Complications Introduced by Pointof Collection Drug Tests

By the early 1990s, pharmaceutical and diagnostic companies have been working on the antigen-antibody (Ag-Ab) pairs to DOA in urine. Lateral-flow methods utilized in pregnancy tests proved to be the most reliable and easiest to use, and both dipstick- and cassette-based lateral-flow DOA devices started to appear in the market. Cassettes hold the lateral-flow device in place within a plastic shell. The upper shell is configured with a well for the specimen to be placed over the absorbent pad, and a window for viewing the visual endpoint color-change reaction (see Chapters 3-5).

The introduction of these products, however, created special concerns in workplace DOA testing applications. Pregnancy tests, designed for home use by patients, were ideal in their design for self-collection, interpretation, and receipt of the test results in the privacy of the home (8). For workplace DOA testing, there exist three distinct parties—a donor (employee), a collector (nurse or technician), and a customer (employer) who has ordered the tests and is the party authorized to receive the test results. Conventional POCT have missed, or ignored, this important distinction.

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