Wednesday, May 7, 2008

Boston Massachusetts Fire Fighters Union - Not the Norm

Random drug-testing programs are problematic for some unions.

Union leadership claims random drug testing is a violation of workers' right to privacy. Yet, this is appears to be an indefensible position.

Concerns of employee safety and public safety should be the #1 priority with union leaders. Sadly, it may not case for some.

Many non-union employees are required to have a pre-employment drug test and a random drug test. If workers refuse testing, they are terminated. If employees fail a drug test ... they are terminated - (which I don't view as best practice)-, or suspended and subsequently referred to an employee assistance program (EAP), which may or may not be funded by company insurance.

Simple... straight forward... and effective.

Random drug testing, conducted properly, is an effective deterent to on-the-job substance abuse, as well as a detection mechanism. What an employee does at home is not the business of any employer. When employee's behaviors effect the safety of their collegues or the public... it's not only their employers' business... it's their employers' legal obligation.

While many unions have adopted, or at least allowed random drug and alcohol testing, the Boston / Massachusetts Fire Fighters Union has failed to protect its members and the public at large.

No employee, or the public wants a drug or alcohol impaired individual in a safety sensitive position.

The Boston Fire Department had a recent tragedy in which two fatalities tested "positive" for drugs and/or alcohol. Whether this information should have been released to the public the way it was... is certainly questionable. No one should question the bravery of the individual involve, and most would not consider it.

The subsequent stonewalling of the fire fighters unions relative to drug testing is unconscionable, however, and a disgrace to everyone.

Thursday, May 1, 2008

Drug Abuse in Construction & The Role of Union Leadership


"A construction work site is no place for an alcohol- or drug-impaired worker," says LI UNA General President Terence M. O'Sullivan. "To limit this risk and, also, to ensure that workers who need help get it, the Laborers support efforts to establish comprehensive drug-free workplace programs in the construction industry."



Abstract

Union stewards, general members, & senior management benefit from training on the many manifestations of substance misuse in the workplace, and their impact on working people and their children, contractors, insurers, and owners. Avitar's novel approach to workplace substance abuse management can assist in providing a framework of knowledge as well as implementation monitoring tools.

Joint development of the training curriculum, drug policy, and testing programs, would, however, require the direct involvement of union management. While Avitar can supply the technical components, to gain organization-wide commitment requires high level of participation and support of union leadership. Arguably, this leadership has been lacking in specific cases.

Unions would benefit by working with contractors, owners, insurers, and innovative drug-free workplace service providers to establish comprehensive drug-free workplace policies that include an education component to demonstrate their commitment to a drug-free workplace, support random testing via observed specimen collection, and provide employee assistance programs.

Random testing via oral is convenient, effective, non-invasive, and targets "on-the-job" drug misuse. Unlike traditional urine-based testing, oral fluid testing;

1. deters substance misuse
2. reduces accidents, workers comp claims and,
2. improves workforce image and quality.


While Construction Union may be aware of the unresolved, and epidemic problem of substance abuse in the construction sector, they may not be aware that a solution exists and the importance of their playing a leading role in mitigating the issue.

Substance abuse diminishes the ability of unions to build membership and mobilize current members.
- It erodes self-esteem and autonomy and undermines union participation, power, and leadership.
- It damages the solidarity of the union community and weakens its ability to withstand employer "attacks".

1. Unfortunately many contractors, owners, and insurers view unions as an impediment to resolution of the substance abuse in the construction sector. The lack of a comprehensive and effective occupational drug-free workplace approach by Unions contributes ineffective, ad-hoc industry practices. Similarly, the AFL-CIO program requiring urine testing and specific vendors, even further delays positive, pro-active change.

2. Unions must be proactive in efforts to deter the abuse of controlled substances and alcohol on construction sites. Laborers, management, and all related constituencies would benefit by developing and negotiating a drug and alcohol testing template programs for all contractors / owners / insurers.

