title: The defined HHS/DOT substituted urine criteria validated through a controlled hydration study.
abstract: This controlled hydration study was designed to validate the substitution criteria used by the Substance Abuse and Mental Health Services Administration (SAMHSA) to classify a workplace urine specimen as inconsistent with normal human urine. Study participants (n = 56) ingested at least 80 oz (2370 mL) of fluid over a 6-h period, 40 oz during the first 3 h (DOT hydration protocol) and 40 oz during the second 3-h period. Urine specimens (n = 498) were collected upon awakening, just prior to hydration, at the end of each hour of the 6-h test period, and upon awakening the next day. No urine specimen satisfied the paired substitution criteria of urine creatinine < or = 5.0 mg/dL and specific gravity < or = 1.001 or > or = 1.020. Seventy-three percent of the participants produced at least one specimen meeting the criteria for dilute urine: urine creatinine < 20.0 mg/dL and specific gravity < 1.003. Fifty-five percent of the participants produced at least one dilute urine specimen during the first 3 h of hydration. In conclusion, this controlled hydration study supports the criteria set by SAMHSA for classifying a specimen as substituted (inconsistent with normal human urine).
authors.affiliation: US Department of Transportation, Washington, DC, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Edgell
authors.forename: Yale H
authors.initials: YH
authors.lastname: Caplan
authors.forename: Leon R
authors.initials: LR
authors.lastname: Glass
authors.forename: Janine Denis
authors.initials: JD
authors.lastname: Cook
mesh_terms: D000328:Adult; D003404:Creatinine / Q000652:urine; D004326:Drinking; D004340:Drug Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D011237:Predictive Value of Tests; D012016:Reference Values; D013046:Specific Gravity; D015813:Substance Abuse Detection / Q000379:methods / Q000592:standards*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014481:United States; D014483:United States Dept. of Health and Human Services; D016482:Urinalysis / Q000592:standards*; D017132:Workplace
chemical_list: D003404:Creatinine