Specimen Integrity Tests

Both the collection site and the laboratory have a number of mechanisms to detect potentially invalid specimens. The temperature of the urine, for instance, should be within 90.5-98.9°F. The specific gravity should be between 1.005 and 1.030 and the pH should be between 4.0 and 10.0. The creatinine concentration should be 20400 mg/dL. A specimen is considered as diluted if the creatinine is <20mg/dL and the specific gravity is <1.003. It is advised that the laboratory should perform creatinine and pH analysis of all specimens submitted for drugs of abuse testing. Additional tests are also recommended to detect the presence of other adulterants. Determination of specific gravity is mandatory for any specimen with a creatinine concentration of <20 mg/dL. Substituted urine specimens have creatinine concentrations <5mg/dL and a specific gravity 1.001 or over 1.020. The urine is adulterated if pH is <3 or >11 (2). Adulteration with sodium chloride at a concentration necessary to produce a false-negative result always produces a specific gravity over 1.035. Use of household chemicals such as bleach, acid, soap and detergent as well as adulteration with vinegar alter the pH of urine to a value outside the physiological range and can be easily detected by specimen integrity tests. Specimens adulterated with liquid soap are usually cloudy. The presence of Visine eye drops in adulterated urine cannot be detected by routine specimen integrity testing. Moreover, newer urine adulterants such as Urine Luck, UrinAid, Klear and Whizzies can also cause false-negative results in drug tests. The presence of these compounds in urine may escape detection by routine specimen integrity tests.

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