Pre-employment urine drug screening: examining trends in THC-COOH positivity rates post-legalization of recreational cannabis in California - a retrospective review.

IF 2.7 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Occupational Medicine and Toxicology Pub Date : 2025-09-08 DOI:10.1186/s12995-025-00468-3

Akbar Sharip, Roshan Razavi

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引用次数: 0

Abstract

Background: This study examines trends in delta-9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH) positivity rates in pre-employment urine drug screenings at a single university-based hospital occupational medicine clinic from 2017 to 2022, following California's recreational cannabis legalization in 2016, with sales beginning officially on January 1, 2018.

Methods: Retrospective analysis of 21,546 de-identified urine drug screenings from 2017 to 2022 was conducted. Initial screening used instant urine drug immunoassays (50 ng/mL cutoff for THC-COOH), followed by confirmatory gas chromatography-mass spectrometry (15 ng/mL cutoff). Positivity rates were calculated annually, and descriptive statistics summarized age and gender distributions among positive cases. The Cochran-Armitage trend test assessed temporal trends.

Results: Of 21,546 screenings, 92 (0.44%) were THC-COOH-positive. The positivity rate increased from 0.12% (4/3,215) in 2017 to 0.94% (45/4,784) in 2022 (Cochran-Armitage, Z = 5.19, p < 0.001), a 683.33% relative increase (absolute change: 0.82%). Among positive cases, 76% were aged 20-39 (mean: 29.00 years, SD = 9.5), and the female proportion rose from 25.00 to 62.22%. Median THC-COOH levels ranged from 60.00 to 176.50 ng/mL (overall: 145.0, IQR: 309.5).

Conclusion: THC-COOH positivity rates increased significantly post-legalization, potentially influenced by increased cannabis use. Urine tests detect past use, not impairment, highlighting the need for impairment-focused testing per Assembly Bill 2188 (2024). Missing total sample demographic data limit age/gender subgroup analyses.

查看原文本刊更多论文

就业前尿液药物筛查：检查加州娱乐性大麻合法化后THC-COOH阳性率的趋势-回顾性审查。

背景：本研究调查了2017年至2022年在一家大学医院职业医学诊所进行的就业前尿液药物筛查中δ -9-四氢大麻酚-9-羧酸（THC-COOH）阳性率的趋势，此前加州于2016年将娱乐性大麻合法化，并于2018年1月1日正式开始销售。方法：回顾性分析2017 - 2022年21546例去鉴别尿药筛查结果。初步筛选采用即时尿液药物免疫测定法（THC-COOH截止值为50 ng/mL），随后采用验证性气相色谱-质谱法（截止值为15 ng/mL）。每年计算阳性率，描述性统计总结阳性病例的年龄和性别分布。Cochran-Armitage趋势检验评估了时间趋势。结果：21,546例筛查中，92例（0.44%）thc - cooh阳性。从2017年的0.12%（4/3,215）上升到2022年的0.94% (45/4,784)（Cochran-Armitage, Z = 5.19, p）结论：大麻合法化后THC-COOH阳性率显著升高，可能受大麻使用量增加的影响。尿检检测的是过去的使用，而不是损害，这突出了根据《议会法案2188（2024）》进行以损害为重点的检测的必要性。缺少总样本人口统计数据限制了年龄/性别亚组分析。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Occupational Medicine and Toxicology PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

19 weeks

期刊介绍： Aimed at clinicians and researchers, the Journal of Occupational Medicine and Toxicology is a multi-disciplinary, open access journal which publishes original research on the clinical and scientific aspects of occupational and environmental health. With high-quality peer review and quick decision times, we welcome submissions on the diagnosis, prevention, management, and scientific analysis of occupational diseases, injuries, and disability. The journal also covers the promotion of health of workers, their families, and communities, and ranges from rehabilitation to tropical medicine and public health aspects.