Author: MN Occupational Health

Many employers have adopted policies and implemented programs for drug and alcohol testing after an employee is involved in a workplace accident. This testing is referred to as “post-accident” or “post-incident” drug testing. The result of the test will be used to determine if drug use was a contributing factor to the accident. When an employer opts to use post-accident drug testing, certain criteria must be established to maintain objectivity and determine what circumstances warrant a drug test.

Many employers require a drug test to be performed if their employee’s action resulted in property damage, a citation from the police, a fatality, or a serious injury. Post-accident drug tests can determine whether the person involved used drugs and is also important in establishing that drugs or alcohol were not involved.

Positivity Rates

Data compiled from the Quest Diagnostics Drug Testing Index (DTI) – based on the results of drug tests administered under the circumstances mentioned above – reveal that positive results occurred in 6.5 percent of post-accident urine drug tests administered to the general workforce.

Specimen Types

Urine-based drug testing is the best method suited for post-accident drug testing and can include the following categories of drugs:

Typical 10-panel Non-Federal urine drug test **** Federal 5-panel Drug Test

• Amphetamines	• Barbiturates	• Benzodiazepines
• Cocaine	• Creatinine	• Marijuana
• Methadone	• Methaqualone	• Opiates
• PCP	• Propoxyphene

Breath Alcohol tests are performed for all Federal (DOT, FAA, Pipeline, Coast Guard, FTA, etc.) testing. Non-Federal alcohol testing within Minnesota, because of case law is normally initiated using Breath Alcohol as a screen or indicator. The level at which alcohol is considered positive must be defined in a drug and alcohol policy, may be as low as 0.04 or even 0.02. If that level is reached, a Blood Alcohol test is normally performed. Minnesota case law allows a worker who tests positive to a drug or alcohol test to pay for a retest of the same specimen. Since non-Federal breath tests do not result in a physical, retestable specimen, blood is collected and sent to a lab, much like urine drug screens.

Conclusion

Drug tests can have many different purposes for an employer. Pre-screening applicants with a drug test can reduce the chance that your organization hires an active drug user. Random screening during employment can discourage current employees from using drugs. Post-accident drug testing is different. Its purpose is to determine whether drug and/or alcohol use played a role in a workplace accident. Post-accident drug and alcohol testing is a useful policy that can lead to improvement in safety practices and a reduction in risk and costs for the employer.

A functional capacity evaluation (FCE) is designed to document both the medical and functional ability of a worker to perform occupational tasks following an injury in order to determine return-to-work readiness and the need for more permanent employer accommodations. FCE’s are typically ordered by an insurer or Qualified Rehabilitation Consultant (QRC).

How does a functional capacity evaluation work?

When MOH Occupational Therapists under the direction of MOH physicians perform an FCE we will typically conduct the assessments:

• Intake review. We will acquire information related to your medical history, general health, job description, the state / condition of your injury and your work-related goals. We will also examine your perception of pain, its impact on your day-to-day activities and the psychological impact it has had on you.
• Musculoskeletal evaluation. We will evaluate your strength, range of motion, sensation and volumetric measurements.
• Physical demand testing. We use standardized and non-standardized tests to observe you using both specific parts and your whole body in work-related tasks.
• Material testing is used to determine your ability to exert force for the purpose of moving items. This test includes lifting, carrying, pulling and pushing. EPIC lift stations are generally used to test lifting capabilities at various heights, while pushing and pulling tests are conducted with a sled.
• Non-material handling evaluates tasks involving bending, kneeling, squatting, crawling and climbing ladders; no significant amount of weight or force is involved.
• General conditioning. This step measures your overall aerobic capacity. The test may involve stair climbing and walking.
• Specific job simulation. Various evaluations may be performed. Simulations include clerical, patient care, law enforcement and housekeeping.
• Psychological factors. Several tests may be conducted to measure behavior. The Spinal Functional Sort test is used to compare your perceived level of capability with your actual level of capability.

The FCE includes a summary of your strengths and limitations regarding work-related tasks. It will contain recommendations for safety, rehabilitation and case resolution. A physical capacities form may also accompany the finished report with information on your general material- and non-material handling abilities.

