WorkCare Glossary: Occupational Health Testing and Screening Terms

A 

Accuracy 

The degree to which the measured concentration of analyte (see below) in a substance aligns with a known reference value. 

Alcoholic beverage 

Any beverage that has an alcoholic content of at least .5 percent by volume.  

Analyte  

A chemical substance being identified and measured in a drug test sample or specimen. 

Audiometry  

Using an audiometric testing device to measure a person’s hearing ability by playing a range of sounds at different volumes and pitches. Tests are repeated over time to detect work-related hearing loss (standard threshold shifts). Refer to OSHA’s occupational noise exposure standard, 1910.95. 

B 

Biometric screening 

Certain measures are used to evaluate an individual’s overall wellness and health risk factors for chronic disease. Commonly used biometric markers include height, weight, body mass index, and waist circumference; blood pressure; cholesterol levels in the blood, e.g., total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides; and blood glucose (blood sugar). 

Blood-alcohol concentration (BAC) 

A measurement of alcohol in the blood. 

Blood pressure 

During a physical exam or self-check, a device is used to measure two blood pressure numbers. The upper number (systolic) measures pressure in arteries when the heart beats. The bottom number (diastolic) measures pressure between beats. A reading of 120 over 80 is considered normal. Higher numbers indicate elevated blood pressure or hypertension. Periodic readings are recommended because untreated high blood pressure increases risk for heart attacks and stroke and most people don’t experience symptoms.  

B reader 

When a work-related respiratory disease is suspected, a radiologist certified as a B reader uses a standardized protocol to identify changes in the lungs that may indicate exposure to certain substances or exposure-related disease. 

Breath-alcohol technician (BAT) 

A person qualified to perform breath-alcohol tests using certified equipment. 

Breath-alcohol test 

A person blows into a device that measures blood-alcohol concentration. The legal driving limit is 0.08 in most U.S. jurisdictions. Under U.S. Department of Transportation regulations, a person who tests at or above 0.04 BAC may not resume job duties until a return-to-duty process has been completed. 

C 

Canceled test 

When there is a problem with a specimen test process, the test is canceled and no results are collected. 

Cannabinoid 

A class of biological compounds in the cannabis plant. The main cannabinoids are THC and cannabidiol (CBD); more than 100 other cannabinoids have been identified. 

Cannabis  

All products derived from the Cannabis sativa plant.  

Chain of custody 

A process used to document the handling of a drug test sample from the time it is collected and tested until it is disposed. Use of a paper or electronic chain-of-custody form is required.  

Chemistry panel 

Typically referred to as Chem(#) to denote the number of tests that have been ordered. For example, a panel may be used to detect diabetes, kidney or liver disease, electrolyte imbalance, or elevated cholesterol or triglyceride levels. Additional testing may include blood proteins, calcium, phosphorus, serum iron, and/or muscle enzymes. 

Chest X-ray and radiographs 

A chest X-ray provides images of the chest, lungs, heart, large arteries, ribs, and diaphragm. A serial chest X-ray (repeated or sequential) may be used to assess changes over time. Radiographs are an imaging technique used to diagnose and treat specific lung diseases.  

Collection site 

A lab, clinic or other facility where donors’ specimens are collected by a qualified person. 

Complete blood count (CBC) 

Commonly performed laboratory test to check for signs of anemia, infection, or bleeding tendencies.  

Confirmation test 

Lab tests are used to confirm or rule out an initial non-negative test result. For a test result to be reported as positive, initial screen and confirmation test results must agree.   

Controlled substance 

Drugs, including illegal and prescription drugs, and certain chemicals are controlled (or regulated) by the government and classified according to their accepted medical use and potential for abuse or dependency. Refer to the Controlled Substances Act.  

Cutoff level 

The minimum quantity of a drug analyte needed for a test result to be non-negative and subject to a confirmatory screen. When a drug or metabolite is detected below a designated cutoff level, the test is negative. 

