&

AGENDA

I III V
OVER VIEW SOA TESTING: APPLIED CASES
SAMPLE COLLECTION.
ADULTERATION PATTERN
ADULTERATION DETECTION

II IV
SITE PREPARATIONS PROBLEMATIC SITUATIONS
I- OVERVIEW
Toxicology Laboratory provides
Specimen Collection Guidelines.
That Express the Polices & Procedures Adopted
By this INSTITUTE
I- OVERVIEW
Laboratory Results for Substances of ABUSE … Often … Used In

Legal Proceedings & Actions.

SO … The manner in which SPECIMENS … are Collected &
Handled… is
Very Important .
I- OVERVIEW
Specimens must be handled … & … controlled by
A Uniform Urine Collection Process,
………. Regardless … The Testing Environment.
II-Site Preparation Collection Area Guidelines

S ecure Collection Area

Free of any areas where Adulterants can be HIDDEN.

C lean Collection Area

Surface for the collector must be CLEAN to use as a Work Area.

SECURE

CLEAN
II-Site Preparation Collection Area Guidelines

S ecure Storage Area

For Collection Supplies & Related Materials Is

SECURE.
SECURE
II-Site Preparation Collection Area Guidelines

S E
Or
ecure Water Source: Liminated Water Source:
in the area of urination. in the area of urination.

Bluing/Greening Agent …
Should be placed in the toilet tanks
…….To prevent SAMPLE DILUTION.
II-Site Preparation Collection Area Guidelines

E liminated Detergent Source:

II-Site Preparation Collection Area Guidelines

S ecure STORAGE AREA Source:

should be available
… … … … To Ensure Specimen Security
Before To Transport To
.. Laboratory ..
II-Site Preparation Collection Area Guidelines

D ocumentation :
All Collected Samples
Should BE Reported
In Paper FORM (General Log Book)
In Electron FORM (OTARR)
III-Sample Collection Urine Sampling Collection Protocol

Principle

The VALIDITY of the results of Urine Drug Screen

Dependent On … Specimen Integrity.

III-Sample Collection Urine Sampling Collection Protocol

Procedure

1st Step …
Ask for IDENTITY card
or
International Card “Passport”
or
National Card
Driver’s License
III-Sample Collection Urine Sampling Collection Protocol

Procedure
2nd Step …
Ask the donor to Remove Any …
Un-Necessary Outer CLOTHES.
Ask the donor to Give All …
Personal BELONGINGs
S L
… Put in a ECURE OCKER
Its Key with The DONOR
Its site apart from COLLECTION AREA.
III-Sample Collection Urine Sampling Collection Protocol

Procedure
3rd Step …
Ask the donor to Wash His / Her HAND … (Before Collection Process)…
To ELIMINATE any POSSIBLE … Adulterating or Contaminating substances
… … In or Under the Donor’s FINGERNAILS.

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
Clean & Unused
4th Step …
PLACE the following information on the bottle LABEL:
•DATE of collection.
•NAME &/or ID No of Donor.
•COLLECTOR’s Initials
•CODE No.

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
5th Step …
INSTRUCT the donor to Fill the container
at least ½ full
(a minimum of 30 mL).
Recommend 50-80 mL

Usually 50 mL

Minimum 30 mL

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
6th Step …
OBSERVE the donor to Urination
I-DIRECT "WITNESSED" OBSERVATION
Greatest Credibility.
Same Gender
Sport Activities

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
6th Step …
OBSERVE the donor to Urination
II- INDRECT "NON-WITNESSED" OBSERVATION
Accepted Credibility … IF IN
SAFEGUARDS PLACE
NO Donor Access … to Any Possible Substances that can be USE in Adulteration Process as;
(Water, Chemicals, Substitute of Urine Sample, etc.)
Maintain Privacy
Complete The Remainder
During Sampling Collection Process

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
Recommended
7th Step …
ACCEPT the sample by GLOVED hand.

