Glossary of Terms

Drug & Alcohol Testing

Accession Number- A number assigned to each specimen by the laboratory. This number stays with the specimen it’s entire lifetime. It is used to identify and track a specimen every step from the time it arrives to the laboratory until the result is reported.

Adulterated Specimen- A specimen that contains a substance that is not expected to be present in human urine, or contains a substance expected to be present but is at a concentration so high that it is not consistent with human urine.

Affidavit- A form that must be signed by the collector to correct a problem on the original Chain of Custody form. For example, if the date was missing, incorrect, or the collector’s signature was missing.

Alcohol- The intoxicating agent in beverage alcohol, ethyl alcohol or other low molecular weight alcohols, including methyl or isopropyl alcohol.

Alcohol Concentration- The alcohol in a volume of breath expressed in terms of grams of alcohol per 210 liters of breath as indicated by a breath test under this part.

Alcohol Concentration Test- A subsequent test using an EBT, following a screening test with a result of 0.02 or greater, that provides quantitative data about the alcohol concentration.

Alcohol Screening Device- A breath or saliva device, other than an EBT, that is approved by the National Highway Traffic Safety Administration (NHTSA) and placed on a conforming products list (CPL) for such devices.

Alcohol Screening Test- An analytic procedure to determine whether an employee may have a prohibited concentration of alcohol in a breath or saliva specimen.

Blind Specimen/Blind Performance Test Specimen- Blind specimen or blind performance test specimen. A specimen submitted to a laboratory for quality control testing purposes, with a fictitious identifier, so that the laboratory cannot distinguish it from an employee specimen.

Breath Alcohol Technician (BAT)- A person who instructs and assists employees in the alcohol testing process and operates an evidential breath testing device.

CLIA- Clinical Laboratory Improvement Amendments are federal regulatory standards relating to all clinical laboratory testing done on humans with the exception of basic research and clinical trials. CLIA was passed by Congress to ensure that irrespective of where a test is done, the results will be accurate, reliable and timely.

CLIA Waived- Health, drug testing and other products that meet certain set standards and have been found to have a high degree of accuracy and are easy to use. Such products can be purchased and used by consumers and will have minimal possibility of error.

Chain of Custody- The procedure used to document the handling of the urine specimen from the time the employee gives the specimen to the collector until the specimen is destroyed. This procedure uses the Federal Drug Testing Custody and Control Form (CCF).

Collection Site- A place selected by the employer where employees present themselves for the purpose of providing a urine specimen for a drug test.

Collector- A person who instructs and assists employees at a collection site, who receives and makes an initial inspection of the specimen provided by those employees, and who initiates and completes the CCF.

Confirmation Drug Test- A second analytical procedure performed on a urine specimen to identify and quantify the presence of a specific drug or drug metabolite.

Confirmation Validity Test- A second test performed on a urine specimen to further support a validity test result.

Confirmed Drug Test- A confirmation test result received by an MRO from a laboratory.

Consortium/Third Party Administrator (C/TPA)- A service agent that provides or coordinates the provision of a variety of drug and alcohol testing services to employers. C/TPAs typically perform administrative tasks concerning the operation of the employers’ drug and alcohol testing programs. This term includes, but is not limited to, groups of employers who join together to administer, as a single entity, the DOT drug and alcohol testing programs of its members. C/TPAs are not “employers” for purposes of this part.

Control Line- A line that should appear in the control section of an instant drug test, irrespective of whether the result is positive or negative. If the control line does not appear, the test is considered to be invalid.

Creatinine- A product that is constantly produced in the body when muscles are broken down. Testers check the levels of creatinine in samples to establish whether the specimen has been diluted. This will result in a negative dilute drug test.

Cutoff Level- The least quantity of a drug metabolite that has to be in a sample for the test result to be either positive or negative. Cutoff levels help to eliminate false positive results occasioned by exposure to a drug or substance.

DOT- These terms encompass all DOT agencies, including, but not limited to, the United States Coast Guard (USCG), the Federal Aviation Administration (FAA), the Federal Railroad Administration (FRA), the Federal Motor Carrier Safety Administration (FMCSA), the Federal Transit Administration (FTA), the National Highway Traffic Safety Administration (NHTSA), the Pipeline and Hazardous Materials Safety Administration (PHMSA), and the Office of the Secretary (OST). These terms include any designee of a DOT agency.

DOT Breath Alcohol Test- A breath alcohol test consisting of certain procedures as determined by the Department of Transportation.  Required testing by any organization that subscribes to regulations set out by DOT.

DOT Urine Drug Screen- A urine drug test consisting of certain panels and procedures as determined by the Department of Transportation.  Required testing by any organization that subscribes to regulations set out by DOT.

Designated Employer Representative (DER)- An employee authorized by the employer to take immediate action(s) to remove employees from safety-sensitive duties, or cause employees to be removed from these covered duties, and to make required decisions in the testing and evaluation processes. The DER also receives test results and other communications for the employer, consistent with the requirements of this part. Service agents cannot act as DERs.

Dilute Specimen- A specimen with creatinine and specific gravity values lower than expected for human urine. A specimen is said to be diluted if the sample has been manipulated to reduce the concentration of the drugs and metabolites in the specimen. This could happen if the subject drinks lots of water before samples are collected or if water is added directly to the sample after collection. Measuring the creatinine levels and specific gravity of the specimen can help to determine if it has been diluted

Drug Metabolites- A chemical that is released from the ingesting process. This is what is checked for in a drug screen. Particular substances produce particular metabolites.

Drug Testing Site- A place selected by the employer where employees present themselves for the purpose of providing breath or saliva for an alcohol test.

Drugs- The drugs for which tests are required under this part and DOT agency regulations are marijuana, cocaine, amphetamines, phencyclidine (PCP), and opiates.

Error Correction Training- Training provided to BATs, collectors, and screening test technicians (STTs) following an error that resulted in the cancellation of a drug or alcohol test. Error correction training must be provided in person or by a means that provides real-time observation and interaction between the instructor and trainee.

