an accident are tested within a certain time frame (medical advice would need to be taken as to how long that should be). Further points to consider include: Treatment of injuries should be paramount; If a subject is conscious but hospitalised, the hospital could be requested to obtain a sample under company and/or jurisdictional requirements. In circumstances of injury other types of testing might be appropriate (e.g. of blood, saliva or urine); If a subject is unconscious or otherwise unable to give evidence of consent to a test then the OIC would need guidance as to how to proceed. For example, by taking all reasonable steps to ensure a urine sample is taken as and when possible as soon as the subject is able to give consent; If the subject can communicate and can give evidence of consent then medical advice needs to be taken to establish whether a urine sample or breath test may be taken; Consider what action should be taken if a subject is able to give consent as above, but will not do so despite medical advice that it is possible to provide a sample. This might constitute a refusal to submit to a test under company procedures, with disciplinary action as a consequence; IMCA SEL 040 7

12 Consider whether other parties in any way involved with the accident need to be tested, whether injured or not Serious Marine Incident Testing A company s requirements for testing following a serious marine incident depends in some part upon its definition of a serious marine incident. A company might require that all persons directly involved in a serious marine incident, as defined by the company, are tested. Breath testing will only be of use in testing for alcohol intake, with urine tests being more common for combined drug and alcohol testing. One advantage of establishing such a procedure would be that this evidence would then be automatically and readily available to the company in any investigation of the incident. It is assumed that where the subject is injured, then the guidance set out under Post-Accident Testing (section 3.3.1), also applies. The following points may be considered: Can the OIC establish whether the subject s actions or performance contributed to the incident?; What evidence does the OIC have to support his or her view and how reliable is it?; Does the OIC need to obtain permission from a subject s work group leader or some other person before proceeding with testing?; It might be necessary to set out guidance to the OIC on how to explain to the subject why a test procedure is taking place. The way in which this is done will depend to an extent upon the workplace culture and contractual conditions of work. Phrases such as reason to believe (the subject s) performance contributed to the accident, or cannot be completely discounted as a contributing factor might be perfectly acceptable in one workplace, but, especially with misinterpretation or bad translation, be inflammatory in another. A request for a sample is only a part of an investigation and reflects a need for additional data, but to the subject it could seem like an accusation, which could trigger differing responses. One view might be that the more rigid the established company procedure (and perhaps contractual terms with sub-contractors) in this respect, the easier the OIC s task could be; Is it possible to isolate and remove the subject from the work site? If so, the subject will need to be accompanied: to safeguard the subject s wellbeing to ensure that there is no opportunity for the subject to ingest anything that could affect the test result to ensure that there is no opportunity for the subject to acquire a clean sample from someone else on the way from the work site; Consider the litigant trail (chain of custody) at all times and the need to document all the events. For example, the reasons for carrying out the test, the times when events happened, perhaps what is said by the OIC and by the subject relating to the test; The procedure could set down a requirement for signature of documents by a senior officer within a certain time, but before results of the tests are released; The OIC might have a difficult task to perform. Guidance may be needed in dealing correctly with possible test subjects, how to phrase what to say to them, and in taking decisions about who should be tested. A well-worded company procedure would assist in this; It could be necessary to set down procedures relating to when a subject is to be allowed back in the same work position or into a safety sensitive area, pending the results of the test. 3.4 Reasonable Cause Testing Reasonable cause testing provides management with a means to identify those who might be affected by drugs or alcohol, who might be a danger to themselves or to others in the workplace. The following points may be considered: 8 IMCA SEL 040