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III-Sample Collection Urine Sampling Collection Protocol

Procedure
8th Step …
MEASURE & RECORD Sample Temperature
Within 4 Minutes

Immediately After Sample Receiving

Normal Between 32-38 C

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III-Sample Collection Urine Sampling Collection Protocol

Procedure FLOW CHART

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 -Adulteration Pattern
Principle
3 CATEGORIES

URINE SUBSTITUTION: FLUID &/or SUBs INGESTION: ADDITION OF ADULTERANT:

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-Adulteration Pattern
Principle

URINE SUBSTITUTION:
• Replace with
Clear Human Urine
Artificial Urine
Animal Urine
• Common
• Effective
• Best Detector “Temperature Measure”

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-Adulteration Pattern
Principle
FLUID, WATER &/or SUBSTANCES s INGESTION:
• Dilute the Sample &/or Interfere with Testing Procedures.
• Ingestion of Large Volume of Cranberry Juice / or Vinegar
• Common
• IN-Effective
• Best Detector “pH/Sp.Gr”
• Ingestion of Large Volume of Water:
• Common
• Effective (Dilute Up To 8 Fold Urine Volume → ↓ Level Below the Cut Off Level of detection)
• Best Detector “Cr. / Sp. Cr.”
• Ingestion of Large Amount of Vitamins C, B12 (MethylCoblamine) B3 (Niacin):
• Less Common
• IN-Effective
• Best Detector “pH/Sp.Gr
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-Adulteration Pattern
Principle

DIRECT ADDITION OF ADULTERANT:

•Aim: To conceal the Laboratory Techniques.
•Mechanism: By Inactivation to Laboratory Testing Methodologies. Especially IN
… Enzyme Immunoassay Procedure.
•Compounds:
• Na Cl
• Na HCO3
• H 2O 2
• Alcohols
• Blood
• Soaps
• Commercial Products (Web Available)
Nitrites (Klear) & Chromates (Urine Luck)
•Efficiency:
Efficient & Give
… … Pseudo Positive & Pseudo Negative ??
-Adulteration Pattern

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-Adulteration Pattern
•Tropical flavoured •3 capsules supplement herbal cleanse
•Herbal cleanse fortified with meta-boost •Fortified with meta-boost
•Includes meta-boost capsule
•↑ Metabolism to help the person urinate

•Simply Golden Synthetic 3.5 oz Urine

•Temp Strip
•Heating Element

• Detox & Utests,

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• UTest Strips
-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

Creatinine Temperature:

pH Odour

Specific Gravity Appearance

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-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

1- Sample Temperature:
•Unwitnessed Collection
•Urine Sample Substitution
•Effective Detector Parameter

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-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

2- Sample Odour:
•Detection of characteristic Adulterant ODOUR As:
Alcohol
Soaps
Bleach
Perfumes

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-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

3- Sample Appearance:
With Characteristic Odour

•Detection of Bubbling Appearance as IN:

•SOAPs
•Detection of Bottom Residue as IN:
•Solid Adulterants
•Detection of Blood as IN:
•Addition of Blood
•Impair Laboratory Testing Procedures.
•Act as Biological Biohazards for laboratory Employees.

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-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

4- Specific Gravity:
Normal S Gr= 1.005 – 1.035.
Very Low Specific Gravity <1.005 … Indicate Diluted Urine Sample
Very High Specific Gravity >1.045 … Indicates Concentrated Urine Sample
By addition of Dissolved Solid Adulterants, as Na Cl & Na HCO3.

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iii- Substance of abuse testing:
3- Adulteration and Dilutional Detection
Principle

5) pH
hIGH pH >7.5
Adulteration:
Direct Adulteration: Addition of basic compounds as… Na HCO3 & Bleach
Physiological : as vegetarian diet
Pathological: Conditions as prolonged vomiting
NORMAL pH = 4.5 – 6.5

Low pH < 4.5

Adulteration:
Indirect Adulteration: Ingestion of Acidic Substances as; Cranberry Juice or Vinegar.
Direct Adulteration: Acidic Compounds Addition.
Pathological:
Starvation or Diarrhea.
-Adulteration Detection
Principle

Detection of Dilution & Adulteration … By (Collector or Laboratory) :

