FAQ’s

FAQ's - Spirometry Assessments

Spirometry is a non-invasive pulmonary function test (PFT) that uses a device called a diagnostic spirometer to measure the volume of air that a person can forcefully expel from their lungs, and how quickly, after inhaling as much as possible.

 

A spirometry assessment is used to evaluate lung function and diagnose lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and other chronic and acute respiratory lung conditions and diseases. It is the primary, and most basic, method of assessing overall respiratory (lung) function, and results of the spirometry assessment may be used as the basis for referring an individual for more sophisticated testing procedures.

 

In terms of general health assessment, there are a number of symptoms or medical conditions that may warrant the use of a spirometry assessment. Medical professionals may use spirometry to:

  • assess the severity of shortness of breath,
  • assess current or former smokers aged 45 and over for COPD,
  • properly classify a case of COPD (i.e., determine which respiratory disease is the root cause of the COPD, e.g., chronic bronchitis, idiopathic pulmonary fibrosis (IPF) and/or emphysema)
  • medically manage individuals with asthma or COPD – i.e., monitor disease progression, and evaluate response to treatment, medication and/or respiratory therapy

In terms of occupational health assessment, spirometry is an important tool in fitness for duty assessments, where it is used to establish an individual’s baseline level of respiratory function and assess an individual’s fitness to wear personal protective equipment (PPE), such as respirators. Spirometry also forms an integral part of many continuous workplace health monitoring programs, where it is the primary tool for surveillance of occupational lung diseases such as asbestosis, mesothelioma, coal workers’ pneumoconiosis (CWP) and silicosis. In industries such as mining, manufacturing, construction, and warehousing, where employees are routinely exposed to respiratory risk factors in the work environment, yearly spirometry assessments provide employers with a simple and effective means of monitoring an employee’s respiratory health over time.

 

A diagnostic spirometer is a portable or stationary medical device that is used to measure lung function. The spirometer is operated by a healthcare professional who is specially trained in proper testing procedures and techniques to produce a more reliable and consistent result – this is particularly important where results of spirometry assessments are to be used comparatively to track an individual’s lung function over time.

 

Each spirometry assessment is completed in approximately 10 minutes.

 

A spirometry assessment will produce results against a set of parameters, the three most important of which are FVC, FEV1 and the FEV1/FVC ratio.

FVC

FVC stands for Forced Vital Capacity and this parameter equates to the maximum volume of air that can be forcibly exhaled from the lungs after having inhaled as deeply as possible. This parameter indicates lung volume and is intended to detect any restriction in lung function – the average FVC result for an elderly man is around four litres; a lower FVC indicates that the individual isn’t able to inhale deeply or exhale completely.

FEV1

FEV1 stands for Forced Expiratory Volume in 1 second, and this parameter equates to the maximum volume of air forcibly exhaled over the first second of the assessment. Typically, in individuals with normal lung function, around 75% of an individual’s lung volume can be exhaled during the first second of the spirometry test. This parameter reflects the mechanical properties of the large and medium sized airways and is intended to measure the extent of any airway obstruction – the average FEV1 result is two to four litres; a lower FEV1 result indicates a more severe obstruction.

FEV1/FVC ratio

This parameter is the ratio of FEV1 to FVC, expressed as a percentage. It is expected that the FEV1 parameter will equate to between 65 and 85 percent of the FVC parameter, but the “normal” range of the FEV1/FVC ratio is determined by the individual’s age. The ratio assists with distinguishing obstruction from possible restriction when FEV1 is reduced.

 

The diagnostic spirometer will produce a graph (flow volume loop) as the spirometry test is performed, and a healthcare professional will be able to interpret that graph to decipher the results of the test and produce a respiratory function report. The shape of an individual’s flow volume loop is dependent upon the mechanical properties of the lungs, and can assist in the diagnosis of respiratory dysfunction.

The respiratory function report, compiled on the basis of graph produced by the diagnostic spirometer, will provide an evaluation of overall lung function and give an indication of where existing or potential problems may lie, for example, whether there is any kind of obstruction or restriction that is preventing an individual from fully inhaling or exhaling, and the severity of the identified issue. The report is provided so that individuals may follow up any issues with their personal healthcare professional, and so employers have a comprehensive record of the spirometry assessment that can be retained in the employee’s occupational health record for retrospective comparison following future assessment/s.

