Osterloh J D, Becker C E
Department of Laboratory Medicine, University of California, School of Medicine, San Francisco.
West J Med. 1990 May;152(5):506-13.
Urine testing for drug use in the workplace is now widespread, with the prevalence of positive drug tests in the work force being 0% to 15%. The prevalence of marijuana use is highest, and this can be reliably tested. Though it is prudent to rid the workplace of drug use, there is little scientific study on the relationship of drug use and workplace outcomes, such as productivity and safety. Probable-cause testing and preemployment testing are the most common applications. Random testing has been less accepted owing to its higher costs, unresolved legal issues, and predictably poor test reliability. Legal issues have focused on the right to policy, discrimination, and the lack of due process. The legal cornerstone of a good program is a policy that is planned and agreed on by both labor and management, which serves both as a contract and as a procedure in which expectations and consequences are known. The National Institute on Drug Abuse is certifying laboratories doing employee drug testing. Testing methods when done correctly are less prone to error than in the past, but screening tests can be defeated by adulterants. Although the incidence of false-positive results is low, such tests are less reliable when the prevalence of drug abuse is also low.
目前，职场中针对药物使用的尿液检测十分普遍，劳动力中药物检测呈阳性的比例为0%至15%。大麻使用的比例最高，且对此能够进行可靠检测。尽管清除职场中的药物使用是审慎之举，但关于药物使用与职场成果（如生产力和安全性）之间关系的科学研究却很少。基于合理理由的检测和入职前检测是最常见的应用方式。随机检测因成本较高、法律问题未解决以及可预见的检测可靠性较差而较少被接受。法律问题集中在政策权利、歧视以及缺乏正当程序方面。一个完善项目的法律基石是一项由劳资双方共同规划并商定的政策，它既是一份契约，也是一个明确期望和后果的程序。美国国家药物滥用研究所正在对进行员工药物检测的实验室进行认证。正确实施检测时，检测方法比过去更不易出错，但筛查测试可能会被掺假物质蒙混过关。尽管假阳性结果的发生率较低，但当药物滥用的比例也较低时，此类检测的可靠性就会降低。