3. A comprehensive drug-free workplace program MUST include:
random drug testing (via observed collection - traditional urine-based testing is relatively ineffective),
education, and
assistance.


Measurement is crucial to the recognition, treatment, and prevention of substance abuse related occupational injuries, and other negative impacts. Deterrence and identification of substance abuse benefits the individuals, their immediate coworkers, workers throughout the industry, and others exposed to the negative impacts of substance misuse. (insurers, owners, contractors, public).



4. What union members do away from work is a private affair as long as they aren't impaired when reporting to work, however, traditional urine drug testing is contrary to this notion. Neither unions nor employers should not be allowed to dictate behaviors while away from work.


5. Deterrence is the goal, however, detection and assitance are true benefits.
Union MAP's (member assistance programs) are underutilized (not used 60% of the time). MAPs serve members as well as health & MMwelfare funds, contractors, owners, alike.
- MAPs help laborers & families access to assistance most needed for personal problems/issues
- MAPs control costs (lack of care created costs far exceeding MAP cost).
Labor organizations can only offer assistance to their members on a variety of health, welfare, and safety issues, including substance use disorders, only if aware of the problem.





Sources and Additional Information:

1. 50% of abuse detected now involves prescription drugs, esp. pain relievers. The abuse / misuse of many popular prescription pain releivers is not tested via traditional DOT-based urine testing.

2. While approximately 15%- 20% of construction workers abuse drugs, the US Bureau of Labor Statistics survey significantly underestimate the incidence of work related injuries and illnesses. The United States does not have a comprehensive national surveillance system for occupational injuries and illnesses. Lacking this system, major sources of US occupational health data include the Bureau of Labor Statistics (BLS) annual survey of occupational injuries and illnesses, workers' compensation records, and physician reporting systems. Data produced by these systems have been described as fragmentary, unreliable, and inconsistent. Moreover, they have been shown to underestimate the incidence of workrelated injuries, illnesses, and even fatalities by as much as several hundred percent. (Occupational injury and illness surveillance: Conceptual filters explain underreporting; Azaroff, Lenore S; Levenstein, Charles; Wegman, David H American Journal of Public Health 09-01-2002 )

3. 77% of adults with substance abuse disorders are employed - Results From the 2004 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 05-4062. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2005, p. 72.

4. LIUNA MAPs save money - Detroit, first-quarter 2003 data indicate that the LAP saves the fund about $175,000 annually over the likely cost of service to members if no MAP existed. In Southern Illinois, drug expenditures for the first two quarters since MAP usage was mandated are running more than 50 percent below the previous year's average. In Massachusetts, since the MAP was established in 1991, the Fund has saved about $8.8 million in average length of service and per diem costs for in-patient care.

5. Substance use disorders affect people from all walks of life, workers & families. According to a 2005 Hazelden Foundation survey, more than 69 percent of employed people indicated that if a family member were struggling with abuse or addiction, it would negatively affect their ability to concentrate and be productive at work. In fact, 36 percent of people who are employed admitted that at least one of their coworkers had been distracted, less productive, or missed work because of alcohol/drug abuse or addiction within their family.

6. A key message for labor organizations to communicate to employers is that treatment for substance use disorders has substantial benefits for businesses. Reported job problems, including incomplete work, absenteeism, tardiness, work-related injuries, mistakes, and disagreements with supervisors, are cut by an average of 75 percent among employees who have received treatment for substance use disorders. Furthermore, treatment has a benefit-to-cost ratio of 7:1, with substance use disorder treatment costing $1,583 on average and having a monetary benefit to society of nearly $11,487.

7. Domestic violence is directly related to substance abuse. Despite the obvious importance of involving unions in domestic violence prevention with men, little works has been done is this area. This may reflect fears that unions would not be receptive to addressing domestic violence. Senior office holders within some unions have been hesitant to apply their leadership to this issue, for various reasons. Sometimes union leadership has not understood how widespread domestic violence is. Sometimes they have argued that it is a private matter best left to the couple affected. At other times they have expressed concern but felt pessimistic about their ability to do anything about it. And on other occasions they have felt torn between their desire to protect a worker from disciplinary action or job loss and their conviction that domestic violence is wrong.

