Oral Fluid and Saliva Tests

In the 2003 European Workplace Drug Testing Society (EWDTS) Symposium, held in Barcelona, the merits of oral fluid, oral mucosal transudate, and saliva as DAT matrices were debated. Although the use of oral fluid-based assays remains low, their demand is definitely on the increase in Europe (4). For example, the original British Rail Alcohol and Drug Policy recommended use of urine tests for standard DOA screening. However, at least one rail operator has already switched to using oral fluids instead, because it is more acceptable among its staff. Less invasive and intrusive than either blood or urine, testing of oral fluid may be performed under direct visual supervision. Furthermore, by eliminating the need to send the sample for laboratory analysis, less time is taken to obtain the results (12). Presence of DOA in oral-fluid samples is also more indicative of recent consumption. At present, however, the levels of sensitivity and specificity of the current generation of oral-fluid tests are still questionable (6,7). Although studies such as the ROSITA II project and the UK Home office custody suite project are still underway, oral-fluid DATs are soon expected to be adopted by other rail companies and police forces in the United Kingdom. In this scenario, oral fluid will quickly become the third most common specimen requested for DOA analysis across Europe.

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