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Frequently Asked Questions About Fitness-for-Duty

Would the drug Ecstasy be detected by the drug tests that NRC requires licensees to perform under Part 26?
Can an individual mask prohibited drug use (e.g., Ecstasy) by taking a commercially available herbal supplement such as Echinacea or golden seal prior to a drug test?
Is an observed collection required if an individual cannot provide a specimen of at least 60 mL in a single attempt and the temperature of the specimen is outside the acceptable range or does not register a temperature?
Is high blood pressure a physical ailment such that a licensee can require a covered individual to comply with a medical doctor’s treatment plan as a condition of performing NRC regulated duties under Part 26?
What is the correct procedure to follow in the rare circumstance when an individual has positive initial breath alcohol tests (2 specimens) but on confirmatory testing, the first of the two confirmatory breath specimen is positive but the second specimen is negative?
If an employee seeks the assistance of a treatment professional to deal with emotional stress that the employee believes is impairing his/her ability to perform job duties covered by Part 26, must the employee disclose this information to the licensee?
What is the responsibility of the Medical Review Officer regarding a second positive test result that is believed to be due to an originally detected use rather than additional use?
Could a blood alcohol level below 0.04% require action by the licensee to determine fitness to safely and competently perform duties?
Are licensees required to have the HHS-certified laboratories with whom they contract for urine drug testing services conduct specimen validity testing in accordance with the revised HHS Guidelines and must licensees audit the laboratories’ validity testing procedures?

Index to All Frequently Asked Questions Pages

Would the drug Ecstasy be detected by the drug tests that NRC requires licensees to perform under Part 26?

Yes, one of the five substances that NRC requires licensees to test for in urine is amphetamine. The test for amphetamine would also detect methamphetamine, a major consistent in the drug Ecstasy.

Can an individual mask prohibited drug use (e.g., Ecstasy) by taking a commercially available herbal supplement such as Echinacea or golden seal prior to a drug test?

No known herbal supplements have been found to prevent the amphetamine drug test from detecting the presence of methamphetamine.

Is an observed collection required if an individual cannot provide a specimen of at least 60 mL in a single attempt and the temperature of the specimen is outside the acceptable range or does not register a temperature?

If a specimen is less than 60 ml, section 2.4(g)(11) in Appendix A to Part 26 provides that the donor may be given liquids to help him/her produce the 60 ml. The additional urine is to be collected in a separate container. Section 2.4(g)(11) also provides that if the donor cannot provide 60 ml, the collector “shall contact the appropriate authority to obtain guidance on the action to be taken.” The temperature of each specimen must be measured. If the temperatures of the specimens fall outside the acceptable temperature range provided in section 2.4(g)(14) [90.5o–99.8oF], then another specimen must be collected under direct observation.

Is high blood pressure a physical ailment such that a licensee can require a covered individual to comply with a medical doctor’s treatment plan as a condition of performing NRC regulated duties under Part 26?

No, high blood pressure does not meet the definition of impairment in Part 26 because the condition does not impair an individual’s current cognitive or physical functioning. Therefore, a licensee may not require an employee to comply with a medical doctor’s treatment plan as a condition of performing covered duties. While high blood pressure may be a precursor to physical ailments such as strokes that could directly affect an individual’s ability to perform his or her job, the potential for a future impairment is not a measure of current job performance.

What is the correct procedure to follow in the rare circumstance when an individual has positive initial breath alcohol tests (2 specimens) but on confirmatory testing, the first of the two confirmatory breath specimen is positive but the second specimen is negative?

Section 2.4(g)(18) in Appendix A to Part 26 requires that "For each screening test, two breath specimens shall be collected from each individual no less than two minutes apart and no more than 10 minutes apart. The test results shall be considered accurate if the result of each measurement is within plus or minus 10 percent of the average of the two measurements. If the two tests do not agree the breath tests shall be repeated on another evidential-grade breath analysis device. Confirmatory testing is accomplished by repeating the above procedure on another evidential-grade breath analysis device."

If the results of the two breath specimens are not within 10 percent above or below the average result of the two breath specimens obtained, then the specimen results do not agree and section 2.4(g)(18) mandates that repeat testing be conducted. However, if the initial two breath specimens and the confirmatory two breath specimens each produce test results within 10 percent of the average of the results, but the initial two breath specimens produce a positive alcohol test result and confirmatory two breath specimens produce a negative result, the test results for the individual would be negative.

