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12 Reporting of Results conduct, and the employee is removed from safety-sensitive work while in that alcohol concentration range. All drug test results fall into one of three categories: 1. Negative results CONSEQUENCES OF A DRUG OR ALCOHOL VIOLATION a. Negative An employee must be immediately removed from perform- b. Negative-dilute, with numerical values for creatinine ing safety-sensitive functions if any of the following condi- and specific gravity tions occur: 2. Nonnegative results a. Positive, with drug metabolites noted A verified positive drug test result. b. Positive-dilute, with drug metabolites noted, with An alcohol test result of 0.040 or higher. (An employee numerical values for creatinine and specific gravity must also be immediately removed from safety-sensi- c. Adulterated, with adulterants noted tive duties with a blood alcohol content (BAC) of 0.020 d. Substituted, with confirmatory values for creatinine or higher, although a regulatory violation occurs only and specific gravity at the 0.040 level.) e. Invalid Refusal to take the test, including verified adulterated 3. Rejected for testing or substituted drug test results. Violation of DOT agency drug and alcohol regulation. Medical Review Officer Employees with a drug or alcohol violation are not eli- gible to return to safety-sensitive work unless they suc- Laboratories send the drug test results to the medical review cessfully complete the return-to-duty requirements. officer (MRO), a licensed physician. The MRO is the gate- keeper of the drug-testing program, responsible for verify- ing the laboratory test results and determining whether there SUBSTANCE ABUSE PROFESSIONAL may be a legitimate medical reason for a positive drug test or whether the employee has committed a rule violation. The The substance abuse professional (SAP) evaluates employ- MRO can evaluate explanations for certain drug results and, ees who have violated DOT drug and alcohol regulations under certain circumstances, has the authority to downgrade and makes recommendations concerning education, treat- a result from positive to negative. MROs must meet stringent ment, follow-up testing, and aftercare. The SAP must have qualifications and must submit to requalification examina- one of the following credentials: licensed physician, licensed tions every 5 years. MROs must keep negative and cancelled or certified social worker, licensed or certified psychologist, results for 1 year and nonnegative results for 5 years. licensed or certified employee assistance professional, state licensed or certified marriage and family therapist, or certi- fied drug and alcohol counselor. The SAP must be knowl- ALCOHOL TESTING edgeable about and have clinical experience in the diagnosis and treatment of alcohol- and controlled substances-related Although alcohol is a legal drug, there is no legitimate medi- disorders, must be knowledgeable about the SAP function as cal explanation for alcohol in one's system. Thus, MROs it relates to employer interests in safety-sensitive duties, and have no role in alcohol testing. must be knowledgeable and keep current on 49 CFR Part 40 and the various agency regulations. Alcohol tests can be administered for the same reasons as drug tests: pre-employment, random, reasonable suspicion, postaccident, return-to-duty, and follow-up. Random alco- RECORDS hol testing is not required under some DOT administrations. The testing laboratory is required to maintain all records per- As for the drug tests, a dual-test procedure is used to taining to each employee urine specimen for a minimum of determine whether an employee has prohibited alcohol 2 years. The MRO must keep negative and cancelled results concentrations in the system. The initial test can use either for 1 year and positive results and refusals for 5 years. The saliva or breath. If the initial test is positive, only breath can SAP is required to maintain copies of the reports to employ- be used in the confirmation test to assess the level of alcohol ers for 5 years. The look-back period that an employer must in the system. An alcohol concentration of 0.040 and above check on the drug- and alcohol-testing record of employees is a positive test, and a violation of DOT regulations. An it is intending to use to perform safety-sensitive duties is alcohol concentration between 0.020 and 0.039 is prohibited 2 years (with exceptions for motor carriers and aviation).