Workplace drug testing performed in Naples (Italy) between 2000-2009

A new Italian legislation for workplace drug testing (WDT) has been recently introduced to establish, for at-risk workers, mandatory procedures for screening tests, in charge to occupational health specialists, and for confirmatory tests, committed to toxicology laboratories. Aim of this study is to assess the impact of new laws on epidemiology of drug abuse in the workplace. The survey regards toxicological examinations performed on 3063 urine samples at Forensic Toxicology Unit of Second University of Naples (Italy) from 2000 to 2009, in order to assess the suitability for at-risk workers (transports, builders, police, army, air force). Confirmatory analysis by GC/MS for opiates, methadone, buprenorphine, THC, cocaine, amphetamine and analogues were requested after a first positive screening test, conducted on 49.294 workers by various public bodies. Operative procedures applied include a further screening test (EMIT-COZART) and confirmation analyses by GC/MS (SIM mode). The results of WDT performed from 2000 to 2009 showed significant differences both in the incidence and type of drugs taken. The prevalence of first-level positivity for drug abuse in workplace, ranged from 4.4% to 7.9% in the period 2000-2008, dramatically drops in 2009 (2.6%). Similarly, confirmed cases, that in the same period ranged from 3.1 to 5.7%, crashed to 0.3% in 2009. The most frequent observed drug in 2000-2004 was THC, while in the 2005-2008 the increase of poly-drug use and the raising trend in cocaine and cannabinoids were observed. The application of the new legislation caused a significant fall of positivity for drug use in 2009 maybe since occupational health specialists are often inexperienced in toxicological screening. In order to avoid an under-detection of drug abuse in the workplace, the consultative role of forensic toxicology laboratories should be highlighted.