- It is every employer's legal responsibility to ensure safety in the workplace. Domestic violence compromises the well-being, job performance, and productivity of valuable employees. Many of the attitudes and gender roles that increase men's risk of using domestic violence also predispose men to other high risk behaviors, such as drug and alcohol abuse, workplace violence, or taking unnecessary safety risks to demonstrate "toughness" to peers.
- Domestic violence is a leading cause of workplace violence; it also creates safety and health risks to everyone in the workplace:
- Since almost one in four women is affected by domestic violence, we can make a conservative estimate that 10% of employees may be affected by domestic violence.
- 24% of abused women said they were either late or missed days of work due to abuse
- 54% of abused women missed up to three full days of work per month.
- 94% of corporate security directors surveyed rank domestic violence as a high security problem at their company.
- Violence against women weakens unions and diminishes their ability to build membership or mobilize current members.
- Domestic violence is a safety and health issue for all members since perpetrators often stalk and harass women at their workplace, possibly jeopardizing co-workers as well. Additionally, domestic violence is a work/family issue, since it has devastating economic and personal consequences for the family.

8. Most union members are in support of drug testing (Discriminating characteristics of union members' attitudes toward drug testing in the workplace, Journal of Labor Research, 2007.)

Thursday, April 24, 2008

Drugged Driving and Alcohol DUI Leading Cause of Deaths


2008 SAMHSA REPORT - United Stated Department of Heatlh and Human Services

5% of people drove under the influence of illicit drugs in the past year (10 million drivers)
(15% under influence of alcohol).

States with the highest drugged driving rates:
District of Columbia (7.0 percent),
Rhode Island (6.8 percent),
Massachusetts (6.4 percent),
Montana (6.3 percent), and
Wyoming (6.2 percent).

Impaired driving is the LEADING CAUSE OF DEATHS among persons aged 3 to 33.


Illicit drugs, as defined above, includes marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.

Friday, April 4, 2008

Random Student Drug Testing - 2008

CALVERTON, Md., April 2, 2008 /PRNewswire-USNewswire/ --

A substantial proportion of the nation's public school districts have instituted random drug testing among their high school students, some possibly going beyond sanctions set by the U.S. Supreme Court, according to a study led by the Pacific Institute for Research and Evaluation (PIRE). These sanctions limit testing to students involved in sports and extracurricular activities.

The study, funded by the National Institute on Drug Abuse, includes data collected from 1,343 drug prevention coordinators in a nationally representative sample of school districts that include high school students. Fourteen percent of the nation's school districts reported conducting random drug testing of students in high school grades in the 2004-2005 academic year.

Nearly all school districts that implemented random drug testing procedures subjected their athletes to the possibility of being tested, and two-thirds randomly tested high school students who participated in other extracurricular activities. More than a quarter of the districts that implemented random drug testing subjected all their high school students to the possibility of being tested.
The Supreme Court ruled in 1995 that testing student athletes for drugs is constitutional, even in the absence of any suspicion of substance use. In a subsequent case, the Court extended its ruling to include students participating in extracurricular activities.

"Random student drug testing will likely continue to be controversial and the practice is likely to be contested, just as we saw with the recent ruling by the Washington State Supreme Court," said Dr. Chris Ringwalt, Senior Research Scientist at PIRE. The Washington State Supreme Court ruled on March 13, 2008, based on a lawsuit that student athletes brought against a local school district, that random drug testing of student athletes is not allowed under the state's constitution, despite the U.S. Supreme Court's 1995 ruling (Supreme Court of the State of Washington. York v. Wahkiakum School District No. 200. Docket No: 99-2-00075-6, March 13, 2008).