Pulmonary function tests consist of a wide range of tests designed to measure the capacity of your lungs to breathe in and exhale air. As a tool to determine the ability of a worker to wear respirators while performing parts of their job, PFT’s are sometimes required. They measure how efficiently your lungs can transfer oxygen to the bloodstream. To measure your lungs’ ability to exhale, our medical practitioners use a spirometer. The use of spirometers, or spirometry, works by measuring the volume of the lungs. The information gathered from spirometry is useful in diagnosing certain types of lung disorders, specifically obstructive lung diseases like asthma and chronic obstructive pulmonary disease (COPD).

Related Information:

• Learn about our functional testing services.

 
Measuring lung volume helps detect restrictive lung diseases in which a person cannot inhale a normal volume of air. These diseases are caused by a number of factors, most commonly inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities the individual’s chest cavity. Finally, diffusion capacity (DLCO) tests provide a fairly accurate estimate of how efficiently oxygen is being transferred from the air to the bloodstream by the lungs.

Conducting the Pulmonary Function Tests (PFTs)

A spirometry test is a relatively simple procedure. The spirometer is connected to an individual mouthpiece with a filter, which the person breathes into. The spirometer then records the rate and amount of air that is being inhaled and exhaled over a specific amount of time. These measurements are recorded by medical professionals.

Preparation

In order to prepare for a spirometry test, the patient should avoid eating a heavy meal prior to the test and should  avoid smoking for at least 4-6 hours beforehand. If the patient is taking medications, or medication dispersion devices like an inhaler, specific instructions for conducting the test will be provided by the doctor.

To learn more about post-offer work simulation in Minnesota, call MN Occupational Health at 651-968-5300.

Evaluating the suitability of candidates for a particular job involves evaluating their attributes and abilities such as his or her education level, skill set and experience. Work simulation involves assessing whether a candidate’s physical abilities are suitable for the essential physical demands of a job.

Many similar jobs have different physical requirements that may vary from workplace to workplace or industry to industry so a Job Task Analysis will identify those variations between different employers or facilities for similar jobs. For example, a job may require an employee to be able to lift a certain amount of weight from one height to another or to climb ladders or steps, etc.. That is why, instead of relying on pre-set general requirements it is important to perform a thorough Job Task Analysis (JTA) in order to determine the essential functional requirements for the job with the tools and infrastructure they will be using on a regular basis.

Documenting and testing process

After the essential functional requirements of the job have been determined, they will be added to the job description and used for preliminary applicant post-offer employment screening. All applicants should be instructed to declare in writing if they are able to meet these functional requirements and that they will be evaluated for their ability to meet the particular physical demands for the job with our without accommodations.

Ensuring an impartial and discrimination-free evaluation process

To ensure a fair evaluation process, the human performance evaluations for an applicant must be conducted either after making an offer of employment.

What is a job task analysis?

A job task analysis (JTA) results in a detailed analysis and description of the essential physical requirements to perform a job. The primary goal of a JTA is to establish the job requirements in terms of activity, task duration, environmental factors, tools, machinery, etc.

What is the purpose of a job task analysis?

Minnesota employers study what tasks the employee can or cannot accomplish so:

• Organizations can choose to not employ someone who cannot perform certain elements or all of the necessary tasks or;
• May decide to hire a worker when reasonable accomodations can be made.

A job task analysis can expedite the return-to-work process be pre-defining the essential physical demands of the job.

If a JTA has not been drawn up on every employee, the company doctor may have trouble signing workers up for exhaustive work duty, particularly if the worker has recently recovered from an injury. When this happens, the workers may experience a challenges returning to work and tasks would consequently end up uncompleted. If both management and the doctor have a JTA, however, they will have an easier time liaising with the injured worker and preparing a formula for getting back to work.

Employ professionals to develop a job task analysis

Do not wait any longer to have a JTA set up for your workplace. When you have a good system for responding to work-related injuries, you can reduce time spent off work and boost productivity. Minnesota businesses need solutions to reduce the human and economic cost of injury.