D 

Department of Transportation (DOT) exams/screenings 

Mandatory physical exams and drug tests are completed under U.S. DOT authority on a DOT-regulated employee. 

Designated employer representative (DER) 

An employee authorized by an employer to take immediate action to remove an employee from safety-sensitive duties and make decisions regarding further testing and evaluation processes. 

Detection window 

Period of time after use that a drug may be detected at or above a specified cutoff level.  

Donor  

An employee or job applicant who submits to a drug test. 

Drug 

Any substance (other than alcohol) capable of altering the mood, perception, pain level, or judgment of the individual consuming it and/or the metabolite of any such substance.  

Drug paraphernalia 

Equipment, product or material used to inject, ingest or inhale a controlled substance. 

Drug screen 

A chemical analysis is used to detect a drug or metabolite in a sample of urine, saliva, blood or hair. The result may be negative or non-negative. A non-negative result requires a confirmatory test. Types of drug screens include: 

• Fitness-for-duty before starting a safety-sensitive job or after a work absence. 

• Follow-up or post-rehabilitation conducted periodically following a positive drug test result and/or completion of a drug or alcohol rehabilitation program.  

• Initial screen used to detect the presence of a substance.  

• Post-accident to determine whether drugs and/or alcohol were a contributing factor.  

• Pre-placement/post-offer, with a negative result a condition of employment.  

• Random selection of employees for drug testing with minimal advance notice. 

• Reasonable suspicion (probable-cause or for-cause) tests are conducted when signs and symptoms of potential impairment are observed and documented by supervisors in the workplace.   

E 

Electrocardiogram 

Sensors are used to monitor heart rhythm and function. This test may be used to help assess the fitness of employees with physically demanding or emotionally stressful jobs. 

Employee assistance program (EAP) 

A qualified third party that provides educational and counseling services to employees under a contract with their employer.  

Ergonomic assessment 

A qualified medical professional with training in ergonomics and body mechanics observes an employee while they are doing their job to assess overexertion, repetitive movements, awkward postures, workstation positioning, the use of tools, and other factors that may contribute to musculoskeletal disorder risk. Some evaluations involve the use of body sensors or replication of essential tasks using specialized equipment to detect strains on the body. 

F 

Fitness-for-duty exam 

Used to determine whether an employee is physically and/or psychologically able to safely do their job. It may be performed to prepare for return to work after an injury or illness, following a prolonged work absence, in response to observed unsafe behaviors, or in follow-up to participation in a substance abuse rehabilitation program. The exam may focus on physical capabilities, mental health, or both. It may also include substance screening. 

Functional capacity evaluation  

Comprehensive assessment of physical capabilities in relation to job demands, including lifting, pushing, and endurance tests. Components vary based on job roles, workplace exposures, and regulatory requirements. 

H 

HAZWOPER physical  

This exam is required under the Hazardous Waste Operations and Emergency Response (HAZWOPER) standard enforced by the U.S. Occupational Safety and Health Administration to protect workers with risk of exposure to hazardous materials. The exam includes a review of medical and work history, pulmonary function and respirator fit tests. Other components may include blood and urine samples, hearing test, chest X-ray, electrocardiogram, and vision screening. Covered employees must undergo an annual HAZWOPER physical, or before and after completing an assignment with hazardous waste exposure risk. 

I 

Impairment 

An employee is considered impaired when certain behaviors affect the ability to work safely. This may be related to substance use, fatigue, an underlying medical or mental health condition, exposure to extreme temperatures or toxic materials, or other factors. In some instances, an employee may be directed to stand down and undergo a drug or alcohol screen. 

L 

Laboratory test 

When a sample is sent to a laboratory for processing and/or confirmation testing. 

Liquid chromatography mass spectrometry (LC-MS) 

Analytical tool that involves the physical separation of analytes in a complex sample/specimen, followed by their mass-based detection and quantification. 