Dr. Ringwalt concluded, "This study will provide a benchmark for monitoring the prevalence of random drug testing of high school students in the future."
Pacific Institute for Research and Evaluation

Friday, March 28, 2008

SAMHSA TO APPROVE ORAL FLUID / SALIVA DRUG TESTING

(source: Forensic Sci Int. 2007 Apr 12)

Despite the lack of speed, likely due program mismangement and lobbying on the part of urine labs and large TPAs that have a vested interest in urine testing, SAMHSA will (per the below) have to approve alternative forms of drug testing in order to manage workplace drug abuse.


The U.S. Mandatory Guidelines for Federal Workplace Drug Testing Programs: Current status and future considerations.
Donna M Bush - Division of Workplace Programs, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, One Choke Cherry Road, Room 2-1033, Rockville, MD 20857, USA.

The U.S. Department of Health and Human Services (HHS) drug testing standards were published in 1988 and revised in 1994, 1998, and 2004.

In a separate notice, HHS proposed to establish scientific and technical guidelines for the Federal Workplace Drug Testing Program to:

(1) permit laboratory testing of hair, oral fluid, and sweat patch specimens in addition to urine specimens for marijuana, cocaine, phencyclidine, opiates (with focus on heroin), and amphetamines [including methylenedioxymethamphetamine (MDMA), methylenedioxyethamphetamine (MDEA), methylenedioxyamphetamine (MDA)];

(2) permit use of on-site point of collection test (POCT) devices to test urine and oral fluid at collection sites;

(3) permit use of instrumented initial test (screening only) facilities [IITF] to quickly identify negative specimens; and (

4) add training requirement for collectors, on-site testers, and MROs.

This proposal was published in the Federal Register on 13 April 2004, with a 90-day public comment period.

The Substance Abuse and Mental Health Services Administration, HHS, reviewed those comments and is preparing the Final Notice that will define the requirements for such testing, including: specimen collection procedures, custody and control procedures that ensure donor specimen identity and integrity, testing facility, initial and confirmatory test cutoff concentrations, analytical testing methods, result review and reporting, evaluation of alternative medical explanations for presence of drug or metabolite in the donor's specimen, and laboratory certification issues.

Voluntary pilot performance testing (PT) programs for each specimen type are on-going since April 2000 to determine how to prepare PT materials for specimens other than urine to evaluate laboratories' ability to routinely achieve accuracy and precision required.


Certification programs will be developed using the current urine drug testing National Laboratory Certification Program model.

The addition of accurate and reliable workplace drug testing using hair, oral fluid, and sweat patch specimens will complement urine drug testing, and aid in combating industries devoted to suborning drug testing through adulteration, substitution, and dilution.

Tuesday, March 25, 2008

Saliva / Oral Fluid Proteins Mapped

Protein map of human spit created
By Julie Steenhuysen 27 minutes ago

CHICAGO (Reuters) - U.S. researchers have identified all 1,116 unique proteins found in human saliva glands, a discovery they said on Tuesday could usher in a wave of convenient, spit-based diagnostic tests that could be done without the need for a single drop of blood.

As many as 20 percent of the proteins that are found in saliva are also found in blood, said Fred Hagan, a researcher at the University of Rochester Medical Center in New York who worked on the study.

"This is potentially a large field that has many clinical implications in the area of disease diagnostics," said Hagan, whose work was published in the Journal of Proteome Research.

The researchers hope saliva-based tests could be used to diagnose cancer, heart disease, diabetes and a number of other conditions.

"To be able to diagnose disease using saliva, you really have to have a comprehensive understanding of the saliva proteome," Hagan said in a telephone interview.

Like a genome, which lists all of the genes in an organism, a proteome is a complete map of proteins. While genes provide the instruction manual, proteins carry out the instructions by regulating cellular processes.

Researchers from five universities -- the University of Rochester, The Scripps Research Institute, the University of Southern California, The University of California San Francisco and the University of California Los Angeles -- sought to determine the complete set of proteins secreted by the major salivary glands.

BLOOD, SPIT AND TEARS

They collected saliva from 23 healthy men and women of several races. They tested saliva samples using some form of mass spectrometry, which determines the identity of proteins based on measurements of their mass and charge.

