Hair Testing Concerns Linger; Experts Urge More Research
This story appears in the Nov. 7 print edition of Transport Topics.
Scientific and technical experts on drug testing hair concluded that additional research is needed before regulators adopt a federal standard for commercial vehicle drivers, according to a group report.
The summary of the May 11-13 Scientific and Technical Review meeting in Washington, noted that the effect of hair color on these drug test results remains “controversial and unresolved” and that the “efficacy of laboratory washing and its effects on hair drug-test results also remains controversial.”
The group of 20 experts met for three days in May. It was composed of hair testing researchers, laboratory practitioners, laboratory directors, a medical review officer and toxicologist familiar with workplace drug-testing regulations, programs, technologies, specimens and policies, according to the summary obtained by Transport Topics.
The document also stated that the group, convened by the federal Substance Abuse and Mental Health Services Administration, or SAMHSA, did have favorable opinions on issues ranging from basic collection parameters to chain of custody and a need to embrace new screening technologies. But, it noted, there are “a number of unresolved issues among the experts that currently limit the appropriateness of hair testing for federally regulated programs.”
The group concluded that currently there is no definitive mechanism to distinguish unintentional environmental exposure of hair to drugs from deliberate or inadvertent ingestion of drugs.
“Many laboratories use ‘washing procedures’ designed to remove environmentally deposited drugs from the hair,” the summary said. “However, these procedures are not standardized and vary widely across laboratories.” In some cases, tests can result in false positives if the decontamination process is ineffective, the summary noted.
Also, some studies in which black, brown and blond hair were placed in a solution of cocaine showed the highest concentration in black hair and the least in blond.
Ronald Flegel, chairman of the SAMHSA’s Drug Testing Advisory Board, called the summary “pre- decisional” and noted that the concerns expressed at the meeting were long-standing issues that the board already is addressing.
“It was a scientific meeting and not designed to offer a consensus of the group,” Flegel said.
He added, “I’m not saying it’s not an accurate summary. I’m saying that everything has to be looked at carefully in the summary, and when you’re writing mandatory guidelines, I think you want to take into account many things.”
Flegel said that he didn’t believe that SAMHSA’s position on all the information that came out of the meeting would not identify any of the 20 experts.
But the summary said the meeting was consistent with on-going interests to improve the program, and to comply with the 2015 FAST Act transportation law and the drug-testing advisory board recommendations.
In a unanimous Aug. 7 secret ballot, and without public comment, the board forwarded a recommendation to SAMHSA Administrator Pamela Hyde that the agency “pursue” the hair-testing alternative. In forwarding the recommendation, the advisory board, heavily composed of drug-testing lab executives, in effect eliminated potential concerns “regarding the scientific methodology and forensic defensibility of hair testing,” as well as legal and public policy questions, according to Flegel.
Although several large motor carriers drug test their prospective hires with hair samples, only urine or oral testing is officially authorized by the U.S. Department of Health and Human Services and the Department of Transportation. And despite a mandate in the FAST Act that the policy be in place by December, Flegel said he could not predict when the proposed standard might be ready for publication.
Before publication, the proposed standard ultimately would need to be approved by administrators at SAMHSA and HHS as well as the White House Office of Management and Budget.
Other members of SAMHSA’s drug advisory board declined comment or did not return phone calls for this article.
However, Abigail Potter, a researcher for American Trucking Associations, said she was told by SAMHSA that the proposed rule was nearing publication and that the agency is continuing research on the potential hair color and contamination concerns mentioned in the summary.
“ATA believes that SAMHSA is moving forward with the rule, planning to do additional research and is taking the congressional mandate seriously,” Potter said. “They have told us they expect to have a rule in less than 12 months barring any complications with the new administration.”
ATA supports the adoption of a hair drug-testing regulation.
The advisory board is expected to again discuss the status of hair testing at a meeting in December, Flegel said.
“Hair testing has promise,” said Natalie Hartenbaum, president and chief medical officer of OccuMedix Inc. and past president of the American College of Occupational and Environmental Medicine. “However, there is still a need for rigorous scientific evaluation of utility and drawbacks, including potential biases and inconsistent test methods.”