13 It might be difficult to establish a procedure setting out when reasonable cause testing should take place. This is because it could be a subjective judgement of someone without medical training observing the performance of a third party not known to them. It could be advisable to involve someone with relevant training in the detection of probable drug or alcohol misuse, who could then substantiate or refute the reasonable suspicions of the first observer; In any event, it would be advisable to establish procedures that ensure provision of relevant information. For example, literature that alerted relevant personnel to the sort of signs indicating that testing an individual might be prudent; A guide could be provided to allow crew to check behavioural traits against a checklist. Such a guide could be obtained from an appropriate government agency; The OIC might be presented with hearsay evidence or anonymous tips, which would not by definition be a reasonable cause; but they might form a basis for further investigation. For example, the OIC might need to ask actual witnesses precisely what they saw. How far away were they? How long did they observe the person? What caused them to believe that it was substance or alcohol related? The OIC might also have to obtain permission from the subject s work group leader before proceeding further; The procedure could include guidance to the OIC on: how to isolate the subject how to remove the subject from the work area how to explain that there is a reasonable cause to believe that their performance is affected by a substance or by alcohol; The subject could then be asked to explain the reason for the suspicious behaviour. The OIC would then need to make a decision, based on the scope of his company s procedure, as to whether or not to request a reasonable cause test and what type of test to carry out, testing breath samples only being an indicator of alcohol and not misuse of other substances; The company procedure could set out a provision whereby perhaps two officers or supervisors have to agree to a reasonable cause test. This would create a stronger defence for the determination that such a test is indeed reasonable. One of those officers or supervisors could be the person specifically trained for this task as noted in the first bullet point above; The procedure could then set out the way in which a request was made and how the subject would be accompanied by the appropriate officer or supervisor to the collection site. The subject could be advised of the company procedure and the consequences of a refusal to submit to testing; During the conversation with the subject, the OIC could be instructed to note the subject s general mien and to record those impressions. For example, indication could be given in the guidance literature mentioned above of the indications to look for, such as shown by the subject s eyes, general demeanour and other physical and mental signs; The procedure could highlight that the litigant trail (chain of custody) will have started at the first indication that a test might be required and that a record of all relevant activities and conversations could be advisable; It could be advisable to stipulate that a written record is drawn up and signed by the witnesses within a prescribed time, say 24 hours of the observed behaviour, or before the test results are released, whichever is earlier; As suggested above it could be advisable for the subject, when leaving the work area, to be accompanied by the appropriate officer or supervisor: to safeguard the subject s wellbeing to ensure that there is no opportunity for the subject to ingest anything that could affect the test result to ensure that there is no opportunity for the subject to acquire a clean sample from someone else on the way from the work site; Procedure could set out the control over when the subject returns to the work site. For example the company might stipulate that the subject should not return to duty until a negative test is confirmed. The subject s safety in the interim might also be covered. IMCA SEL 040 9

14 Generally the following elements should be present to have reasonable suspicion to substantiate any searches and/or drug and alcohol testing: Direct observation of the suspected person and/or any physical evidence by two persons in supervisory positions ( direct meaning the supervisors must personally see the evidence for themselves); There must be some physical, behavioural performance indication of use or intoxication; Indicators include but are not limited to: an individual's speech, behaviour, or appearance drugs or drugs paraphernalia in clothing and personal property, or concealed in rooms or elsewhere smoke, breath, and body odours slurred and incoherent speech lack of co-ordination and balance nodding and dozing off inability to report for duty frequent or extended unexplained absences from assigned duties sudden or wide changes of mood. Since illness, injury, or other factors could also cause these circumstances and conditions, the decision to test for reasonable cause should be made with prudence and common sense. 3.5 Testing Following a Positive Test Result Return to Duty Testing If there is a positive test result, or a subject has refused to submit to a test, consideration may be given to procedures setting out when and how a subject might be able to return to duty. These are likely to involve: A specific return-to-duty process. Such process could ensure that the subject has since undergone and complied with an appropriate course and/or passed relevant tests which assist the employer in determining whether to re-employ the subject; The relevant jurisdictional requirements being observed; Follow-up testing (see below), which could be a tool for observing the subject, after a return to duty Follow-up Testing Follow-up testing is a management tool for observation of personnel who have returned to operations following return-to-duty testing. It is common that urine testing would be used for this purpose. Points to consider for company procedure may include: Whether or not, after returning to duty, the person would be subject to a reasonable programme of follow-up testing, over a prescribed period; Such testing is likely to be more effective if instigated without notice; The number of tests, the type, their frequency and the duration of the period of testing could be determined by professional advice and could vary according to each individual case. It could however be reasonable for minimum and maximum limits to be set out in the procedure; During the prescribed period, procedure might allow appropriate officials to terminate the testing; When a follow-up test subject tests positive, the procedure needs to clearly set out what action should result. 10 IMCA SEL 040

