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Oral Fluid Testing: What You Should Know

 The U.S. Department of Transportation (DOT) is currently working toward implementing oral fluid testing. 

Oral fluid is a sampling method that is used for drug and alcohol testing. Oral fluid primarily consists of saliva, but also contains other fluids from the oral cavity (mouth) and components including residue from inhaled (breathed in) or ingested (eaten/drank) substances.  

There are two forms of oral fluid testing, and each have their own sample collection devices: 

  1. Point-of-Collection Tests (POCT) oral fluid testing provides results quickly within minutes of the sample being collected. 

  2. Laboratory-Based Testing requires the sample to be sent to a laboratory, which typically takes one to two days for a result to come back. 

Oral fluid testing is a convenient method of sampling that offers some advantages over its predecessor, urine testing.

Advantages include: 

  • less risk of tampering because the collection process is fully observed by the collector; 

  • Easier to collect sample, because privacy of a bathroom is not required; 

  • Oral fluid is unaffected by an individual’s water intake unlike urine samples; and,  

  • Oral fluid testing narrows the window of detection to show more recent use of a substance. 

Given the advantages, oral fluid testing in the workplace is gaining popularity; however, there are some considerations which are important for employers to be aware of when considering making the switch from urine testing.

Considerations include: 

  • Drugs and their breakdown products (metabolites) do not remain in oral fluid as long as they do in urine. For example, cannabis use can be detected in urine samples for upwards of 6 weeks (or longer in chronic users) but can only detected in oral fluid samples for approximately 24 hours. Therefore, if testing is performed beyond the narrow window of detection, use of a substance may be missed by oral fluid testing. Note – The narrow detection window can also be seen as a benefit. If THC is present, it indicates recent use and if that recent use is linked to when an employee was at work, it may point to a violation of an employer’s drug and alcohol policy.  

  • Although there have been significant advancements, the currently available oral fluid POCT devices do not perform as well as urine POCT devices. As such, it is still recommended to either combine oral fluid POCT with laboratory confirmation to enhance reliability of the results, or to just conduct lab-based oral fluid testing. 

Please note that oral fluid is currently not an acceptable form of testing by US Department of Transportation (DOT) but they are in the process of implementing this in the near future.  

Related Services:

Oral Fluid Drug Testing

Articles of Interest:

Webinar Recording – Exploring Oral Fluid Testing in Transportation and Other Safety-Sensitive Industries

Oral Fluid Drug Testing FAQs

New Rule Encourages Department of Transportation to Implement Oral Fluid Testing by 2020

DOT Authorizes Employers to use Oral Fluid Drug Testing

Have Questions? Get in touch!