Evidential Breath Testing Device- A device approved by NHTSA for the evidential testing of breath at the .02 and .04 alcohol concentrations, placed on NHTSA’s Conforming Products List (CPL) for “Evidential Breath Measurement Devices” and identified on the CPL as conforming with the model specifications available from NHTSA’s Traffic Safety Program.

Initial Validity Test- The first test used to determine if a specimen is adulterated, diluted, or substituted.

Invalid Drug Test- The result of a drug test for a urine specimen that contains an unidentified adulterant or an unidentified interfering substance, has abnormal physical characteristics, or has an endogenous substance at an abnormal concentration that prevents the laboratory from completing or obtaining a valid drug test result.

Laboratory- Any U.S. laboratory certified by HHS under the National Laboratory Certification Program as meeting the minimum standards of Subpart C of the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs; or, in the case of foreign laboratories, a laboratory approved for participation by DOT under this part. (The HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs are available on the internet at http://www.health.org/workpl.htm or from the Division of Workplace Programs, 1 Choke Cherry Road, Room 2-1035, Rockville, MD 20857.)

Medical Review Officer (MRO)- A person who is a licensed physician and who is responsible for receiving and reviewing laboratory results generated by an employer’s drug testing program and evaluating medical explanations for certain drug test results.

Medical Review Officer Assistant (MROA)- Someone that works directly under a licensed physician that is a medical review officer (MRO) in order to organize and facilitate the drug testing process. The MROA does not have to be a licensed physician but should be trained in the rules and regulations of drug testing and HIPAA requirements, along with any other medical or legal issues surrounding drug testing.

NIDA- An Abbreviation for the National Institute on Drug Abuse. This is a research institute under the federal government that seeks to be at the forefront in national efforts to bring to bear the power of science in matters drug abuse and addiction.

Negative Dilute Result- A result showing that the amount of drug metabolites in a given sample did not exceed certain limits.

Negative Result- A result that indicates that the specimen did not exceed certain levels of drug metabolites. The average turnaround time for a negative result is 24 hours from the time the laboratory receives the specimen, though this could vary.

Non-Negative Specimen- A urine sample that has been found to have been substituted, adulterated, invalid or tested positive for drugs.

Positive Test Result- A result that indicates that the specimen exceeded certain drug or drug metabolite cutoff levels.  A result where the laboratory has established the presence of the drug(s) or metabolites being tested for. Confirmed with follow-up and confirmation tests. The outcome can only be said to be a positive test result when the MRO rules it to be positive.

Preliminary/Presumptive Positive Test Result- The initial stage in the process of drug screening where a saliva or urine specimen tests positive. Every single preliminary positive drug test has to be sent to the laboratory for further analysis and tests since specific over the counter medications and foods can lead to an untrue positive drug test.

Primary Specimen- In drug testing, the first urine specimen bottle that is opened and tested by a laboratory to determine whether the employee has a drug or drug metabolite in his or her system; and for the purpose of validity testing. The primary specimen is distinguished from the split specimen, defined in this section.

Qualification Training- The training required in order for a collector, BAT, MRO, SAP, or STT to be qualified to perform their functions in the DOT drug and alcohol testing program. Qualification training may be provided by any appropriate means (e.g., classroom instruction, internet application, CD–ROM, video).

Rapid Urine Drug Screen- Also referred to as an instant or rapid drug test, this test will provide results within a few minutes of analyzing the sample. Since the test can be done at the collection site and results produced fast, the test eliminates the need to send samples to a laboratory if it returns negative results. It is only if the results are positive that they should be taken to a lab for a confirmation test.

Refresher Training- The training required periodically for qualified collectors, BATs, and STTs to review basic requirements and provide instruction concerning changes in technology (e.g., new testing methods that may be authorized) and amendments, interpretations, guidance, and issues concerning this part and DOT agency drug and alcohol testing regulations. Refresher training can be provided by any appropriate means (e.g., classroom instruction, internet application, CD–ROM, video).

SAMHSA- Short form of Substance Abuse and Mental Health Services Administration. This is a federal agency that sets standards relating to drug testing as well as governs and regulated drug testing laboratories that have received the required approval.

Safety Sensitive Position- A position in which the normal or periodic job responsibilities of the employee entail, at some point and to some degree, a higher level of concern for the safety, health, and/or welfare of the employee in that position, his or her co-workers, those who use our products or services, those who come onto or in contact with Company property, and the public at large [and for whom the illicit use of drugs and/or misuse of alcohol by the employee in that position could create a greater danger to the safety, health, and/or well-being of those individuals].

Security-Sensitive Position- A position in which the normal or periodic job responsibilities of the employee entail, at some point and to some degree, access to cash, securities, bonds, or other negotiable instruments, and/or precious and/or valuable commodities; involve the use of, or access to, firearms and/or other weapons and/or armaments; involve protection of property, valuables, and/or individuals; relate to matters of national security, military, or law enforcement; and/or entail access to assets and/or information vital to, sensitive for, and/or with high proprietary interest to the Company [and for whom the illicit use of drugs and/or misuse of alcohol by the employee in that position could compromise the interests of the Company and/or any individual or entity affiliated to, or in contact with, the Company].

Service Agent- Any person or entity, other than an employee of the employer, who provides services specified under this part to employers and/or employees in connection with DOT drug and alcohol testing requirements. This includes, but is not limited to, collectors, BATs and STTs, laboratories, MROs, substance abuse professionals, and C/TPAs. To act as service agents, persons and organizations must meet the qualifications set forth in applicable sections of this part. Service agents are not employers for purposes of this part.

Shy Bladder- Also known as pauresis, shy bladder is a term used to describe someone who becomes fearful or anxious at the thought of urinating with others nearby.  This can present a challenge for workplace drug testing programs when urine drug testing is used.