6- Creatinine:
Urinary Creatinine Level
o > 20 mg/dL:
NORMAL Creatinine Urine; Random Urinary Sample Level. 100
o 10- 20 mg/dL:
NATURAL Water Intake; Possible indicator of; ↑ Liquid Consumption as … Dietary Habit
o 2- 10 mg/dL: 20
FORCED Water Indicate:
- Frank Indicator of a Forced attempted Ingestion of Large Volumes of Water “In 10
Short Term Water of Loading” → Dilute a Urine, so Any Abused Substance In Urine 2
will be ↓ Below Analytical Testing Cutoff Levels.
- Attempted water Intake, usually, 3-5 hours before time of sampling collection.
o <2 mg/dL: 0
DIRECT ADDITION OF Water: To Urine Sample “Frank Indicator”
o 0.0 mg/dL: ?? Normal Ranges
SAMPLE REPLACEMENT: Frank Indicator THAT ..“Sample is not Consistent With Human Usually in Freshly Voided Urine Sample.

Urine”
IV-Problematic Situations:
Outside Temperature RANGE

Visible Blood

Uncooperative Donor

Suspected Adulteration

Insufficient Sample
APPLIED ases
1. Specimen
Specimen Temperature Outside
Temperature Limits:
Outside Limits:

• VINEGAR
• CHOLOX
• DETERGENT
• SALT
• STRAW BERRY JUICE
• FLASH
• OVEN CLEANER
• LEMON JUICE
• SODA
• EYE DROPS
• TAPE WATER
• DEIONISED WATER
• WARM WATER
(Regular Sample)
Creatinine: ≈40
Nitrite: N
Glutaraldehyde: N
pH: ≈7
Specific gravity: 1005
Bleach: N
Pyridium Chlorochromate: N

Cr…Nitirte…Glut….pH…...SpGr….Bleach
(Acidic Adulteration)
Creatinine: 10-20
Nitrite: N
Glutaraldehyde: N
pH: 2-3
Specific gravity:>1020
Bleach: N
Pyridium Chlorochromate: N
 1. Specimen Temperature OutsideLimits:

(Clorox Adulteration)
LOW Adulteration Degree
Creatinine: 20-30
Nitrite: N
Glutaraldehyde: N
pH: ≈8
Specific gravity: 1015
Bleach: V. Faint Blue
Pyridium Chlorochromate: V. Faint Blue
(Clorox Adulteration)
MODERATE Adulteration Degree
Creatinine: ≈20
Nitrite: N
Glutaraldehyde: N
pH: ≈8
Specific gravity: 1015
Bleach: Dark Blue
Pyridium Chlorochromate: Dark Blue
(Clorox Adulteration)
HIGH Adulteration Degree ?
Creatinine: ≈6
Nitrite: >20
Glutaraldehyde: N
pH: ≈8
Specific gravity: 1015
Bleach: Red Brown
Pyridium Chlorochromate: Dark Red Brown
(Detergent Adulteration)
Creatinine: ≈40
Nitrite: N
Glutaraldehyde: N
pH: ≈8
Specific Gravity: >1020
Bleach: N
Pyridium Chlorochromate:N
(FLASH Adulteration)
Creatinine: ≈20-25
Nitrite: N
Glutaraldehyde: N
pH: ≈2
Specific Gravity: >1020
Bleach: N
Pyridium Chlorochromate: N
(Lemon Juice Adulteration)
Creatinine: ≈20-30
Nitrite: N
Glutaraldehyde: N
pH: ≈3
Specific gravity: >1020
Bleach: N
Pyridium Chlorochromate: N
( SODA Adulteration)
Creatinine: ≈10-20
Nitrite: N
Glutaraldehyde: N
pH: ≈10
Specific gravity: >1020
Bleach: N
Pyridium Chlorochromate: N
Real Adultered Sample
Adulteration With ETHANOL
Creatinine: ≈50
Nitrite: N
Glutaraldehyde: N
pH: ≈7
Specific gravity: >1020
Bleach: N
Pyridium Chlorochromate: N