They compared their findings with recent protein maps of human blood and tears.

Early analysis has already turned up a number of proteins with known roles in Alzheimer's, Huntington's and Parkinson's diseases; breast, colorectal and pancreatic cancer and diabetes.

Most of the proteins were part of signaling pathways, which are key to the body's response to system wide diseases.

Hagan said the work should accelerate the development of new tools for tracking disease throughout the body.

Already there are saliva-based antibody tests to detect human immunodeficiency virus, or HIV, and hepatitis infections, Hagan said. He said this protein map will provide new targets.

"Monitoring disease as well as drug use could be more easily done with saliva as opposed to blood or urine," he said.

Other groups are working on a saliva-based test for breast cancer that would detect a protein fragment from the HER2 protein. Hagan said such tests could eventually replace uncomfortable and costly mammograms.

"We envision in the future spitting in a tube and looking for a marker like this breast cancer marker. It would be much easier to do, potentially at home," he said.

"Given that we've made this information publicly available, we fully expect a number of research groups will be picking their favorite targets and developing their own tests. That is the intent -- to create a wealth of data to stimulate more research and increase the chances of producing better diagnostic tests," Hagan said.

(Editing by Maggie Fox and Mohammad Zargham)

Tuesday, March 18, 2008

Workplace Drug Abuse Statistics Misleading?

The following statistics are misleading at best.

A review of the data shows that drug abuse rates among workers have been stagnant for past decade.

Any statement that workplace drug abuse is lower, would be unsupportable by the findings.


The data does potentially indicate that that drug abusers have learned to cheat urine-based drug tests. This being supported by research recently concluded by the U.S. Government General Accounting Office (GAO) noting that cheating urine-based testing is easily accomplished and virtually undetectable.


The report also neglects to point out the opiate detection rates continue to climb. .. particularly oxycodones have gone up nearly 40% in one year!

" Use of Methamphetamine Among U.S. Workers and Job Applicants Drops 22 Percent in 2007 and Cocaine Use Slows Dramatically, Reports Quest Diagnostics"

Findings from Quest Diagnostics Drug Testing Index® also show that overall drug positivity remains at record lows

MADISON, NJ, March 12, 2008 — The percentage of positive tests for methamphetamine among U.S. job applicants and workers in the general U.S. workforce dropped more than 22 percent between 2006 and 2007.

These findings, from the Quest Diagnostics Drug Testing Index®, reflect the reversal of an upward trend in use of the drug by more than 73 percent from 2002 to 2004. These data were released today by Quest Diagnostics Incorporated (NYSE: DGX), the nation's leading provider of employment-related drug testing services.


The report also shows that positive tests for cocaine in the general U.S. workforce were down 19 percent between 2006 and 2007 and that overall drug use, among workers subject to drug testing, remains at an all-time low.

Methamphetamine, the most commonly abused type of amphetamine, increased in production and trafficking during the 1990’s to become the most prevalent illegally manufactured synthetic drug in the United States. Analysis of the Quest Diagnostics Drug Testing Index, released semi-annually, suggests that efforts to reduce illicit, clandestine production of methamphetamine may be having an impact on workplace positive tests for the drug.

"The fact that America's workers are using cocaine and methamphetamine at some of the lowest levels in years is further evidence of the tremendous success that law enforcement is having at impacting the nation's illicit drug supply," said DEA Acting Administrator Michele M. Leonhart. "DEA will continue its relentless assault on the drug supply to help keep these dangerous drugs out of our neighborhoods."

While the 2007 Quest Diagnostics Drug Testing Index shows that positive methamphetamine tests have decreased, it also indicates that the use of amphetamine in the general workforce has increased slightly, by about five percent. Testing for methamphetamine and amphetamine was conducted among employees and applicants in the U.S. workforce tested for the class of drugs called amphetamines.