15 4 Tests for Drug and Alcohol Abuse Taking samples for testing on alcohol or drugs includes taking specimens of urine, breath, blood, oral fluid, hair or sweat. 4.1 Urine Testing Laboratory detection of drugs in urine samples is possible for several days after ingestion, or even longer in certain cases. Appropriately controlled collection facilities and laboratory validity testing can identify almost all attempts at sample interference. 4.2 Breath Testing Breath tests can generally be made quickly, relatively easily and in virtually any situation. Breath tests are currently only used for the determination of whether alcohol has been ingested. 4.3 Blood Testing Blood testing is not traditionally used in the workplace for a number of reasons. It is a much more invasive procedure than other methods. It requires expert medical collection facilities and personnel, and it poses a number of health and safety issues during handling and disposal. It requires sophisticated analysis, and drugs may only be detectable for a limited period of time. 4.4 Oral Fluid (Saliva Testing) A number of fluids are secreted into the mouth, so that the most appropriate term for them is oral fluids rather than just saliva. There are no internationally recognised or accepted guidelines for the collection or analysis of oral fluid. The legal basis and validity of oral fluid testing has yet to be fully established. Testing could consist of inserting a cotton swab stick in the mouth, which is moistened and the swab tested on site using a kit provided. There are alternative portable testing systems for the rapid screening of drugs of abuse in oral fluid. 4.5 Hair Testing Hair testing requires highly sensitive laboratory technology to determine a drug s presence. Thus it is a more expensive method than urine testing and it cannot determine if a subject is under the influence of a drug at a specific time. It can only determine that an individual has taken a drug at some time during the period covered by the hair sample. 4.6 Sweat Testing Sweat samples can provide detectable levels of drugs, but there are problems with contamination of the sweat collection device, particularly if the sample is collected in an environment where there is a background contaminant level. Additionally, as with oral fluids, there are no internationally recognised standards for the determination of drugs in sweat. Moreover, the legal basis of sweat testing has yet to be fully challenged in court. IMCA SEL

16 5 Urine Testing Urine samples are taken to establish whether there is a presence of drugs or alcohol in a person, and would need to be taken in accordance with company and relevant jurisdictional procedures and requirements. 5.1 Collection Site There may not be much choice in the location of a collection site, especially on board a vessel. Sometimes access to other shore based or platform based facilities might be possible. The company will thus need to establish a procedure based upon the facilities that are likely to be available. In any event, the site needs to be an area under the control of the person(s) in charge of the actual collection, referred to in this guidance as the collector. Points to check include: All local and company health and safety requirements should be observed; Privacy cultural issues to consider, e.g. provision of screen doors to facility or not; Access to the area consider whether the collector should have the authority to ban entry to anyone who is not part of the collection process. The collector should have clear sight of all access points to ensure that no interference with the process is possible; Water supply it is a good idea to include a suitable colouring agent (e.g. bluing agent) or strong smelling disinfectant to flushing water. This will show up attempts at adulteration of a sample. Consider all other water supplies to the facility; could they be shut off or sealed with tape? It could be helpful if the source of water for hand washing is outside of any closed room where the sample is given; No soaps, cleaning materials or other substances that could be used to adulterate the specimen should be available to the subject providing the sample, out of sight or control of the collector; If it is not possible to separate the washing basin from the room where the sample is given, one suggestion could be to shut off the water supply to that basin and provide hand cleansing wipes or tissues outside the room; A check should be made of the room to ensure that there are no places where it might be possible to conceal contaminants, for example such places as ledges, paper towel holders, waste bins, undersink areas, etc.; The subjects could be asked to wash and dry their hands before giving the sample. After giving the sample their hands could be checked before washing; If the collection site is in a facility normally used for other purposes, such as a ship s hospital, the collector would need to ensure that: access to collection materials and specimens is properly restricted signs are placed to prevent entrance the facility is secured against access to ensure the privacy of the subject, prevent interference from third parties and to prevent the distraction of the collector; There should be a suitable place for all the materials and equipment needed for taking the samples. This should be secure and under constant supervision. Similar provision should be made for the secure temporary storage of samples, before sending them to a laboratory. For details of the materials required for the collection process, see Collection Kit (section 5.2); There should be a suitable area for dealing with the completion of forms and other administrative tasks. The above precautions need to be checked between each collection to ensure the site s continued integrity. 12 IMCA SEL 040

