Preparing the Testing Area
- Set up a private testing space with all necessary equipment, paperwork, and personal protective equipment (PPE).
- Place an absorbent disposable pad on the testing table.
- Designate a private toilet stall for testing, away from others.
- Remove unnecessary items (bin, soap cakes, brushes, etc.).
- Turn off the tap and seal it.
- Flush the toilet, then tape the cistern shut.
- Add color dye to the toilet bowl to prevent tampering.
- Close and seal any windows.
- Donors must leave personal belongings (jackets, bags, and items in pockets) behind before providing a sample.
- Donors may wash hands with water only before the test and should be provided with soap and water afterward.
If a second sample is needed, the donor must remain supervised until the test is complete.
Integrity Testing: Ensuring a Valid Sample
Initial Checks
When the donor hands over the sample, check:
- Temperature:
- Normal urine temperature: 35.5 – 37.5°C.
- Check the temperature immediately (it may drop by 1°C before being read).
- Record the temperature on the form.
- Color: Should be yellow with no signs of dye from the toilet water.
- Control Lines: If required, activate the test by inserting the key. Ensure all control lines are present to confirm the cup is working correctly.
Detecting Sample Tampering
Common Adulteration Methods:
- Substitution: Donor replaces their urine with a fake sample.
- Dilution: Drinking excessive water or adding water to the sample.
- Adding chemicals: Using substances to alter test results.
Integrity Tests and What They Detect
| Test | What it detects |
| Creatinine (CRE) | Confirms urine is real and undiluted. Low levels indicate possible dilution. |
| Specific Gravity (S.G.) | Checks for excessive water content (least reliable alone). |
| Nitrite (NIT) | Detects commercial adulterants like Whizzies or Klear. High nitrite can also indicate infection. |
| Oxidants (OX) | Identifies bleach, hydrogen peroxide, and other oxidizers. |
| Glutaraldehyde (GLUT) | Detects sterilizing agents used to mask drugs. |
| pH Level | High pH (>9) or low pH (<4) suggests chemical adulteration. |
Handling Failed Integrity Checks
- If the sample fails an integrity check, ask the donor to provide a new sample.
- Do not accuse the donor; simply state that the sample cannot be verified.
- Set the chain of custody document aside with the first sample and start a new chain of custody for the second sample.
- If the second sample passes integrity checks:
- Proceed with reading and recording the results.
- If negative, the test is complete.
- If non-negative, follow the next steps in the collection procedure.
Final Steps
- Always follow company policy when handling samples and reporting results.
- Maintain proper documentation to ensure a secure chain of custody.
- Handle donor concerns professionally to maintain the integrity of the testing process.