 

Yes. Hayden Health & Safety require photographic identification from each individual who presents for a spirometry assessment.

If an individual is being tested as part of an on-site assessment process and they are unable to provide photographic identification, the individual’s supervisor or manager will be required to complete a written statement (declaration) confirming the individual’s identity.

 

Yes. Because of the nature of the assessment process, Hayden Health & Safety requires individuals to disclose any pre-existing lung conditions, their smoker status, and use of any medically prescribed or over-the-counter drugs prior to undergoing the spirometry assessment.

While generally considered to be safe, high airway and intrathoracic (inside your chest) pressures are generated during the test, so there are certain situations in which a spirometry assessment is not advisable. Individuals should also advise the testing technician if they are aware of any health or medical conditions that may cause difficulty with, or prevent, their safe completion of the assessment. Such conditions may include high blood pressure, unstable angina, a recent heart attack, recent eye, abdominal or thoracic surgery, suspected or confirmed communicable infectious disease, e.g., COVID-19, influenza or tuberculosis.

 

Yes. There are several things individuals should and should not do when preparing for a spirometry assessment. These include:

  • Try not to take any inhaled medications, especially short acting (for 4–6 hours) and long acting (for 12–24 hours) bronchodilators (e.g., Ventolin) prior to the assessment
  • Do not smoke or perform strenuous exercise on the day of the assessment
  • Do not consume alcohol or eat a large meal within the 4 hours prior to the assessment
  • Wear unrestrictive, loose clothing during the assessment

 

Hayden Health & Safety recommends that individuals who are required to have a pre-employment spirometry assessment be referred to our clinic, conveniently located in Gateshead NSW.

Where you require several employees, or all workers at your worksite, to undertake a spirometry assessment, and you’d like to be able to schedule the assessments in such a way that they cause the least amount of disruption to your workforce (e.g. have all assessments done in one session/on one day), Hayden Health & Safety recommend on-site testing. Our mobile testing vehicle and accredited testing technician/s can come to your site, anywhere in NSW, and provide you with timely, efficient and non-disruptive spirometry assessment services as required.

 

1. Contact us

Contact Hayden Health & Safety to discuss your organisation’s needs and arrange a suitable time for assessment/s to be conducted.

2. Prior to the assessment date

Where the testing process is a planned or routinely scheduled, a Hayden Health & Safety testing technician will contact you to discuss the testing process, answer any further questions you might have and confirm the following details:

  • Date and time of the testing
  • The location for the testing (e.g., on-site or at Hayden Health & Safety premises)
  • Any PPE and site induction requirements for the Hayden Health & Safety testing technician/s
  • The number of employees to be assessed
  • Key stakeholder contact details (e.g., site supervisor, project manager, safety representative, etc.)

3. On the day of the assessment

If assessments are to be performed at your worksite, the fully accredited Hayden Health & Safety testing technician/s will arrive at your workplace in our specially designed, fully contained mobile testing vehicle at the appointed time. Employees can then be directed to our testing vehicle in a systematic way that enables your business to continue to operate with minimal disruption.

If an assessment is to be conducted at Hayden’s office premises, the individual should arrive at our office 10 minutes prior to the scheduled appointment time, to allow for completion of required paperwork.

NB There are specific preparation instructions that must be followed by individuals being assessed – see above for more information.

4. After the assessment process

The spirometry assessments performed by Hayden Health & Safety provide instant results, so individuals can be provided with their results immediately.

If only one employee is being assessed, your organisation’s key stakeholder contact will be given a report at the conclusion of the assessment.

If you have arranged for more than one employee to be assessed in one session, the Hayden Health & Safety testing technician/s will provide your organisation’s key stakeholder contact with a summary report of the results returned for each individual we have tested, upon completion of the assessment process.

 

FAQ's - Drug and Alcohol Testing

In Australia, some occupations such as rail, transportation and construction, are subject to mandatory drug and alcohol testing. However, regardless of the nature of your business, it is legal for an employer to conduct random or scheduled workplace drug testing of their workforce, provided the employer has a comprehensive drug and alcohol testing policy in place before testing procedures are implemented.

