A snapshot of workplace drug testing in Italy

Abstract

The Italian Decree on Health and Safety at Work (81/08) prescribes mandatory drug tests for jobs which pose safety hazards to others. Workplace drug testing is performed in accordance with the Provision of the Government-Regions Conference, 2008. The aim of our survey was to examine the prevalence of drug use and the main drug findings in a sample of Italian workers performing hazardous jobs. From September 2009 to February 2011, 551 urine samples were collected in 42 Italian companies. Sample collection was carried out at the workplace by qualified laboratory personnel sent from the Institute of Occupational Medicine of the Catholic University (UCSC) of Rome. The workers to be tested were informed the day before, as the law requires. The samples were checked for adulteration, coded, and sent immediately to the laboratory of the UCSC Forensic Toxicology Analytical Unit. The screening test was an immunoassay. The positive samples proceeded to the confirmatory analysis with liquid chromatography-tandem mass spectrometry (LC-MS/MS). The urine samples were analyzed for cannabis, opiates, amphetamines, methamphetamines, cocaine, methadone, and MDMA. Out of 16 samples .9% screened positive; only 4 of them (0.7%) were confirmed with the LC-MS/MS. Confirmed results included cocaine (2 samples), cannabis (1 sample), both cocaine and cannabis (1 sample). The prevalence of positive samples was lower than expected. Such finding cannot be explained by a low reliability of the testing procedure but could be due to test scheduling. More positive cases might be found performing short-notice random testing.

Seven years of workplace drug testing in Italy: A systematic review and meta‐analysis

“…On the whole, 18 studies were included in the final review and meta‐analysis to estimate the overall prevalence of positivity at WDT (Table ). They were all cross‐sectional, for a total of 212 654 participants.…”

“…[13,20,[25][26][27][28]33] All of them answered and completed the missing data. On the whole, 18 studies [12][13][14][15]18,[22][23][24][25][26][27][28][29][30][31][32][33][34] were included in the final review and meta-analysis to estimate the overall prevalence of positivity at WDT (Table 1). They were all cross-sectional, for a total of 212 654 participants.…”

Workplace drug testing and alcohol policy in Italy; there is still a long way to go

“…In Italy the expected WDT positivity rate was around 4–10% . However numerous publications have reported a positivity rate lower than 2% (diverging also significantly from similar experiences in the international arena), indicating a de facto failure of the aim set by Italian legislators, that is, to identify even the occasional drug consumer . As a matter of fact it is not realistic to think that the positivity rate for WDT among Italian workers is so low.…”

“…As a matter of fact it is not realistic to think that the positivity rate for WDT among Italian workers is so low. The main objections indicate as possible causes of this failure the option of allowing the use of inadequate screening tests (such as on‐site screening testing) as well as the choice of the Occupational Health Physician (OHP) as a professional assigned to perform the screening . Indeed, the OHP has always been nominated to carry out health surveillance and health promotion, but since the introduction of these regulations he has also begun to play a role of ‘inspector’.…”

“…[1] However numerous publications have reported a positivity rate lower than 2% (diverging also significantly from similar experiences in the international arena [2] ), indicating a de facto failure of the aim set by Italian legislators, that is, to identify even the occasional drug consumer. [3][4][5][6][7][8][9][10][11][12][13][14][15] As a matter of fact it is not realistic to think that the positivity rate for WDT among Italian workers is so low. The main objections indicate as possible causes of this failure the option of allowing the use of inadequate screening tests (such as on-site screening testing) as well as the choice of the Occupational Health Physician (OHP) as a professional assigned to perform the screening.…”