Workforce Health Update on Oral Fluid Testing

Oral Fluid Testing Approved Method by DOT

In May 2023, the Department of Transportation (DOT) published a final rule on drug testing, which incorporated the use of oral fluid (saliva) testing for DOT-regulated personnel. The rule allows employers to choose either urine or oral fluid testing. Employers can choose different methods of testing for different situations (pre-employment vs. reasonable suspicion) and can choose a different test method for situations such as “shy bladder” (inability to produce a sufficient sample within the allotted timeframe). Oral fluid collection is mandated for transgender and nonbinary individuals who require direct observation of their testing.

Oral fluid testing detects drug use over a range of hours to days. It is especially useful when an employee is suspected of being impaired at work. Testing usually takes only a few minutes, but it may be longer if a specimen is positive for THC, as THC decreases saliva production.

Additional Options for Employee Drug Testing

Reliable rapid tests are now available also. However, non-negative rapid fluid specimens require confirmation testing by a lab. A second specimen is collected and sent for analysis immediately following the non-negative collection.

While the DOT rule is two years old, it has not yet been implemented. Nor has the DOT certified any Department of Health & Human Services labs for oral fluid drug testing. However, other labs are able to perform this test. The DOT continues to work on this and released “DOT Oral Fluid Specimen Collection Procedures Guideline” in January 2025.

Urine and hair collections are additional options for drug testing. These tests look back at a longer window of time - days to weeks for urine and weeks to months for hair.

Workforce Health Technicians

Froedtert Workforce Health has been collecting oral fluid specimens for over five years, and our technicians are skilled at the process. Contact us with questions about how to implement testing for your workforce.