Seven years of workplace drug testing in Italy

A systematic review and meta-analysis

Gian Luca Rosso, Cristina Montomoli, Luca Morini, Stefano M Candura

Research output: Contribution to journalReview article

Abstract

In Italy, Workplace Drug Testing (WDT) has been compulsory by law for specific categories of workers since 2008, offering the opportunity to compare studies conducted within a single regulatory framework. The aims of this paper are to estimate the overall prevalence of WDT positivity (at screening survey) among Italian workers and evaluate the percentage of true and false positives at confirmation analysis. A systematic review and meta-analysis of the scientific literature on WDT in Italy from January 2008 to March 2015 was carried out, according to the MOOSE guidelines. A random effects model was utilized to calculate pooled prevalence. Potential sources of heterogeneity were explored using sensitivity test and subgroup analysis. The overall meta-analytical prevalence of positivity at WDT among Italian workers was 1.4% [95% confidence interval (CI) = 1.1-1.7%]. It was significantly lower among workers screened with an on-site test (1%; 95% CI = 0.5-1.5%), compared with a bench-top test (1.7%; 95% CI = 1.3-2.1%). Nine studies provided data on false positives at the screening test, with a combined prevalence estimate - calculated on positive cases - of 30% (95% CI = 16-44%). In Italy, the number of true positives at first-level workplace drug testing is low, while the frequency of false positives is relatively high. A revision of the Italian legislation on the subject seems advisable. Copyright © 2017 John Wiley & Sons, Ltd.

Original languageEnglish
Pages (from-to)844-852
Number of pages9
JournalDrug Testing and Analysis
Volume9
Issue number6
DOIs
Publication statusPublished - Jun 2017

Fingerprint

meta-analysis
workplace
Workplace
Italy
Meta-Analysis
drug
confidence interval
Confidence Intervals
Testing
Pharmaceutical Preparations
Screening
Literature
regulatory framework
Nuclear Family
Legislation
legislation
Guidelines
test
screening
analysis

Keywords

  • Journal Article
  • Review

Cite this

Seven years of workplace drug testing in Italy : A systematic review and meta-analysis. / Rosso, Gian Luca; Montomoli, Cristina; Morini, Luca; Candura, Stefano M.

In: Drug Testing and Analysis, Vol. 9, No. 6, 06.2017, p. 844-852.

Research output: Contribution to journalReview article

Rosso, Gian Luca ; Montomoli, Cristina ; Morini, Luca ; Candura, Stefano M. / Seven years of workplace drug testing in Italy : A systematic review and meta-analysis. In: Drug Testing and Analysis. 2017 ; Vol. 9, No. 6. pp. 844-852.
@article{3d6f91e897cd4b9abf372032b6c485e8,
title = "Seven years of workplace drug testing in Italy: A systematic review and meta-analysis",
abstract = "In Italy, Workplace Drug Testing (WDT) has been compulsory by law for specific categories of workers since 2008, offering the opportunity to compare studies conducted within a single regulatory framework. The aims of this paper are to estimate the overall prevalence of WDT positivity (at screening survey) among Italian workers and evaluate the percentage of true and false positives at confirmation analysis. A systematic review and meta-analysis of the scientific literature on WDT in Italy from January 2008 to March 2015 was carried out, according to the MOOSE guidelines. A random effects model was utilized to calculate pooled prevalence. Potential sources of heterogeneity were explored using sensitivity test and subgroup analysis. The overall meta-analytical prevalence of positivity at WDT among Italian workers was 1.4{\%} [95{\%} confidence interval (CI) = 1.1-1.7{\%}]. It was significantly lower among workers screened with an on-site test (1{\%}; 95{\%} CI = 0.5-1.5{\%}), compared with a bench-top test (1.7{\%}; 95{\%} CI = 1.3-2.1{\%}). Nine studies provided data on false positives at the screening test, with a combined prevalence estimate - calculated on positive cases - of 30{\%} (95{\%} CI = 16-44{\%}). In Italy, the number of true positives at first-level workplace drug testing is low, while the frequency of false positives is relatively high. A revision of the Italian legislation on the subject seems advisable. Copyright {\circledC} 2017 John Wiley & Sons, Ltd.",
keywords = "Journal Article, Review",
author = "Rosso, {Gian Luca} and Cristina Montomoli and Luca Morini and Candura, {Stefano M}",
note = "Copyright {\circledC} 2017 John Wiley & Sons, Ltd.",
year = "2017",
month = "6",
doi = "10.1002/dta.2189",
language = "English",
volume = "9",
pages = "844--852",
journal = "Drug Testing and Analysis",
issn = "1942-7603",
publisher = "John Wiley and Sons Ltd",
number = "6",