The intent of section 2.4(g)(18) in Appendix A to Part 26 is to protect a donor’s right to accurate breath alcohol test results. If either the initial test produces an accurate positive test result and an accurate negative test results or the confirmatory test produces an accurate positive test result and an accurate negative test result, then the result of the breath analysis is negative.

If an employee seeks the assistance of a treatment professional to deal with emotional stress that the employee believes is impairing his/her ability to perform job duties covered by Part 26, must the employee disclose this information to the licensee?

Part 26 does not require an individual to self report emotional impairment. If a licensee maintains a self reporting requirement, the individual would be obligated to comply with the licensee’s FFD program policy. Even if the employee is not required to self-report emotional impairment, if the employee believes that the emotional stress is significant enough to impair his/her ability to perform job duties covered by Part 26, then the employee's supervisors or co-workers may notice this impairment and report it. The NRC requires licensees to provide supervisors with training in behavioral observation techniques, for detecting degradations in performance, impairment, or changes in employee behavior, and in the procedures for initiating appropriate corrective action.

What is the responsibility of the Medical Review Officer regarding a second positive test result that is believed to be due to an originally detected use rather than additional use?

The NRC recognizes that in rare circumstances a second positive test result is possible when successive collections are relatively close together, even when the person has not used the drug in question after providing the first specimen. In these cases, the MRO may determine that the second positive test result is due to the continued presence of the drug from the originally detected use rather than additional use. In these cases, the MRO can decline to find that a second FFD policy violation has occurred.

Could a blood alcohol level below 0.04% require action by the licensee to determine fitness to safely and competently perform duties?

Yes. 10CFR §26, 26.10 requires that a "fitness for duty program must", in part, "Provide a reasonable assurance that nuclear power plant personnel are not under the influence of any substance which in any way affects their ability to safely and competently perform their duties." Further, §26.27(b)(1) requires that, "Impaired workers, or those whose fitness may be questionable, shall be removed from activities within the scope of this part, and may be returned only after determined to be fit to safely and competently perform activities within the scope of this part." While a licensee may not have specified a more stringent cut-off level as authorized in Appendix A to Part 26, §2.7(e)(1), the licensee is required to remove a worker from activities and make a determination of fitness at any time a worker's fitness is questionable.

Are licensees required to have the HHS-certified laboratories with whom they contract for urine drug testing services conduct specimen validity testing in accordance with the revised HHS Guidelines and must licensees audit the laboratories’ validity testing procedures?

The NRC has received several questions related to specimen validity testing at laboratories that are certified by the U.S. Department of Health and Human Services (HHS) to perform urine testing for drugs, which licensees must use for initial and confirmatory drug testing under 10 CFR 26. These questions have arisen because HHS-certified laboratories were required to implement the HHS’ revised Mandatory Guidelines for Federal Workplace Drug Testing Programs, as published on April 13, 2004 (69 FR 19643 ), and begin conducting specimen validity testing in accordance with the new requirements on November 1, 2004.

Part 26 FFD programs are required to submit suspect specimens to HHS-certified laboratories for further testing under Section 2.4(g)(16) in Appendix A to Part 26 which states, "All urine specimens suspected of being adulterated or found to be diluted shall be forwarded to the laboratory for testing." However, the current rule does not require licensees to conduct specimen validity tests nor have the HHS-certified laboratory subject such specimens to validity testing. Section 2.7(d) in Appendix A to Part 26 permits specimen validity testing, but does not require it, as follows: "Special processing may be conducted to analyze specimens suspected of being adulterated or diluted (including hydration). Any evidence of adulteration or dilution, and any detected trace amounts of drugs or metabolites, shall be reported to the Medical Review Officer."

Therefore, licensees need not contract with HHS-certified laboratories for specimen validity testing nor require HHS-certified laboratories to conduct it in accordance with the revised HHS Guidelines. However, if a licensee contracts for specimen validity testing and the HHS-certified laboratory conducts it in accordance with the revised HHS Guidelines, licensees would be required to audit those services annually under §26.80(c) and Section 2.7(m) [Inspections] in Appendix A to Part 26.

NOTE: The information herein is provided as a public service and solely for informational purposes and is not, nor should be deemed as, an official NRC position, opinion or guidance, or "a written interpretation by the General Counsel" under 10 CFR 26.4, on any matter to which the information may relate. Accordingly, the fact that the information was obtained from this web site will not have a precedential effect in any legal or regulatory proceeding.