"Although some may conclude that there is a reduced availability for methamphetamine, the fact that our data show an increase in amphetamines suggests that some workers might be replacing one stimulant drug for another in the larger drug class of amphetamines," said Barry Sample, Ph.D., Director of Science and Technology for Quest Diagnostics' Employer Solutions division.

Methamphetamine and amphetamine are both types of stimulants, which typically are used by individuals to increase alertness and relieve fatigue. Stimulants are also used for euphoric effects or to counteract the "down" feeling of tranquilizers or alcohol. Possible side effects of stimulants include increased heart and respiratory rates, elevated blood pressure, dilated pupils and decreased appetite. High doses may cause rapid or irregular heartbeat, loss of coordination or collapse. Indications of possible misuse may include excessive activity, talkativeness, irritability, argumentativeness or nervousness.

Cocaine Use Continues to Decline

The Quest Diagnostics Drug Testing Index shows that the percentage of positive tests for cocaine was down 19 percent among the U.S. general workforce since the first half of 2007 - the largest single-year drop since 1997. Positive tests for cocaine among the general workforce declined to 0.58 percent in 2007 from 0.72 percent in 2006.

Overall Drug Use Remains at All-Time Low

Additionally, drug use by employees remains at its lowest level since Quest Diagnostics began publishing the Drug Testing Index in 1988. Among the combined U.S. workforce, only 3.8 percent of the tests had positive results — the same level reported in 2006 — compared to a high of 13.6 percent in 1988. Further, among safety-sensitive federal workers only, the Drug Testing Index showed that drug use was at an all-time low of 1.8 percent of the tested work force.

The 2007 Drug Testing Index is a summary of results from 8.4 million workplace drug tests performed by Quest Diagnostics between January and December 2007. Results are based on tests that Quest Diagnostics performs for employers that conduct pre-employment, random or for-cause drug testing. For more information, see additional results below.

About the Drug Testing Index

The Drug Testing Index is published as a public service for government, media and industry and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates — the proportion of positive results for each drug to all such drug tests performed — among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce. Federally mandated, safety-sensitive workers include pilots, bus and truck drivers, and workers in nuclear power plants, for whom routine drug testing is mandated by the U.S. Department of Transportation and the Nuclear Regulatory Commission.

About Quest Diagnostics

Quest Diagnostics is the leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its national network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative new diagnostic tests and advanced healthcare information technology solutions that help improve patient care. Additional company information is available at: www.questdiagnostics.com.

The statements in this press release which are not historical facts or information may be forward-looking statements. These forward-looking statements involve risks and uncertainties that could cause actual results and outcomes to be materially different. Certain of these risks and uncertainties may include, but are not limited to, competitive environment, changes in government regulations, changing relationships with customers, payers, suppliers and strategic partners and other factors described in the Quest Diagnostics Incorporated 2005 Form 10‑K and subsequent SEC filings.

The Drug Testing Index © 2008 Quest Diagnostics Incorporated. All rights reserved.

Tables Follow
Positive Prevalence Rates for Amphetamine and Methamphetamine —
Percentage of All Tests for “Amphetamines“
2007 2006 2005 2004 2003 Amphetamine 0.40% 0.38% 0.44% 0.45% 0.41% Methamphetamine 0.14% 0.18% 0.28% 0.33% 0.32% Percent Difference - Amphetamine 5.3% -13.6% -2.2% 9.8% Percent Difference - Methamphetamine -22.2% -35.7% -15.2% 3.1%

Positivity Rates for Cocaine
2007 2006 2005 2004 2003 Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Percent Difference - Cocaine -19.4% 2.9% -2.8% -2.7%

Annual Positivity Rates
For Combined U.S. Workforce
(More than 8.4 million tests from January to December 2007)
Year Drug Positive Rate 1988 13.6% 1989 12.7% 1990 11.0% 1991 8.8% 1992 8.8% 1993 8.4% 1994 7.5% 1995 6.7% 1996 5.8% 1997 5.0% 1998 4.8% 1999 4.6% 2000 4.7% 2001 4.6% 2002 4.4% 2003 4.5% 2004 4.5% 2005 4.1% 2006 3.8% 2007 3.8%