Specific Gravity- The ratio or portion of the density of a given substance to the density of another substance used as reference.  In drug testing, the first substance will be urine while the reference substance will be water.  Normally, the specific gravity for urine when compared to water will be between 1.010 and 1.025.

Specimen Bottle- The bottle that, after being sealed and labeled according to the procedures in this part, is used to hold the urine specimen during transportation to the laboratory.

Specimen ID Number- A number assigned to each specimen by the laboratory. This number stays with the specimen it’s entire lifetime. It is used to identify and track a specimen every step from the time it arrives to the laboratory until the result is reported.

Split Specimen- In drug testing, a part of the urine specimen that is sent to a first laboratory and retained unopened, and which is transported to a second laboratory in the event that the employee requests that it be tested following a verified positive test of the primary specimen or a verified adulterated or substituted test result.

Stand-Down- The practice of temporarily removing an employee from the performance of safety-sensitive functions based only on a report from a laboratory to the MRO of a confirmed positive test for a drug or drug metabolite, an adulterated test, or a substituted test, before the MRO has completed verification of the test result.

Substance Abuse Professional (SAP)- A person who evaluates employees who have violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare.

Substituted Specimen- A specimen with creatinine and specific gravity values that are so diminished that they are not consistent with human urine.

Temperature Strip- A strip that is used to determine whether or not the urine is in the 90- to 100-degree range. This helps to ensure that tampering has not occurred.

Verified Test- A drug test result or validity testing result from an HHS-certified laboratory that has undergone review and final determination by the MRO.

Occupational Health Terms

Antigen- A substance that causes the human body's immune system to generate antibodies in response to that substance entering the body. White blood cells called lymphocytes respond to the foreign substance by generating particular antibodies that attack the antigen.

Area Noise Level Measurement- The practice used to monitor the exposure of workers to sound in the workplace. In particular, noise level measurements assess the level of unwanted sound, or noise in a specified area. Area noise level measurements are used to evaluate hazards in the workplace. This information can then be used to develop an employer's hearing conservation program. These measurements allow an employer to assess the continuous noise level that an employee working in a particular location will be exposed to during a regular 8-hour shift. A sound level meter is the device most often used to take area noise level measurements.

Audiogram- A graphic display of the hearing threshold of standardized frequencies for a specific individual. It gives a visual description of a person's ability to hear sounds at different and varying frequencies. It is also useful to show which frequencies a person is unable to hear. An audiogram can show the severity of a person's hearing loss, by showing which frequencies they cannot hear.

Audiometric testing- The act of measuring a test subject’s ability to hear sounds. During audiometric testing, pure tones are delivered to the test subject via headphones. The test is used to determine the minimum volume, or intensity, necessary for the subject to hear each tone. An audiometry test is more sensitive than a simple screening test and can detect the early stages of hearing loss.

Baseline Audiogram- In audiometric testing, provides a static reference point for future audiometric tests for a specific individual and lets a trained medical professional document any changes in hearing capabilities over time. It is used to monitor whether or not an employee's hearing level is decreasing or being maintained, so that any hearing loss can be detected early.

Baseline Testing- In medicine, this refers to any test that measures a patient's current or pre-treatment condition. In a clinical study, a baseline test would be conducted at the beginning of the study. Baseline testing results are used as a reference point for comparison to subsequent test results. Baseline testing results are useful in tracking employee wellness individually as well as measuring results in a group of an employee wellness promotion program.

Basic Metabolic Panel (BMP)- A series of blood tests that are carried out to evaluate the body's metabolism. The tests provide information on blood glucose levels, kidney function, and electrolyte and acid/base balance. It is usually conducted as part of an employee health assessment program that promotes employee wellness.

Biometric Measurements- Within the context of health and wellness, refer to information collected about an individual's physical attributes, such as height, weight, and blood type. Often called just biometrics, these measures are used for both identification and health assessment purposes.

Blood Glucose- The chemical form of sugar that is transported by the blood to each of the cells of the body. The body is fueled in part by calories derived from this sugar. In a healthy body, a normal amount of glucose is present in the blood and is processed by the cells on an ongoing basis. However, in some cases, the body fails to properly process its glucose stores or does not manufacture the right amount of glucose. This malfunction can result in a situation where an individual's blood glucose is either too high or too low.  High or low levels of glucose in the blood can cause complications ranging from fatigue, thirst, and hunger in mild situations to unconsciousness, coma, and death in extreme cases. Individuals with diabetes often experience abnormal blood glucose levels and must monitor their blood sugar regularly using a blood glucose test.

Blood Lead Test- A procedure used to determine lead levels in a substance. When used in medical diagnostics, a lead test measures the level of lead in the test subject's blood. A lead test is relatively easy to perform, requiring either a skin prick or blood draw to obtain a sample. The test is often used to determine if an individual has been exposed to excessive levels of lead which can lead to a condition called lead poisoning.

Breathing Zone- In a workplace is defined as the area closest to an employee's mouth and nostrils. The U.S. Occupational Safety and Hazard Administration (OSHA) defines the breathing zone as the area within a ten-inch radius of the worker's face. When conducting air sampling to determine whether an employee will be exposed to airborne hazards in the workplace, personal air samples may be collected within the worker's breathing zone. These levels represented by the sampling are then compared to the permissible exposure levels (PEL) for the specified substance. In many cases, this method of sampling is voluntary. However, for some substances, personal breathing zone sampling is mandatory pursuant to OSHA guidelines.  This may also be referred to as a personal breathing zone.

Chronic Pain- Discomfort experienced in any part of the body that lasts for more than 3 months. The type of pain can be intense or dull and may be continuous or intermittent. People experience chronic pain when they incur an injury or a health condition that causes the body to send pain signals to the brain well after the injury or condition has been overcome.

Clinic- A medical facility that caters to patients on an outpatient basis, addressing and treating common conditions and illnesses. Many employers are beginning to coordinate a strategic plan with certified medical personnel to integrate workplace clinics featuring traditional programs and services as an incentive for employees to adopt healthier lifestyles while, in turn, reducing general health care costs and absenteeism for the respective parties.