}

TY - JOUR

T1 - Seven years of workplace drug testing in Italy

T2 - A systematic review and meta-analysis

AU - Rosso, Gian Luca

AU - Montomoli, Cristina

AU - Morini, Luca

AU - Candura, Stefano M

N1 - Copyright © 2017 John Wiley & Sons, Ltd.

PY - 2017/6

Y1 - 2017/6

N2 - In Italy, Workplace Drug Testing (WDT) has been compulsory by law for specific categories of workers since 2008, offering the opportunity to compare studies conducted within a single regulatory framework. The aims of this paper are to estimate the overall prevalence of WDT positivity (at screening survey) among Italian workers and evaluate the percentage of true and false positives at confirmation analysis. A systematic review and meta-analysis of the scientific literature on WDT in Italy from January 2008 to March 2015 was carried out, according to the MOOSE guidelines. A random effects model was utilized to calculate pooled prevalence. Potential sources of heterogeneity were explored using sensitivity test and subgroup analysis. The overall meta-analytical prevalence of positivity at WDT among Italian workers was 1.4% [95% confidence interval (CI) = 1.1-1.7%]. It was significantly lower among workers screened with an on-site test (1%; 95% CI = 0.5-1.5%), compared with a bench-top test (1.7%; 95% CI = 1.3-2.1%). Nine studies provided data on false positives at the screening test, with a combined prevalence estimate - calculated on positive cases - of 30% (95% CI = 16-44%). In Italy, the number of true positives at first-level workplace drug testing is low, while the frequency of false positives is relatively high. A revision of the Italian legislation on the subject seems advisable. Copyright © 2017 John Wiley & Sons, Ltd.

AB - In Italy, Workplace Drug Testing (WDT) has been compulsory by law for specific categories of workers since 2008, offering the opportunity to compare studies conducted within a single regulatory framework. The aims of this paper are to estimate the overall prevalence of WDT positivity (at screening survey) among Italian workers and evaluate the percentage of true and false positives at confirmation analysis. A systematic review and meta-analysis of the scientific literature on WDT in Italy from January 2008 to March 2015 was carried out, according to the MOOSE guidelines. A random effects model was utilized to calculate pooled prevalence. Potential sources of heterogeneity were explored using sensitivity test and subgroup analysis. The overall meta-analytical prevalence of positivity at WDT among Italian workers was 1.4% [95% confidence interval (CI) = 1.1-1.7%]. It was significantly lower among workers screened with an on-site test (1%; 95% CI = 0.5-1.5%), compared with a bench-top test (1.7%; 95% CI = 1.3-2.1%). Nine studies provided data on false positives at the screening test, with a combined prevalence estimate - calculated on positive cases - of 30% (95% CI = 16-44%). In Italy, the number of true positives at first-level workplace drug testing is low, while the frequency of false positives is relatively high. A revision of the Italian legislation on the subject seems advisable. Copyright © 2017 John Wiley & Sons, Ltd.

KW - Journal Article

KW - Review

U2 - 10.1002/dta.2189

DO - 10.1002/dta.2189

M3 - Review article

VL - 9

SP - 844

EP - 852

JO - Drug Testing and Analysis

JF - Drug Testing and Analysis

SN - 1942-7603

IS - 6

ER -