Positivity Rates By Testing Category
Testing Category 2007 2006 2005 2004 2003 Federally Mandated, Safety-Sensitive Workforce 1.8% 2.0% 2.3% 2.3% 2.5% General U.S. Workforce 4.4% 4.4% 4.5% 4.9% 5.0% Combined U.S. Workforce 3.8% 3.8% 4.1% 4.5% 4.5%

Positivity Rates By Testing Reason
For Federally Mandated, Safety-Sensitive Workforce
(More than 1.8 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 2.8% 3.0% 3.1% 3.3% 3.4% For Cause 11.1% 12.5% 13.4% 14.1% 13.8% Periodic 0.75% 0.59% 0.76% 0.51% 0.75% Post-Accident 2.6% 2.7% 3.0% 2.9% 3.1% Pre-Employment 2.0% 2.3% 2.6% 2.7% 2.9% Random 1.5% 1.5% 1.8% 1.8% 1.9% Returned to Duty 3.3% 3.2% 3.0% 2.9% 2.8%

Positivity Rates By Testing Reason
For General U.S. Workforce
(More than 6.6 million tests from January to December 2007)
Testing Reason 2007 2006 2005 2004 2003 Follow-Up 7.7% 7.4% 9.6% 9.9% 9.6% For Cause 19.2% 18.1% 28.3% 27.8% 28.2% Periodic 1.4% 1.9% 2.4% 1.9% 2.2% Post-Accident 5.8% 5.7% 5.8% 5.7% 5.7% Pre-Employment 3.9% 3.9% 3.9% 4.1% 4.1% Random 5.7% 5.5% 6.6% 7.1% 6.6% Returned to Duty 5.6% 5.8% 6.0% 5.5% 5.6%

Positivity Rates By Drug Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.25% 0.28% 0.35% 0.31% 0.29% Cocaine 0.44% 0.58% 0.60% 0.57% 0.59% Marijuana 0.88% 0.94% 1.10% 1.25% 1.34% Opiates 0.18% 0.17% 0.18% 0.17% 0.19% PCP 0.04% 0.03% 0.04% 0.04% 0.04%

Positivity Rates By Drug Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.44% 0.42% 0.48% 0.52% 0.49% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.58% 0.72% 0.70% 0.72% 0.74% Marijuana 2.34% 2.38% 2.54% 2.88% 2.96% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.35% 0.32% 0.32% 0.32% 0.34% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.01% 0.02% 0.01% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Positivity Rates By Drug Category
For Combined U.S. Workforce, as a percentage of all such tests
(More than 8.4 million tests from January to December 2007)
Drug Category 2007 2006 2005 2004 2003 Amphetamines 0.40% 0.39% 0.46% 0.49% 0.45% Barbiturates 0.24% 0.23% 0.25% 0.27% 0.29% Benzodiazepines 0.67% 0.62% 0.58% 0.58% 0.60% Cocaine 0.55% 0.69% 0.69% 0.70% 0.71% Marijuana 2.01% 2.04% 2.28% 2.59% 2.67% Methadone 0.23% 0.22% 0.23% 0.21% 0.20% Opiates 0.32% 0.28% 0.29% 0.29% 0.31% Oxycodones 0.88%1 0.64%2 0.56%3 -- -- PCP 0.02% 0.02% 0.02% 0.02% 0.03% Propoxyphene 0.58% 0.55% 0.57% 0.63% 0.67%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For Federally Mandated, Safety-Sensitive Workforce, as a percentage of all such tests
(More than 1.8 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.01% 0.00% 0.01% 0.01% 0.01% Invalid 0.11% 0.12% 0.12% 0.08% 0.08% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.02% 0.03% Substitution 0.05% 0.05% 0.05% 0.06% 0.06%