Comprehensive Metabolic Panel (CMP)- A panel of fourteen different blood tests that is often ordered by physicians during routine physicals and as part of workplace wellness programs. The CMP screens for issues with the liver and kidneys, electrolytes, and blood sugar, as well as health problems such as diabetes.

Department of Transportation (DOT)- A division of the United States federal government that is tasked with overseeing national transportation programs. This agency consists of several subdivisions that oversee various segments of the nation's transportation system ranging from water and roadways to air traffic.

Diagnostic Testing- Within a health and wellness context, refers to any testing used to determine the type and severity of a condition. Diagnostic testing methods are used in medicine to diagnose or detect a medical condition. Diagnostic testing may also be used to rule out the existence of a condition or determine its stage or progression.

Diagnostic X-Ray- An image of the inside of the body captured using electromagnetic radiation. Diagnostic X-Rays are called this because they are used by medical professionals to assist in the identification and diagnosis of medical conditions. X-Ray technology is used to create images called radiographs that can show blockages, tumors, broken bones, or other conditions inside the body.

Drug and Alcohol Clearinghouse- A database system established by the Federal Motor Carrier Safety Administration (FMCSA) that permits the access and retrieval of drug and alcohol testing violation(s) precluding applicants or employees from occupying safety-sensitive positions involving the operation of a commercial motor vehicle (CMV). The facility of the drug and alcohol clearinghouse is designed to enhance the protocol for cross-referencing material on a need-to-know basis about outstanding alcohol or drug abuse offenses relevant to commercial and public transit in determining job placement.

Electrocardiogram (EKG)- Refers to a standardized test that measures the electrical activity of the heart, accounting for corresponding variables relative to normal or abnormal functionality. An EKG consists of electrode placement over the bare chest to assess and calibrate the electrical pattern of rhythmic contractions responsible for filling and pumping blood in the heart. An EKG is also called an ECG.

Employee Exposure- Part of the terminology used in the U.S. Occupational Safety and Health Administration (OSHA) respiratory protection guidelines to indicate the level of exposure to an airborne contaminant that an employee would experience if not using some form of respiratory protection. These contaminants may include dust or chemical particulates, gases or fumes, or biological contaminants such as spores or bacteria.  Employee exposure is determined through air sampling and other procedures that identify the level of respiratory hazard in a particular environment.

Employee Wellness Program- Any program centering around health and fitness methodologies that companies utilize in accommodating the mental and physical health needs of their workforce. According to the Centers for Disease Control and Prevention (CDC), sedentary occupations and persistent stress can adversely impact various aspects of one's health including body mass index (BMI), cholesterol, and blood glucose levels, which in turn can lead to epidemiological health risks and emotional disturbances including anxiety, depression, and obesity.

Employer Wellness Report- A comprehensive assessment of the employer's health promotion and wellness program. The report is provided to the employer as a means of assisting the employer in making improvements to the workplace wellness program. A version supported by the Centers for Disease Control and Prevention assessing employer performance is called a Worksite Health Scorecard.

Essential Job Task- A basic function required to execute all relevant duties and tasks associated with a job position. For instance, a secretary must demonstrate typing skills as an essential job task to access, retrieve, and/or store electronic data in a computer. Job descriptions incorporate essential job tasks that serve as criterion for measuring eligibility of an employee during the hiring process. Factors that correspond to essential job tasks can include academic credentials, previous experience, auxiliary functions related to the job, and duration of time to finish primary responsibilities.

Fasting Blood Cholesterol- A blood test that is conducted after a patient has fasted. A fasting blood cholesterol test is used to detect high cholesterol, a condition that puts an individual at risk for heart disease. The fasting period for this test is usually nine to twelve hours during which time only water may be ingested. Following this fasting period blood samples are drawn and tested to determine the patient's lipid profile. The full profile will include measures of a patient's total cholesterol, low-density lipoproteins (LDLs), high-density lipoproteins (HDLs) cholesterol, and triglycerides. A fasting blood cholesterol test may be referred to as a lipid panel or lipid profile.

Fasting Blood Glucose- A test used to assess a person's blood sugar level. One of several different tests used to assess the level of glucose in the blood, the fasting blood glucose test is designed to measure a person's baseline glucose level without the interference of food or drink that would present a huge array of variables. This test is conducted after the person has refrained from eating or drinking (anything beyond water) for a period of at least 8 hours. This fasting period is required to allow the body time to fully process any consumed carbohydrates or sugars prior to testing. Fasting blood glucose is also referred to as fasting blood sugar (FBS).

Fasting Blood Test- Testing done on a blood draw after the patient has refrained from food or water consumption for several hours. The exact fasting time can vary based on the tests planned for the blood draw. Conditions such as diabetes are often looked for with a fasting blood test. A fasting blood test is often referred to as a fasting blood draw.

Fit-for-Work Testing- An evaluation conducted to determine if a particular individual may safely perform work tasks based on guidelines determined by the needs of fitness to work goals. To be fit for work, an employee must be able to perform the essential tasks of a job without endangering that individual’s health and safety or the health and safety of others. The physical, mental, and emotional state of the worker are all considered during fit for work testing. Also called fit for work testing, fitness for work testing, fit for duty evaluation, fitness for work evaluation, fit for work assessment, fitness for work assessment, or fit for duty assessment.

Fit Test- The assessment to evaluate the proficiency of a respirator's seal between the facepiece and the wearer's face by determining the amount of leakage that the seal permits. A fit test is carried out on a person who must wear a respirator in order to prevent them from inhaling toxic substances while performing their job. A fit test is often called a mask fit test.

Full and Microscopic Examination of Urine (Urine FEME)- An analysis of a urine specimen using biochemical methods as well as examination of a sample using a microscope. Separately, these two examinations are sometimes referred to as dipstick, or chemical testing, and microscopic urinalysis.