As an employer you have a responsibility to ensure the safety of your workplace and take reasonable care of all workers. In performing this duty of care, and where you have comprehensive workplace drug and alcohol testing policy in place, you have the right to require drug and alcohol testing for your workers, provided the reasons are justifiable and the parameters of your drug and alcohol policy are applied consistently and fairly.

To ensure your organisation isn’t subject to legal claims related to unfair treatment or dismissal on the basis of inadequate workplace drug and alcohol testing policies or education, employees should receive information and education on the workplace drug and alcohol testing policy and its parameters, including the types of testing they may be subjected to, when they may be tested, how the results will be used and what the ramifications will be in the event they refuse a drug and alcohol test or return a positive test result.

 

Employers have a legal responsibility to provide a safe workplace and ensure the safety of all employees. In performing this duty of care, an organisation has the right to develop and implement a workplace drug and alcohol testing policy that may reasonably require prospective or current employees, or contractors attending your worksite, to undergo the following kinds of testing procedures:

  • Pre-employment – testing an individual before they begin employment with your organisation
  • Blanket testing – testing all employees, or everyone at your worksite, in one session
  • Random testing – testing a randomly selected proportion of workers
  • Suspicion or For-cause testing – testing one or more employees when a supervisor has concerns for their behaviour or, for example, if drugs or alcohol are found on-site
  • Post-incident (near miss) or post-accident – testing one or more employees after an accident or near-accident
  • Return-to-work – testing an employee who has previously returned a positive test result and is required to return a negative test result before being allowed to return to the work site or resume normal duties

 

Broadly speaking, employers can test employees for a range of stimulants or depressants – both legal and illegal – as part of a standard drug and alcohol screening process.

Stimulants are substances that act to speed up the activity of an individual’s central nervous system (CNS), including the brain, and tend to elevate a person’s mood and promote wakefulness. Depressants, also known as relaxants, are substances that act to slow down the activity of the CNS and are often effective in lessening a person’s perception of pain and helping to relax muscles and induce sleep.

While these drugs are often safe and useful when prescribed by a doctor and used as directed, they also have a number of negative and potentially dangerous side-effects – especially when used in the workplace.

Standard oral and urine drug screening tests for:

  • Amphetamines – both legal (e.g., dextroamphetamine, prescribed by a doctor for treatment of conditions like ADHD) and illegal (e.g., ‘Speed’)
  • Methamphetamines – for example, MDMA (‘Ecstasy’) and crystal meth (‘Ice’)
  • Cocaine
  • Benzodiazepines – for example, Valium (diazepam) and drugs used in sleeping tablets (e.g., temazepam)
  • Opiates – including legal but restricted drugs, such as prescription pain relief medications like codeine, oxycodone (e.g., Endone), and morphine, and illegal drugs such as opium and heroin
  • THC (Marijuana or Cannabis)

It is important to note that non-negative test results may be returned for other substances found in medications that can be bought over the counter at a pharmacy, such as pseudoephedrine (found in some cold and flu preparations and medications such as Sudafed) and cough mixture.

Alcohol is the most commonly used depressant substance. Some occupations are subject to standard legal requirements for blood alcohol concentrations, such as those employed as professional drivers and in other transportation industries. However, regardless of the industry in which your business operates, provided your organisation’s workplace drug and alcohol policy clearly stipulates acceptable blood alcohol concentrations in the workplace and the justifiable parameters under which testing operates, employers can reasonably require workplace alcohol testing.

 

Each test procedure is completed in approximately 10-15 minutes.

In the event that an employee returns a positive breath alcohol test result, additional time will be required as a further testing process is necessary. For more information on this, see What happens if an individual returns a positive breath alcohol test result?

Where an employee returns a non-negative drug test result, additional time will be required to prepare the specimen for laboratory testing and alert the appropriate organisational contact/s. For more information on this, see What happens if an individual returns a non-negative or positive drug test result?

 

Yes. Hayden Health & Safety require photographic identification from each individual who presents for drug and alcohol testing.

If an individual is being tested as part of an on-site workplace drug and alcohol testing process and they are unable to provide photographic identification, the individual’s supervisor or manager will be required to complete a written statement (declaration) confirming the individual’s identity.

