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Table 20: Summary table of included studies (TES)
Study
details
Country Focus of
research
Type of study
or article
Aims/ Objectives Implications
Baiker,
199428
USA Detection Laboratory
testing
To report the effects of small amounts of
bleach on known concentrations of
tetrahydrocannabinol (THC) when measured
by radioimmunoassay (RIA), fluorescence
polarisation immunoassay (FPIA), and gas
chromatography/mass spectrometry (GC/MS).
Very small amounts of household bleach can significantly
affect the quantitation of THC by both immunoassays and
GC/MS. All three methods show some effect at any given
level of bleach.
Barrett,
200145
USA Detection Laboratory
tests
To report the results of field evaluations of the
ORALscreen System for screening of drugs in
oral fluid.
The advantages of the ORALscreen over a laboratorybased
urine screening test include: results obtained at the
point-of-collection in minutes, no need for special collection
facilities, observed sample collection and no requirement
for special laboratory equipment or reagents.
Beck,
200029
Sweden Detection Laboratory
tests
To check for urine adulteration in a Stockholm
clinic for young people with drug abuse
problems.
The Adultacheck strip might be useful in detecting dilute
urine specimens already at the clinic, though the test strip
levels did not agree well with the respective laboratory
results. Adulteration of urine specimens was not common
at the clinic, and specimen collection for urine drug testing
could be performed in a reliable manner.
Berg, 199930 UK Intervention Uncontrolled
pre-post study
To determine the outcome for children after
psychiatric intervention in cases of factitious
illness by proxy (Munchausen's syndrome by
proxy).
Family reunification is feasible for certain cases, but longterm
follow-up is necessary to ensure the child's safety and
to identify deterioration in parent's mental health. The
outcome for reunited children compared well with reported
untreated cases.
Cody,
200131
USA Detection Laboratory
testing:
controlled
study using
samples
An analysis of morphine and codeine in
samples adulterated with Stealth (an
adulterant used to avoid detection of drug
abuse).
It is important to consider this procedure as an option for
samples that screen positive but the opiates and their
respective internal standards are not recovered for GC-MS
analysis.
Cody,
200132
USA Detection Laboratory
testing
To assess the effect of the adulterant "Stealth"
(a peroxidase) on various clinical parameters
and immunoassay testing for drugs of abuse.
Addition of Stealth to urine samples would not be detected
by current routine analyses designed to identify adulterated
specimens.
Cone,
199833
USA Detection Uncontrolled
pre-post test
To investigate the effects of excessive fluid
ingestion on immunoassay test results
following marijuana and cocaine
administration.
It was concluded that claims of 'flushing' and 'cleansing' for
the herbal products were not accurate and that ingestion of
large amounts of water was responsible for the production
of false-negative urine test results.
Critchfield,
199334
USA Detection Laboratory
testing
To test whether an antibody-mediated
interference could arise in a homogeneous
immunoassay used to determine the presence
of cocaine metabolites in urine.
Whether antibody-mediated interference is a practical
problem at the present time is unknown. It may be difficult
to detect excess interfering antibody by using some
traditional tests for urine adulteration.
details
Country Focus of
research
Type of study
or article
Aims/ Objectives Implications
Further investigation of these findings may help to
delineate the possible magnitude of the problem and
provide methods less susceptable to this potential
interference.
Ferslew,
200146
USA Detection Laboratory
testing
To test the application of capillary ion
electrophoresis (CIE) for the direct detection of
anionic concentrations in normal human urine
and urine speciments suspected of
adulteration.
CIE is applicable to forensic analysis of urine anion
concentrations. CIE can easily quantitate numerous
endogenous anions and offers a method to detect and/or
confirm anion adulteration of urine specimens.
Jones,
200047
USA Detection Laboratory
testing:
controlled
study using
samples
To determine whether the methylene blue
method was suitable for the detection of
anionic surfactants (detergent) in forensic urine
drug test specimens that were suspected of
adulteration.
The extent of interference depends upon the type of
immunoassay reagent used, the pH of the specimen, the
concentration of other constituents in the specimen, the
concentration of the surfactant, and the type of surfactant
used.
This analysis for detecting anionic surfactants in urine can
be used along with other indicators such as the physical
presence of unusual foaming and/or odor to support the
forensic determination that a specimen is adulterated by a
detergent.