Functional Capacity Evaluation (FCE)- This refers to a compilation of tests and evaluations combined in order to determine a worker's ability to function in the required tasks and circumstances within a workplace. A functional capacity evaluation relies on comparing the health status and body functions of an employee with the requirements of the worksite.

Functional Capacity Testing- The measuring of the ability of an individual to physically perform work-related tasks. The test regimen designed to measure how well the individual will function within the workplace setting. Functional capacity testing may be conducted to determine a prospective employee’s ability to perform a job. It is also often employed to assess an employee’s residual functional capacity, or ability to return to work after an injury or disability. Functional capacity testing is also known as functional capacity evaluation (FCE) and may be part of a general medical assessment.

Graded Exercise Test (GXT)- A screening tool to track an individual's fitness level. The test evaluates the participant's exercise capacity by measuring cardiovascular response to physical activity.  Testing typically involves engaging in some kind of physical activity such as a treadmill or stationary bike with an increase in intensity at regular levels. The test is always administered with ECG monitoring and ends when an individual's maximum heart rate reaches 85% or when they feel they can no longer continue the exercise.  Graded exercise test is also known as maximal exercise test or stress ECG test.

Gripping/Grasping- This refers to the physical action of holding something in the hand. Specifically, the term refers to applying pressure to secure it between the fingers and the palm.  In vocational and employment settings, the terms gripping or grasping are used to indicate the physical demands of a particular job or capacities needed. For instance, a job that requires someone to pull a hand lever would indicate that once of the essentials physical abilities for the job was grasping. The ability to grip or grasp may be used as a qualifying factor for a job if they are essential for the performance of the job's tasks.

Health and Safety Policy- An organization's statement regarding its commitment to maintaining a safe and healthy work environment. In the United States and Canada, employers are legally required to maintain a safe and healthy workplace. An employer's health and safety policy communicates this safety commitment and obligation to each individual employee. Similar to a health and safety program, the size and scope of an employer's health and safety policy will depend on the size and needs of the particular organization.

Health and Safety Program- The action (how things actually work) of a plan or policy created by an employer to encourage the maintenance of a safe workplace. The plan may also address environmental and health policies as well. The goal of a health and safety program is to improve overall workplace health and safety within the organization.  A workplace health and safety program serves as part of the physical action called for in the health and safety policy. Each employer creates its own health and safety program as part of the health and safety policy. Thus, the elements included in a program may vary. Laws or regulations may sometimes require that an employer's health and safety program include specific features. These requirements may vary by industry or jurisdiction.  May also be called an occupational health and safety program or a safety management system.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)- A legal act that was created to make it easier for employees to transfer between jobs while still maintaining their health insurance. A comprehensive piece of healthcare legislation, HIPAA also included provisions designed to reduce fraud and abuse in the delivery of healthcare and secure the privacy and security of individual healthcare records. While all of the provisions of HIPAA have had an effect on the delivery of healthcare and provision of healthcare insurance since its enactment, the act's privacy and security provisions have perhaps had the largest impact. HIPAA requires so-called covered entities who handle or have access to individual's healthcare information to securely maintain that information and protect the individual's privacy.

Heart Rate- This defines the cyclical process of blood filling the ventricular chambers and pumping it through the circulatory system to generate motor activity. A heartbeat constitutes a single phase of diastolic and systolic interaction or the complete passage of blood to and from the heart. It’s a self-repeating process calculated by the number of heartbeats occurring within a fixed time interval, known interchangeably, as beats per minute. Although sometimes abbreviated as HR, it is much more common to see an abbreviation with a qualifying term to classify the type of heart rate such as basal (BHR) or resting (RHR).

Industrial Medicine- A field of study and practice dedicated to ensuring a safe and healthy workplace environment. In particular, industrial medicine is focused on the prevention of workplace illness. Industrial medicine professionals monitor and assess workplaces to detect and eliminate health hazards. An industrial medicine program should include process to detect and avoid chemical, physical, biological, and ergonomic hazards. Ideally, through careful attention and study, health hazards can be anticipated and prevented.

Injury Analysis- A thorough summary of all related factors connected with a particular injury sustained on the job. An injury analysis report contains pertinent information that addresses specific details including nature of injury, direct and/or indirect causes, affected part(s) of body, location area, and designated time/shifts. The Occupational Health and Safety Administration (OSHA) requires employers with more than ten employees to report all accidents, incidents, and near misses that result in injury or carry the potential for injuries.

Impact Noise- A sound that occurs as a brief interval. It is a sudden burst of high intensity sound, such as that which results from an explosion or a hammer strike. While similar, impulsive noise and impact noise are slightly different. Impact sounds are caused by the impact of two solids hitting one another. Impulsive sounds include noises that are not caused by the striking of solid objects against one another. Because of the variable nature of impact and impulsive sounds, monitoring of such noise in the workplace requires special attention. Impact noise may also be referred to as impact sound, impulsive noise, or impulsive sound.

Laboratory Testing- This refers to the process of performing any medical tests or procedures that are conducted in a controlled environment where the appropriate equipment, supplies, and certified expertise are available. Laboratory testing can be simply referred to as a laboratory test or lab test.

Lifting- This refers to the act of moving something from a position on a lower surface to a higher one. For example, a person might lift a box from the floor to a shelf. In the workplace, the act of lifting may be performed by a person or a machine. In some instances, an individual worker may use a tool or powered device to aid him or her in lifting an item.When lifting unassisted, an individual may exert effort across several of his or her large muscle groups, particularly his or her arms and legs.

Lipid Panel- A set of tests used to assess levels of lipids, or fatty substances, in the blood. Most lipid panels include a test to measure a person's total cholesterol level. The level of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) present in the blood are tested as well. Triglyceride levels are also commonly tested as part of a lipid panel.  A lipid panel may also be called a coronary risk panel, cholesterol test, or lipid profile and is often used to assess an individual's risk of developing cardiovascular disease.