 

As noted above, it is possible for an individual to return non-negative or false positive test results due to use of either prescribed or non-prescribed medications, or a combination of both. Because of this, Hayden Health & Safety requires individuals to disclose their use of any medically prescribed or over-the-counter drugs prior to undergoing their instant drug test.

 

Yes. In Australia, an employee has the right to refuse a request to have a drug and/or alcohol screening test.

However, in the event that the employee declines to be tested, and your workplace drug and alcohol policy clearly outlines your organisation’s position on drug and alcohol screening, or the individual’s employment contract clearly states that they are obligated to undergo justifiable drug and alcohol screening as required, the individual can be subject to disciplinary action or even dismissal.

For this reason, it is critical that your organisation’s drug and alcohol policy specifies the action that will be taken should an employee refuse a drug or alcohol test.

 

Hayden Health & Safety recommends that individuals required to undergo pre-employment, for-cause or return-to-work testing, be referred to our clinic, conveniently located in Gateshead, NSW.

Where you require blanket testing of all workers at your worksite, in one session; testing of a randomly selected proportion of your workforce; or testing of several employees in a for-cause situation (e.g., if drugs or alcohol are found on-site), or post-incident (near miss) or post-accident, Hayden Health & Safety recommend on-site testing. Our mobile testing vehicle and accredited testing technicians can come to your site, anywhere in NSW, and provide you with timely, discrete and non-disruptive drug and alcohol testing services as required.

 

Alcohol breath test

Alcohol breath testing is a fast, easy and reliable means of screening workers for recent alcohol use.

Hayden Health & Safety uses Type-2 hand-held electronic testing devices to conduct breath alcohol screening, in line with Australian Standard AS 3547:2019 – Breath Alcohol Testing Devices. Where an individual returns a positive result on a breath alcohol test, our testing technicians require the individual to wait in the testing area and a second breath alcohol test is conducted after 20 minutes. A positive breath alcohol reading must be confirmed by a second positive reading on a re-test in order to provide the employer with a legally defensible result.

Urine drug test

Urine drug testing is the most widely used form of workplace drug use testing, due to the relative ease of sample collection and the ability to obtain almost instant results. Metabolites of most basic drugs tested for in workplace drug screening tests can remain detectable in urine for up to 5 days after use – and marijuana (THC) can remain detectable for up to 30 days.

All facets of Hayden Health & Safety’s urine drug test process comply with the requirements of Australian New Zealand Standard AS/NZS 4308:2008, to ensure we collect and analyse an uncompromised specimen without overly impinging on the privacy of the individual being tested. Where the person being tested returns a non-negative result on a urine drug screen, our testing technician follows proper chain of custody procedures, ensuring the integrity of the specimen, to refer it for full and complete confirmatory testing at our NATA-accredited laboratory.

Oral drug test

Oral drug testing (also called ‘oral fluid testing’ or ‘saliva testing’) allows for non-invasive specimen collection and almost instantaneous results that show similar drug concentrations to blood plasma, making it a good testing option if evidence of very recent drug use is sought.

Hayden Health & Safety conduct our oral fluid testing processes in full compliance with Australian New Zealand Standard AS/NZS 4760:2019 Amd 1:2020. Where the person being tested returns a non-negative result on a urine drug screen, our testing technician follows proper chain of custody procedures, ensuring the integrity of the specimen, to refer it for full and complete confirmatory testing at our NATA-accredited laboratory.

Hair follicle testing

Hair follicle testing involves collecting a sample of hair from the head or body, which is then packaged according to specific guidelines and sent for laboratory testing. The laboratory performs a rapid-detection test (ELISA, or enzyme-linked immunosorbent assay) to obtain an initial result, which is then confirmed by a different, more in-depth laboratory test (gas chromatography-mass spectrometry).

Because of its inability to give instant results at the point of testing, hair follicle testing is not routinely used as a fitness for duty screening tool in the same way that urine, breath and saliva testing are. However, it is the only drug testing method that is able to detect drug use over the preceding 90 days, making it the ideal choice for identifying long-term use or misuse of illicit drugs or prescription medications.