M 

Medical review officer (MRO) 

A licensed physician (Doctor of Medicine or osteopathy) responsible for receiving and reviewing laboratory results generated by an employer’s drug testing program and evaluating medical explanations for certain findings. 

Marijuana 

Products from cannabis plants that contain tetrahydrocannabinol (THC). 

Mental health screening 

Psychological questionnaires and consultations are used to evaluate an employee’s mental health, including symptoms of anxiety, depression, and stress responses such as anger, withdrawal, fatigue, or lapses in concentration.  

Metabolism 

The ways in which the body modifies a drug’s chemical structure to enhance or reduce its effect and/or eliminate or retain it. This process produces metabolites. Urine- and hair-based testing detects inactive metabolites. 

P 

Physical exam 

A physical examination performed by an occupational medicine physician to review a job applicant’s or employee’s medical history and assess their health status. Considerations include type of industry and occupation, workplace hazard exposure risks, and the individual’s ability to perform essential job functions. If exam findings indicate a personal health issue, the applicant/employee is referred to their personal provider. 

Psychoactive substances 

Drugs with psychoactive properties affect mental processes such as perception, consciousness, cognition, mood and a range of emotions. 

Pulmonary function test  

Used to assess lung and airway function. Spirometry is the most frequently used pulmonary function test. (See below) 

R 

Respirator fit test 

A procedure used to ensure that a respirator is comfortable and the facepiece has a tight seal on the wearer’s face to prevent potential leaks and exposure to hazardous substances. 

S 

Safety-sensitive position  

A job that involves tasks with higher-than-average workplace safety, injury and/or legal exposure risks. 

Sensitivity and specificity 

Sensitivity is the ability of a test to correctly identify people who have drugs in their system. A highly sensitive test has few false negatives. Specificity is the ability of a test to correctly identify people who do not have drugs in their system. A highly specific test has few false positives. Ideally, a drug test is both highly sensitive and highly specific. 

Spirometry 

A pulmonary function test that requires the test subject to inhale deeply and exhale with force. Repeated inhalations and exhalations are recorded to obtain valid results, which are expressed as a percentage and adjusted by age, height, ethnicity, and gender. Spirometry results include forced vital capacity and forced expiratory volume in one second to detect obstructive disease. 

Split sample 

A single urine specimen is divided into two samples: one is used for the initial screen and, if positive, the second sample is used for the confirmation test.   

Substance abuse professional (SAP) 

A person who has completed specialized training and been certified to evaluate employees who have violated a workplace drug-and -alcohol policy and provide follow-up guidance.  

T 

Tetrahydrocannabinol (THC) is the principal psychoactive compound in cannabis. There are two common types of THC found in cannabis products: delta-8 and delta-9. 

Tuberculosis (TB) test 

Healthcare professionals, first responders, teachers, and people in other occupations with risk of work-related exposure to TB may be required to be tested. There are two types of tests:  

• A Mantoux tuberculin skin test involves injecting tuberculin fluid into the skin of the forearm. The result is read by a medical provider within 48 to 72 hours after injection. A chest X-ray is used to determine whether a positive finding is inactive or active TB. 

• An Interferon Gamma Release Assay (IGRA) test is used to measure how the immune system reacts to TB germs. 

U 

Urinalysis 

A urine specimen is collected and tested to check for urinary tract infections and the presence of blood, sugar, or protein in the urine. A donor’s urine may also be tested for the presence of drug metabolites (residues) to detect recent use of controlled substances, which may have been in the body’s system for hours or days. 

V 

Vaccinations 

Some jobs (e.g., healthcare, food service) require vaccinations against specific diseases such as hepatitis and influenza. 

Validity testing 

The evaluation of a urine specimen to determine whether certain adulterants or foreign substances were added to it, the specimen was diluted, or it was substituted.  

Vision test 

Testing equipment or eye charts are used to measure a person’s ability to see colors, discern details at near and far distances (visual acuity), and check for gaps or defects in their field of vision.