Lower Extremity- One of the lower parts of the body. The hips, legs, ankles, and feet are all considered lower extremities. Each specific lower extremity has both an anatomical term and common name used to identify more precisely the part of the body being considered. A lower extremity is often at higher risk for circulation disorders in workers who must sit much of the day. The body's lower extremities may also be referred to as a lower limb.

Lumbar- A section of spine composed of the 5 lumbar vertebrae (L1-L5) and their corresponding discs in the lower back. The lumbar spine lies between the thoracic spine and the sacrum. The lumbar spine is also commonly known as the low back, or lower back. Low back pain is the most common cause of job-related disability and a leading contributor to missed work days. Low back pain causes are commonly diagnosed with an X-ray, MRI, CT scan, bone scan, or ultrasound imaging.

Magnetic Resonance Imaging (MRI)- An imaging technique that uses radio frequency waves and a magnetic field to capture a visual representation of the interior of an object. Magnetic resonance imaging is often used to create images of the inside of the human body for diagnostic purposes. Magnetic resonance imaging may also be referred to as nuclear magnetic resonance imaging.

Medical Evaluation- A comprehensive assessment of a patient's overall medical history and current condition for the purpose of identifying health problems and planning treatment. Medical evaluations may be part of an individual's routine healthcare or required under certain work related circumstances, such as an employee's return to work after an injury.

Medical Examination- Also known as a physical examination, refers to a standard health procedure to assess vital signs including blood pressure, body temperature, pulse rate, and respiration. However, other physiological variables such as fitness levels, physical capacity and stamina, and psychological soundness fall into the categorical umbrella of medical examination parameters.

Medical Surveillance- In the context of occupational health and safety, medical surveillance is a structured evaluation of employees that may have been exposed to health hazards within the scope of their job duties. This medical surveillance assessment in intended to identify any adverse health conditions due exposure to hazardous materials and situations, and will also help an employer to evaluation whether or not their current exposure prevention programs are sufficient.

Nasal Masks- Distinctive masks that fit over the bridge of the nose down to the upper lip, feeding indirect airflow through the nasal cavity from a connecting hose via a continuous positive airway pressure (CPAP) machine to facilitate breathing cycles during sleep. Many individuals prefer nasal masks given the different style of fittings available that conform to the dimensions of a person’s face combined with higher pressure settings for moderating airflow.

The National Institute for Occupational Safety & Health (NIOSH)- A federal agency established by the Occupational Health and Safety Act of 1970. NIOSH is part of the United States Department of Health and Human Services' Center for Disease Control (CDC) and is tasked with protecting the safety and health of workers within the United States. To fulfill their mandate, NIOSH works closely with other federal agencies, including the Occupational Health and Safety Administration (OSHA) and the National Occupational Research Agenda (NORA) partnership program. NIOSH initiatives address issues ranging from chemical hazards in the workplace to emergency preparedness through training, research, grant funding, and other activities.

Needs Assessment- Within the context of workplace health and safety, refers to employer standards of job performance and whether or not employees are capable of effectively meeting those standards based on an evaluative criteria. It also entails the employer asking employees what they need to better live up to those standards. Employers apply this method as a useful means to examine differences of job performance in terms of existing strategies while, potentially, introducing alternative measures to leverage optimum results.

Occult Blood Screen/Test- A process that tests a sample for the presence of blood. This type of test may be performed on bodily fluids or feces to detect blood that is not observable by visual examination. This test is used to determine if there is excess blood in the digestive tract.

Occupational Health (Occ Health)- The discipline of determining and altering anything that is detrimental to the health and well-being of a worker. It relates to the identification, assessment, and control of hazards in the workplace from hazardous chemicals, environmental factors, and operating around heavy machinery, to workers operating in noisy areas, to something as simple and second nature as the use of personal protective equipment. All of the identification, assessment, and control of hazards is used to maintain or improve the health and well-being of workers both physically and mentally on the job site. Occupational health is interchangeable with occupational health and safety, workplace health, and workplace health and safety.

Occupational Safety and Health Administration (OSHA)- A United States governmental organization that was created to introduce and enforce standards of safety measures intended to foster workplace health and covers across-the-board employers of particular fields and distinct trades. The purpose of OSHA is to define guidelines within the context of health and safety that identifies potential workplace hazards relative to environmental surroundings including equipment, ergonomics, available resources, and effective protocol management.

On-the-Job Evaluation- A method used in vocational rehabilitation and workforce development. An on-the-job evaluation takes place at the physical worksite, not a simulated environment. During the evaluation the individual being assessed with be observed to determine how well or he or she performs the essential tasks of the job.An on-the-job evaluation is usually conducted over a pre-determined period of time. Often this evaluation is a precursor to receiving a job offer. The purpose of the assessment is to determine if the individual is prepared and able to consistently perform in the workplace setting.

The OSHA 300 Log- A form that some employers covered by the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) are required to maintain as a record of serious occupational illness or injuries. In this log, employers must record and classify any illness or injury that result from exposures or events that occurred at the workplace.  Also known as the Log of Work-Related Injuries and Illnesses or OSHA Form 300.

Particulate- Within the context of workplace safety, relates to solid particles and/or liquid droplets released as composite emissions into the atmosphere from a host of various environmental factors. Some of these sources including industrial processes and operations associated to manufacturing factories (plants), automotive transportation, and even the natural element of fire. Particulate matter, or PM, consists of toxic compounds that pose overexposure from constant inhalation, absent of protective masks, over a protracted period of time.

Peak Load- This refers to using the maximal degree of physical exertion on an isolated occasion to accomplish a duty or task, usually exceeding the sustainable capacity for manual labor, placing undue biomechanical stress on the body that can cause injury. Different trades involve physically demanding positions where employees are susceptible to detrimental musculoskeletal injuries that can affect the bursae (sac lining the knee), joints, ligaments, muscles, nerves, tendons, and spinal discs, carrying significant health implications of chronic pain, inflammation/swelling, and immobility.