 

There are important differences to consider when deciding on which type of instant drug testing to use. Perhaps the most important consideration is the purpose for which the testing is being conducted – that is, is your business using instant drug testing to identify potentially risky behaviours/habits and detect longer term or ongoing drug use? Or are you determining your workers’ current fitness for duty?

Oral fluid testing considerations

Oral fluid concentrations of basic drugs such as amphetamines, cocaine, some opioids and marijuana are similar or higher than those in blood plasma, meaning that oral fluid testing for these drugs is able provide an indication of very recent use. For example, amphetamines and cocaine can be detected in saliva within 5 to 10 minutes of a person taking the drug, and opiates and marijuana are generally detectable within around 1 hour (depending on the frequency with which an individual uses a drug and the concentration/purity of the drug taken).

Oral fluid has been seen as a non-invasive alternative to blood and as an alternative to urine when substitution or adulteration is suspected. However, despite recent advances in technology which allow testing to be performed on relatively small samples, the fact remains that physiological and environmental factors can affect an individual’s ability to produce a sufficient quantity of saliva for testing in an adequate timeframe, which may require the collection of an alternative specimen (e.g., urine) anyway.

Another potential downside of oral fluid testing is the window of time within which basic drugs are detectable. While amphetamine and its derivatives are generally detectable for 72 hours (3 days) after use, cocaine and opioids are only detectable in saliva for as little as 12 to 24 hours. Marijuana (THC) is detectable in saliva for a period of around 12 hours – there is significant local absorption of the drug in the oral cavity, which substantially increases THC concentrations in saliva for a period after use, however elimination from oral fluid occurs relatively quickly meaning that the window for detection is quite small. (NB again, these detection window timeframes are dependent on the frequency with which an individual uses a drug, and the concentration/purity of the drug used)

Urine testing considerations

The basic drugs tested for using urine specimens take longer to accumulate in concentrations large enough to be detectable in an instant drug screening process. For example, amphetamine and its derivatives, cocaine, opiates and marijuana all require between 2 and 5 hours before being detectable in urine (again, depending on the frequency with which an individual uses a drug and the concentration/purity of the drug taken). Longer minimum detection time means that urine testing may not always be ideal for establishing a worker’s fitness for duty immediately prior to starting work, or even for detecting drug use on the day of testing.

While urine is also a non-invasive alternative to blood testing, it may be argued that its results are more easily compromised than any other form of testing, due to the potential for substitution or adulteration of the specimen. However, more tightly controlled collection procedures have reduced opportunities for both substitution and adulteration, and more recent advances in testing technology mean that compromised samples are more readily identifiable.

A potential benefit to be had from urine testing is the duration of time for which basic drugs are detectable. Amphetamines, cocaine and opioids are detectable for at least 2 days – and, sometimes, for as long as 4 to 5 days – after use. Marijuana (THC) is detectable in urine for a much longer period of time, i.e., anywhere from 15 to 30 days following its use. (NB as with oral fluid testing, these detection window timeframes are dependent on the frequency with which an individual uses a drug, and the concentration/purity of the drug used)

Hair follicle testing considerations

While not generally used as a standard drug screening tool – due to the nature of the testing and analysis process – hair follicle testing may be considered an excellent testing option for identifying long term substance abuse and risky behaviours in individuals whose actions or behaviour have given an employer cause for concern over a period of time, or prior to making an offer of employment.

Although collection is time consuming and results cannot be provided instantly, with its ability to detect illicit drug use and misuse of prescription medication over the preceding 90 days, it is the most effective means of screening individuals for longer term drug abuse. Hair follicle testing is also limited in scope by its inability to detect very recent drug use, and its potential to miss longer term but infrequent drug use.

 

The standards that govern workplace drug and alcohol testing may return one of three results: negative, non-negative or positive. A non-negative result equates to an initial positive result returned on an approved instant drug testing/screening device, using a sample collected, handled and processed by an accredited testing technician. An initial positive result cannot be confirmed positive by an instant drug screening device.

A sample that returns a non-negative result is then prepared by the testing technician according to chain of custody requirements and forwarded to an accredited external laboratory for confirmatory pathological testing. Importantly, not all non-negative results on instant drug screens are indicative of illicit drug use. There are many prescription and over-the-counter drugs that may cause a non-negative result to be returned, but pathological laboratory testing should be able to differentiate between illicit substances, misuse of prescription or over-the-counter medications and legitimate use of a declared medication.