Non-Negative Rates By Specimen Validity Test (SVT)4 Category
For General U.S. Workforce, as a percentage of all such tests
(More than 6.6 million tests from January to December 2007)
SVT Category 2007 2006 2005 2004 2003 Acid-Base 0.00% 0.00% 0.00% 0.01% 0.01% Invalid 0.13% 0.15% 0.16% 0.10% 0.10% Oxidizing Adulterants 0.00% 0.00% 0.00% 0.01% 0.02% Substitution 0.01% 0.01% 0.01% 0.03% 0.03%

Non-Negative Rates By Drug/SVT Category
For Federally Mandated, Safety-Sensitive Workers, as a Percentage of All Non-Negatives
(More than 35 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.47% 0.15% 0.27% 0.32% 0.37% Amphetamines 12.7% 12.6% 14.8% 12.7% 11.4% Cocaine 22.2% 26.3% 25.4% 23.2% 22.7% Invalid 5.5% 5.7% -- -- -- Marijuana 45.2% 43.8% 47.8% 52.4% 53.6% Opiates 9.2% 7.8% 7.7% 7.1% 7.4% Oxidizing Adulterants 0.00% 0.00% 0.06% 0.42% 0.52% PCP 2.1% 1.6% 1.8% 1.4% 1.7% Substituted 2.7% 2.2% 2.3% 2.4% 2.3%

Non-Negative Rates By Drug/SVT Category
For General U.S. Workforce, as a Percentage of All Non-Negatives
(More than 315 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.04% 0.04% 0.06% 0.11% 0.16% Amphetamines 9.2% 8.8% 10.1% 10.0% 9.0% Barbiturates 2.8% 2.6% 2.7% 2.7% 2.8% Benzodiazepines 6.9% 6.1% 5.4% 5.0% 5.1% Cocaine 12.2% 15.0% 14.7% 13.8% 13.8% Invalid 2.8% 3.2% -- -- -- Marijuana 48.8% 49.5% 53.0% 55.0% 55.0% Methadone 2.2% 2.0% 2.0% 1.7% 1.6% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.4% 6.6% 6.6% 6.1% 6.3% Oxycodones 1.5% 0.74% -- -- -- Oxidizing Adulterants 0.00% 0.00% 0.05% 0.16% 0.48% PCP 0.35% 0.31% 0.31% 0.28% 0.51% Propoxyphene 5.6% 4.9% 4.9% 4.9% 5.0% Substituted 0.26% 0.27% 0.26% 0.49% 0.58%

Non-Negative Rates By Drug/SVT Category
For Combined U.S. Workforce, as a Percentage of All Non-Negatives
(More than 350 thousand non-negative test results from January to December 2007)
Drug/SVT Category 2007 2006 2005 2004 2003 Acid/Base 0.09% 0.05% 0.08% 0.13% 0.18% Amphetamines 9.6% 9.3% 10.6% 10.2% 9.3% Barbiturates 2.5% 2.3% 2.5% 2.5% 2.5% Benzodiazepines 6.1% 5.4% 4.9% 4.5% 4.7% Cocaine 13.2% 16.4% 15.7% 14.7% 14.6% Invalid 3.0% 3.5% -- -- -- Marijuana 48.4% 48.8% 52.5% 54.8% 54.9% Methadone 2.0% 1.8% 1.8% 1.5% 1.4% Methaqualone 0.00% 0.00% 0.00% 0.00% 0.00% Opiates 7.6% 6.7% 6.7% 6.2% 6.4% Oxidizing Adulterants 0.00% 0.00% 0.09% 0.19% 0.52% Oxycodones 1.4% 0.65% -- -- -- PCP 0.53% 0.46% 0.45% 0.38% 0.61% Propoxyphene 5.0% 4.3% 4.4% 4.4% 4.5% Substituted 0.51% 0.49% 0.45% 0.66% 0.73%

1 More than 500,000 tests

2 Approximately 400,000 tests

3 More than 200,000 tests

4 Specimen validity testing is the evaluation of a specimen to determine if it is consistent with a normal human specimen. Tests for specimen validity include tests to determine whether a specimen is adulterated or substituted.

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