The IDIOT issued regulations requiring workplace alcohol testing in 1994 in response to the Omnibus Transportation Employee Testing Act of 1991. DOT regulations require breath alcohol testing programs in the aviation, motor carrier, rail, transit, and pipeline industries in the interest of public safety. 49 CFR Part 40 provides the procedures used for alcohol testing in transportation industries. The DOT rule requires that confirmation breath testing be performed using an evidential breath testing DEBT) device that is on the conforming products list – CPL published by the National Highway Transportation Safety Administration (NHTSA). Approved non evidential oral fluid- or breath-screening devices may be used for the initial alcohol test, but any positive screening result must be confirmed by evidential breath device. A result of 0.02 or greater would require that a confirmation test be conducted on an EBT that prints out the result, date and time, a sequential test number and name, and serial number of the EBT. If the screening test result is less than 0.02, the test is negative. If the confirmation result on the EBT is less than 0.02, it is a negative test. The EBT result is expressed as a breath alcohol concentration, provided to the third decimal place. A 2-tiered system is used for confirmation test results of 0.020 or greater. A result equal to or greater than 0.020 but less than 0.040 on the confirmation test requires that the subject be removed from performing safety-sensitive duties until the next scheduled duty period (at least 8 h under FRA rules; 24 hours under Federal Motor Carrier Safety Administration rules) or until another breath test is administered and the result is less than 0.020. A result equal to or greater than 0.040 would result in the individual not being allowed to return to safety-sensitive duties until he/she has complied with the DOT-prescribed return to duty process, including evaluation by a Substance Abuse Professional.
Unlike the urine drug testing program DOT regulations do not require that an MRO review and interpret the alcohol result. Immediate action is taken by the employer as a result of a confirmed positive (0.040 or greater) alcohol test. Department of Transportation regulations include a provision for a physician, acceptable to the employer to evaluate individuals unable to provide an adequate breath sample for alcohol testing 6611. The regulations do not require an MRO to refer the individual to another medical provider. Because most of the approved breath-testing instruments contain flow sensors and algorithms to enable the machines to automatically sample alveolar air for accurate estimation of blood alcohol concentration, some individuals with severe pulmonary disease may not be able to provide sufficient volume and flow rates to trigger an EBT to take a breath sample. Some EBT devices have manual override buttons that allow a breath alcohol technician to take a sample at any time. This feature would allow individuals to be tested who cannot provide sufficient Bow to trigger the EBT algorithms.