Performance Test- An evaluation used to assess an individual's physical performance of a task.  In some instances, an individual may be asked to perform specific motor functions or movements, such as lifting a box or turning a knob. In other cases, a performance test may be used to evaluate the individual's ability to craft a final work product. For example, an individual may be asked to stuff envelopes with uniformly folded letters and assessed on his or her ability to perform this task.  May also be called a performance assessment.

Pre-Employment Medical Exam- Part of the employment process and may include a drug test and/or a physical examination. This is ordinarily the last thing a person must have before starting a new job. While administered to assure safety in the workplace, care must be taken to avoid using the information for discriminatory purposes.

Preventive Screening- A health examination and associated testing that is designed to identify and avoid the development of future health problems. Preventative screenings may include such services as physical examinations, blood tests, or behavior and lifestyle interviews. Preventive screenings may also be called health screenings.

Pulmonary Function Test (PFT)- A clinical method used to assess the relative health of the lungs by measuring distinct factors including gaseous exchange, lung volume, total lung capacity, and airflow rate. A technician can administer pulmonary function tests to check for abnormalities in breathing patterns that might suggest either an obstructive or restrictive lung disorder. Specialized equipment such as a spirometer can help gauge the physiological condition of the lungs according to baseline metrics that indicate normal breathing cycles.

Qualitative Fit Test- (QLFT) is the testing method used to assess the effectiveness of a respirator when worn by a specific employee. This testing, known as mask fit testing, is conducted when a worker selects a tight-fitting respirator for use in the workplace. A QLFT should simulate the conditions under which the mask will be worn by the employee. Thus, it is conducted with the worker wearing the chosen mask and any other equipment he or she will wear during the work day.  During a qualitative fit test, a worker wearing the selected respirator is exposed ambient air containing a non-toxic airborne contaminants. U.S. Occupational Safety and Health regulations allow testers to use one of four substances for qualitative testing. Each of the substances is designed to trigger a sensory reaction if it enters the wearer's airways through a leak in the face to mask seal of the respirator. Isoamyl acetate has a fruity aroma that a worker will be able to smell. Saccharin solution carries a sweet taste that can be detected when inhaled. Bitrix has highly noticeable a bitter taste. A fourth alternative, stannic chloride, is an irritating smoke with a strong odor.

Quantitative Fit Test- (QNFT) is one type of mask fit test used to determine whether a respirator properly fits an individual employee. Mask fits tests are used with tight fitting respirators to ensure that equipment fits the wearer properly. Without a proper fit, ambient air can leak into the mask and expose the wearer to airborne contaminants. A quantitative fit test (QNFT) is performed by collecting and analyzing air samples from within the respiratory inlet cover of the respirator while it is worn by the intended user. This collection is accomplished through use of a hose inserted into the face piece of the mask, which then delivers the air sample to a separate device for analysis. This testing procedure results in a numeric value for the level of contaminants within the mask. By comparing this number to the concentration of the contaminant outside the mask, a fit factor can be calculated. This number should indicate if and at what level any leakage exists when the worker is wearing the mask.  A quantitative fit test differs from a qualitative fit test because the latter relies on subjective feedback from the wearer to detect potential leaks.

Recordable Hearing Loss- A hearing loss that is required to be reported in the OSHA 300 Log pursuant to federal law. The Occupational Safety and Health Administration (OSHA) regulations define when a shift in hearing capacity must be recorded and tracked as a part of an employer's hearing conservation program. In general, recordable hearing losses are those that would indicate a problem with the employer's workplace hearing conservation program or a problem with individual employee's exposure to on the job hearing hazards.

Respiratory Inlet Covering- The part of a respirator that forms the barrier of protection between the ambient air and the wearer's airway. Any air inhaled by the wearer of the respirator will pass through this inlet covering.  In some instances, the covering is designed to allow ambient air to pass through and be filtered by the covering. In other instances, the inlet includes a hose or tube that supplies safe air to the respirator. Respiratory inlet coverings may take many shapes. The U.S. Occupational Safety and Health Administration (OSHA) refers to the entire apparatus that seals the wearer's airway against incursions of ambient air as the respiratory inlet covering. Some commonly used coverings include sealed face pieces, full hoods, helmets, or just a mouthpiece with a nose clamp.

Rest Allowances- Scheduled breaks designed to permit an employee to recover from fatigue during the work day. The time allotted for rest allowances is usually included in the job design and are usually in addition to scheduled lunch or other breaks that may be mandated by regulation. A failure to provide for rest allowances can result in the loss of productivity and injuries due to fatigue. Rest allowances are also called fatigue allowances or work-rest allowances.

Safety-Sensitive Position- This refers to a job in which the employee is responsible for his or her own or other people's safety. It also refers to jobs that would be particularly dangerous if performed under the influence of drugs or alcohol. Safety-sensitive positions are often the focus of drug and alcohol testing.

Shift Work- A work schedule that requires an employee to be on duty during a time other than the traditional work day. In the United States, the normal work week is considered to be Monday through Friday during daylight hours. A person who works a night shift, or other schedule outside these normal work hours is said to be doing shift work. Shift work is may also be written as shiftwork.

Spirometer- A device for measuring the volume of air in the lungs. This determines pulmonary health by examining four subunits of lung volume control including tidal volume, expiratory reserve volume, inspiratory reserve volume, and residual volume. Technicians apply spirometers for making comparative analyses of regular and irregular breathing patterns, which translates to the cardiopulmonary capacity of the lungs and any determinant factors that predispose people to certain health risks, especially in the workplace.

