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DRUG TESTS BRING WORRIES OF ACCURACY
April 16, 1998
"I go to extraordinary lengths before I call a positive."óDr.
Berg, Medical review officer said.
The water-cooler talk is true: Poppy seeds can produce a
positive test for heroin, and cold medicine can suggest
But medical experts say workers have little to worry about as
changes in Iowaís drug-testing law go into effect today.
Thatís because the new law requires medical review officers to
evaluate drug tests. They act as judges, determining whether
the positive test is a result of illegal drug use or a
legitimate medical cause.
"Iím there to protect people from false positives as much as
Iím there to find drug (evidence) for their employers," said
Dr. David Berg, an MRO and director of occupational medicine
for the Des Moines office of HealthSouth. "I go to
extraordinary lengths before I call a positive."
Accuracy is a concern as private-sector employers gain more
power to test employees for drugs and alcohol. Occupational
health clinics and laboratories say the law could lead to more
business, but they donít expect a rush starting today.
Business groups have been pushing for a change for years, and
some construction companies and other safety-sensitive
employers are moving quickly to start testing, said James
Aipperspach, president of the Iowa Association of Business and
Industry. But most are still learning about the changes and
deciding what options to take.
Employers are not required to test. They could randomly test
workers for alcohol and other drugs. They could test if they
have reasonable suspicion that a worker is under the
influence. They could require workers to get treatment after a
confirmed positive drug test, or they could fire them. Critics
say the law gives employers more power than police. They also
question the reliability of testing, and say the workers would
have little recourse if they falsely test positive.
The new law protects employers from liability unless they
clearly should have known a false positive test result was in
error and ignored the correct test result.
The Iowa Civil Liberties Union isnít saying whether it will
fight the law. But lawyers and legislators have talked to the
group about a challenge, said executive director Ben Stone.
Random testing could result in more false positives, said
Craig Zwerling, a University of Iowa professor and expert on
Statistics vary widely on the likelihood of false positives,
depending on the test and the lab. Civil libertarians say 5
percent is a conservative estimate.
Medical experts acknowledge that false positives arenít
impossible. But they say urinalysis, the most common means of
drug testing, has improved.
The Iowa Methodist Medical Center laboratoryís testing is more
than 99 percent reliable, said Rich Snyder, who supervises
The lab uses a combination of gas chromatography and mass
spectrometry, which is considered by most experts to be the
most precise procedure for the detection of banned substances.
The new Iowa law requires such a technique to be used to
confirm positive tests.
Employees can request a second confirmatory test at another
lab, at their expense. If that test comes back negative, the
employer must reimburse the employee.
But tests still read some innocuous substances as illegal
drugs. Because of the poppy seed problem, the federal
government is raising the threshold for the detection of
opiates in urine. Additional tests can be done to determine
whether a Vicks inhaler is causing a methamphetamine positive,
Medical review officers also look at more than the test,
searching for evidence of needle tracks or asking whether the
person is on a prescription drug.
Testers also watch for adulterated samples. An industry is
booming on the Internet, providing drug users with tips and
products to taint their tests. Snyder said most of the
methods, such as mixing the urine with bleach or soap, are
easy to catch.
Medical review officers also are on guard for every excuse
imaginable. Theyíve heard them all, including the one
gold-medal snowboarder Ross Rebagliati gave when he tested
positive during the Olympics. Second-hand marijuana smoke will
produce a positive test only in extreme cases, research has
"Thereís no way," Berg scoffed.
Reporter Lynn Hicks can be reached at email@example.com or