17 5.2 Collection Kit Collection Containers Points to observe when selecting the collection containers could include: On delivery to the collection site, the container should be clinically clean and still wrapped, as it left the manufacturer, with the wrapper still properly sealed; Consider the size of the container needed and the graduations that need to be marked on it; If the containers are fitted with temperature strips, then care should be taken that they are provably accurate and that the design does not provide potential for contamination of the sample; If containers are not fitted with temperature sensing devices, then a procedure could be established to ensure that there can be no cross-contamination between samples, for instance by use of a thermometer; The lid could be designed such that it can be sealed with an obvious tamper-evident system Specimen Bottles Points to consider in respect of the type of bottle needed could include: Shipment Bag It should be leak resistant and sealable with an obvious tamper-evident system; When the bottle leaves the manufacturer it should be supplied clinically clean in a tamperevident sealed bag; The bottle should remain in the bag until it is actually put into use at the collection site, with clinically clean caps and seals inside the bag with the bottle; Leak proof caps securing the bottle; the seal over the cap would need to be of a tamperevident type, with the seal able to be written on by both the collector and the subject, as suggested under Collection (section 5.2) It should not be possible to damage the seal by writing on it. Using the seal should not conceal any information on it; It could be necessary to have two sizes of bottle to cope with the split sample collections that are sometimes required; Graduated markings on the bottles to show the amount contained. It would be useful if the bag had the facility to take one large or two small bottles, preferably in separate sealable pouches, and a separate compartment for the associated forms/paperwork. It would be advisable for the design to include space for enough absorbent material in the bottle pouches to absorb the entire contents of the specimen bottles. The whole bag should have a tamper-evident seal Shipment Container This should clearly be designed to protect the bottles from shipment damage and would depend upon the relevant locations and environment of and between the collection site and laboratory. Laboratory advice might be useful. 5.3 Collection Cultural issues will possibly interfere with some procedural steps. Each company should develop policy and procedures that are sufficient to deal with the expected workplace cultures in all areas of operation. Further points to consider in drawing up procedure could include: Ensuring the security and integrity of the site; IMCA SEL

18 Once the site is deemed satisfactory, there may be company, port state or flag state requirements to comply with. These will probably involve the use of forms and the collector should ensure that the forms are properly understood and that there are a sufficient number. (For guidance on a possible company form see The Form (section 7.1.1)) Suitable clothing and equipment for the collector; Access to the site restricted to those authorised for the collection process; Verification of the subject s identity; Explanation of the basic collection procedure to the subject; Removal of outer clothing and/or equipment that might be capable of concealing substances that could be used to tamper with a specimen. It would be useful if the collector had the authority to check the subject s pockets for the same reason. (A way of imposing the collector s authority could be to establish that a failure to comply with procedure would be construed as a refusal to take a test (see section 8.1). A further procedure could set out the actions to take in that event.) Provision in company procedures for dealing with any suspect material found, possibly by use of the Form or by instigating a directly observed collection (see Section 5.3.1); Include completion of sections of the Form at relevant places in the procedure; Ensure hygiene, health and safety issues are properly attended to; Consider the equipment likely to be necessary (see Collection Kit (section 5.2)); Establish a system whereby the collector and subject open the sealed units (described in Collection Kit (section 5.2)) when together, preferably only opening the specimen bottle after the container has been used. There should be no possibility of the specimen bottle being left anywhere unattended and unsealed; Provision of the sample is the part of the procedure that might be most affected by cultural issues. This is particularly the case when the collector needs to pay careful attention, so far as is reasonably practicable, to the subject throughout the collection process. The reason for this is to note any