Spirometry- More specifically, spirometry as it relates to occupational health and safety, it is used to test to ensure that a worker is not getting sick from exposure to chemical or material substances at a workplace. Spirometry is a common pulmonary function test (PFT) that measures how quickly and how much air a person can inhale and exhale in one forced breath. Spirometry is used to diagnose pulmonary conditions that can affect normal breathing. Patients are required to inhale to their top lung capacity and exhale through the mouthpiece as fast and forcefully as possible until their lungs are emptied. In the context of occupational health, spirometry testing is required to determine personal protective equipment compatibility and the assessment of health-risk exposure environments. Safety standards require a spirometry testing for workers who work at risk of exposure of harsh chemicals or material as part of medical surveillance.

Spirometry Test- A report that is used for pulmonary analysis in patients to determine lung functionality. The test reports are formatted as graphs with variable factors arranged in columns that allows physicians to interpret results easily by cross-referencing between normal test values and actual test values from their patients. Spirometry test reports consists of a basic formula to calculate measurements including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and the FEV1-to-FVC ratio, which represents the total percentage of air released one second. This is the standard model applied when observing for abnormalities or changes in the lungs prior to making a proper diagnosis.

Treadmill Test- A clinical evaluation tool used to assess a person's cardiovascular strength. The treadmill test requires a person to engage in exercise such as walking on a treadmill while their heart rate and blood pressure are monitored. Treadmill tests are used to place physical stress on the heart through exertion. This additional burden sometimes reveals heart abnormalities or conditions that are not detected when a person's heart is monitored while at rest.  Also known as a treadmill stress test, exercise stress test, or simply a stress test.

Tight-Fitting Face Piece- The part of a respirator that fits against the face of the wearer. A respirator with a tight-fitting face piece is a type of personal protective equipment (PPE) that protects an individual against exposure to airborne hazardous agents. To be effective, this face piece must form a complete seal against the face of the wearer, preventing ambient air from entering the space within the face piece. Any leakage around the edges of the face piece will permit air from the environment to enter the mask and puts the wearer at risk for exposure to airborne hazards.  Tight-fitting face pieces are most often made of durable, flexible materials such as silicone, neoprene or natural rubber. Usually, a harness or strap is used to hold the face piece in place.

Tinnitus- A condition that causes unwanted sounds that without an outside source of the sound. Although the sound is internal, it may appear to the sufferer to be distant in origin in some cases. There are two types of tinnitus: subjective and objective. Subjective is when only the person experiencing it can hear it. Objective tinnitus however, can be heard by a medical professional during an examination as this type of tinnitus is caused by a physical event such as by turbulent blood flow, malformed vessels, or a growth of some sort.

Upper Extremity- An anatomical term referring to those body parts comprising the upper limbs. Upper extremity can include the shoulder, arm, forearm, wrist, and hand. The upper extremities are particularly vulnerable to repetitive motion injuries and injuries from poor posture. The term upper limb is sometimes used to refer to the body's upper extremity.

User Seal Check - A procedure that is performed to confirm that a tight-fitting respirator is adequately sealed against the face of the wearer. Each wearer of this type of personal protective equipment (PPE) must perform a user seal check whenever he or she puts on a tight-fitting respirator. During a user seal check, the wearer will assess the adequacy of the mask face piece's seal. The seal check may be performed using a positive or negative pressure check as prescribed by U.S. Department of Labor standards or the procedure recommended by the respirator's manufacturer.

Work Practices- This refers to the execution of specific duties and tasks related to a job description, leveling potential hazards or risk factors that can compromise health and safety standards. Employers may conduct a job safety analysis (JSA) or hazard risk assessment (HRA) as a means to identify, develop, and implement safe work practices within the framework of different job sectors where various hazards may exist.

Workplace Health Program- The term refers to all of the activities, policies and programs executed by an employer to meet the health and safety needs of its workforce. A workplace health program encompasses the workplace’s specific health promotion programs, benefits provision, health promotion facilities or resources, employer and community supports, and all other activities related to workforce health. A workplace health program may sometimes be referred to as a comprehensive workplace health program, a wellness and health promotion program or worksite health promotion.

Work Capacity Evaluation (WCE)- A tool used to measure the functional ability of a person to perform a work-related series of tasks on a safe and dependable basis. The test is typically done in one day, however a two day test can be utilized when appropriate. The goal of a WCE is to objectively evaluate the abilities of a worker, typically someone with medical impairment, to perform work tasks as well as activities of daily living. If the person's impairment affects their ability to perform meaningful tasks, this would be called a functional limitation. A WCE also evaluates the consistency of effort and symptom reports during the assessment. This combination allows the evaluator to answer these questions; "What can the worker physically do right now?", "What is the worker's potential for work?" and "Did the worker try their best?". Work capacity evaluation is also known as a functional capacity evaluation or a functional capacity test.

Work Recovery Cycles- Work practices that provide a balance between high and low exertion tasks. Alternating between tasks that involve high and low physical demands should allow a worker's muscles to recover and therefore reduces fatigue in the workforce. Failure to provide for recovery periods within the work cycle may lead to injury or loss of productivity.

Work Tolerance Screening- A method used to assess an individual's ability to perform a specific job. During a work tolerance screening an individual will be subjected to the same conditions as he or she would be subjected to when performing the targeted job. The environment, physical demands, and pace of the job are all replicated in the screening.  These screenings may also be performed in a vocational training setting to determine a person's employability. This assessment may also be used to evaluate current or prospective employees for proper job placement within a company or department. Work tolerance screenings may also be used to determine whether an injured employee is fit to return to work after rehabilitation.  Physical or emotional reasons why an employee is not suitable for a specific job may also be identified during this process.  Work tolerance screening is sometimes referred to as work tolerance testing or a work hardening assessment.

Worker's Compensation (worker’s comp)- A type of government mandated insurance that employers provide for their employees. This insurance is designed to provide financial compensation if a worker suffers a work related injury or disability that results in time away from work. The compensation from this type of insurance is designed to assist with making up for lost wages and assist with making medical payments.

The World Health Organization (WHO)- An agency that was created April 7, 1948. WHO strives to improve public health and public health services worldwide within the United Nations' system. It primarily focuses on promoting health across the globe through education about, surveillance of, and response to disease outbreaks.

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