 

Where a non-negative result is returned on an initial drug screening/testing device the following process will be followed by Hayden Health & Safety:

  1. The employee or contractor will be asked to remain in the testing area
  2. The Hayden Health & Safety testing technician will contact your key testing stakeholder or site contact (this may be, for example, your site safety officer, project coordinator/manager, site supervisor, or WHS representative)
  3. The Hayden Health & Safety testing technician, following the legally required chain of custody process, will prepare the sample for transport to our NATA-accredited laboratory for confirmatory testing
  4. Your key stakeholder or site contact will follow your organisation’s drug and alcohol and fitness for duty policies in determining the next steps for managing the employee/contractor

 

Where laboratory testing returns a positive result, it is confirmation that the sample contains levels that meet or exceed the detectable or allowable level for that particular drug class, as defined in the Australian Standards. Although the laboratory report accompanying a confirmed positive result will indicate whether the result is due to legitimate use of a declared medication, concerns may still exist around the effect of that medication on the employee’s fitness for duty. Again, actions your organisation takes in response to a confirmed positive drug test result will be determined by your organisation’s drug and alcohol and fitness for duty policies.

 

Where a positive result is returned on a breath alcohol test the following process will be followed by Hayden Health & Safety:

  1. The employee or contractor will be asked to remain in the testing area
  2. The Hayden Health & Safety testing technician will contact your key testing stakeholder or site contact (this may be, for example, your site safety officer, project coordinator/manager, site supervisor, or WHS representative) to advise them of the result and will request their attendance in the testing area
  3. A second breath alcohol test will be conducted 20 minutes after the first breath alcohol test
  4. If the second breath alcohol test again returns a positive result, an evidential breath screen will performed and a declaration signed by both the employer or contractor and the key testing stakeholder or site contact
  5. Your key stakeholder or site contact will follow your organisation’s drug and alcohol and fitness for duty policies in determining the next steps for managing the employee/contractor

 

While Hayden Health & Safety don’t personally offer drug and alcohol training or information sessions, we partner with a leading provider of specialist Work Health & Safety (WHS/OHS) service, Risk and Safety Solutions.

Chris Hadrill, Managing Director of Risk and Safety Solutions, has over 25 years’ experience in WHS and Risk Management, across a wide range of industries including mining, transport, manufacturing, construction and infrastructure.

Risk and Safety Solutions’ consultants have extensive experience in all facets of WHS, with an extensive history of developing efficient and effective solutions for organisations throughout NSW and the ACT, and are perfectly placed to advise and assist your organisation with:

  • provision of training to management and staff on drug and alcohol use and fitness for duty requirements, policies and procedures
  • drug and alcohol policy and procedure development

 

Risk and Safety Solutions also provide a wide range of other WHS-related services, which may also be of benefit to your organisation.

Hayden Health & Safety can highly recommend you contact Risk and Safety Solutions for assistance with all your WHS needs.

 

While Hayden Health & Safety don’t personally offer organisations assistance with development of drug and alcohol policy and procedures, we partner with a leading provider of specialist Work Health & Safety (WHS/OHS) service, Risk and Safety Solutions.

Chris Hadrill, Managing Director of Risk and Safety Solutions, has over 25 years’ experience in WHS and Risk Management, across a wide range of industries including mining, transport, manufacturing, construction and infrastructure.

Risk and Safety Solutions’ consultants have a wealth of experience in all facets of WHS, with an extensive history of developing efficient and effective solutions for organisations throughout NSW and the ACT, and are perfectly placed to advise and assist your organisation with:

  • development of drug and alcohol policy and procedures appropriate to your business
  • development of risk management processes
  • WHS risk assessments
  • provision of training and information sessions for management and staff on your organisation’s drug and alcohol and fitness for duty policies

 

Risk and Safety Solutions also provide a wide range of other WHS-related services, which may also be of benefit to your organisation.

Hayden Health & Safety can highly recommend you contact Risk and Safety Solutions for assistance with all your WHS needs.