conduct that would indicate an attempt to tamper with the sample, for instance by substitution or adulteration. If this does occur, or is suspected of occurring, perhaps the procedure should set out what action the collector should take. For instance a directly observed collection could be required (see Directly Observed Collections (section 5.3.1)); Use company/medical/state/government advice as to the amount required in a sample; Consider cultural issues for actual provision of the sample; The subjects could be asked to wash and dry their hands before giving the sample; after giving the sample their hands could be checked before washing; The subjects could be asked not to flush the toilet system before handing over the sample; Obtain medical/state/government advice as to the acceptable temperature range of a sample and within what time span the temperature should be taken; Consider how quantity and temperature are to be checked, i.e. to detect substitution (see also section 5.2); If amount or temperature is outside of the requirements, the procedure could set down how this should be dealt with. For instance, the Form could have provision for this. Someone further along the line of authority might make a decision upon it; and/or the collector might be qualified and/or authorised to take further action at the time. Such actions might involve, in the case of an insufficient amount, a second attempt after a certain period, with a prescribed fluid intake over that time, the period and amount established and set down in the procedure after appropriate medical consultation. Or the collector might require a directly observed collection (see Directly Observed Collection (section 5.3.1)); It would be essential to keep the integrity of the process secure. Consider such practices whereby the collector, in the sight of the subject, breaks open the seal or wrapping of a specimen bottle, pours in the specimen and secures the specimen bottle with tamper evident seals; the collector then writes the date and any necessary identification on the seal and signs it, further corroborated by the subject s own signature; 14 IMCA SEL 040

19 The Form could then be completed, signed and dated by the subject and the collector and placed in a plastic bag with the specimen bottle. The bag would then need to be secured with tamper proof seals; The subjects need to be asked if they are on or have been on any type of medication, possibly for example over the previous 14 days, depending on medical advice obtained. Details of the medication would clearly be needed; This could end the contribution of the subject. Consideration could then be given to the preparation of the bag for secure shipment to the laboratory. This preparation would need to be covered by a shipment procedure which safeguards the continued integrity of the sample and the collection process. It would be advisable, for example, for names and signatures of all persons who had custody of the sample at any time during the process to be recorded; There are possible occasions where collectors might have to process a large number of people if a whole crew is to be checked, for example. To avoid distractions that could compromise security, it could be advisable to limit the collector to conducting collections one at a time; also to consider the number of suitable personnel available to conduct the tests; Variations on the above collection process could sometimes be necessary. Some of these possible variations are listed in the sections below, with some likely extra points for consideration included Directly Observed Collections (DOC) This method is intended to address situations that have arisen, such as where there is doubt concerning the validity of a test, or perhaps when conducting return-to-duty (section 3.5.1) or follow-up tests (section 3.5.2). Clearly, there would need to be a rigid procedure to ensure the integrity of such a collection. Points that might be considered as to the circumstances governing why and how a direct observed collection is conducted could include, but not be limited to, the following: Why a DOC might be carried out: The laboratory reports that a specimen is invalid and the MRO is satisfied that there is no adequate medical explanation for the result; The original positive, adulterated, or substituted test result had to be cancelled because the test of the split specimen could not be performed; The company might wish a collection under direct observation to be carried out if the test is a return to duty or follow-up test; The collector observed materials brought to the collection site, or the subject s conduct clearly indicated an attempt to tamper with a specimen; The temperature of the original specimen is out of range; The original specimen appeared to be tampered with. How a DOC might be carried out: For best effect, the subject would have no advance warning; It could be advisable for the company to explain to the subject why such a test is required; A new Form to complete; The reason for the test on the Form is the same as on the first Form; The reason for an observed collection could be noted; If two sets of specimens are being sent because of suspected tampering on site, then the labels could be marked (e.g.1 of 2, 2 of 2) and a note included in the remarks section of the Form; Cultural and relevant legal considerations to observe, such as: whether the observer needs to be of the same gender as the subject whether the observer can be a different person from the collector whether it is necessary for the observer to have relevant qualifications IMCA SEL