Mikkelsen,
198835
USA Detection Laboratory
tests
To investigate eight readily available
substances claimed to cause false-negative
results when added to urine that would
otherwise test positive by the EIA screening
assays for illicit drugs. To identify effective
means of detecting urine specimens that are
contaminated so that an unadulterated
specimen may be obtained.
The adulterants interfered somewhat differently with each
of the drug assays. EIA assays for illicit drugs can be
invalidated by specimen adulteration producing falsenegative
results. Therefore, if urine drug testing is to be
conducted, pH, relative density and appearance should be
assessed and suspect specimens should be rejected. Not
all adulterants can be detected, so observed collection is
strongly recommended.
Sanchez-
Lopez,
200036
Spain Prevalence
(extent of
problem)
Controlled
study
To prove that handling fresh foods prepared
for prick-prick tests with latex gloves can
tamper with the results in patients with latex
allergy.
Confirms the importance of manipulating foods with vinyl
gloves or other material containing no latex in order to avoid
false results.
Schwartz,
198537
USA Detection Laboratory
testing:
uncontrolled
longitudinal
study
To report on experience with a photometric
immunoassay to measure urinary
cannabinoids (marijuana).
The specificity of the method for detecting recent marijuana
use appears excellent; the sensitivity depends on the
potency, time of last use, frequency of previous use, and
specific gravity of the urine specimen.
Unless samples are collected under direct observation,
urine colour, temperature, specific gravity, and dipstick
tests for blood and pH should also be recorded.
Schwarzhoff
, 199338
USA Detection Laboratory
testing
A battery of adulterating agents previously
tested against radioimmunoassay (RIA) were
The FPIA test is susceptible to specimen adulteration, but
the susceptibility is unique to the particular chemical agent
Study
details
Country Focus of
research
Type of study
or article
Aims/ Objectives Implications
evaluated in a similar format using
fluorescence polarisation immunoassay
(FPIA).
and to the specific drug test.
Although the results of pH measurement on adulterated
samples verified its utility in identifying some samples
adultered with interfering agents, other adulterants that
cause substantial effects would not be identified by pH
measurements alone.
Stechova,
200239
Czech
Republic
Prevalence
(extent of
problem)
Survey:
questionnaire
(uncontrolled
cohort)
To investigate non-compliance in diabetic
patients treated by insulin pump. Patients
suspected of tampering with their own blood
sugar or urine test samples to avoid detection.
The results of the questionnaire confirm the authors'
experience that non-compliance (at least occasional) is a
relatively frequent phenomenon in the group of type 1
diabetes patients.
Tsai, 199840 USA Detection Laboratory
screening
tests
To investigate the effect of high concentrations
of nitrites on the detection of five commonly
abused drugs by immunoassay screening and
GC-MS analysis.
The problem of nitrite adulteration could be alleviated by
sodium bisulfite treatment even when the specimens were
spiked with 1.0M of nitrite ion.
Tsai, 200041 USA Detection Laboratory
tests:
controlled
study using
samples
To investigate the influence of both urine
sample matrix and the duration of nitrite
exposure on nitrite interference of a
cannabinoid (THCCOOH) detection.
The decrease or loss of immunoassay detectable
cannabinoid cross-reactives in acidic 'THC-positive
samples' can be attenuated by chemically increasing the
pH value of the samples to the basic pH range.
Uebel,
200242
South
Africa
Detection Laboratory
screening
tests
To investigate the influence of household
chemicals used to adulterate test results of
urine samples that tested positive for cannabis
or methaqualone (Mandrax)
Hand soap, which is commonly available in most public
toilets, gave false-negative results for both tests.
Urry, 199843 USA Detection Laboratory
tests and
literature
review (nonsystematic)
To identify all sources of nitrite in urine and the
range of concentrations associated with these
sources and to determine if nitrite adulteration
can be supported based on a quantitative
result.
A quantitative measurement of nitrite by a well-structured
assay can provide scientifically valid and forensically
defensible proof of adulteration with a nitrite-containing
substance.
Wu, 199944 USA Detection Laboratory
testing:
controlled
study with
samples
To examine the effect of pyridinium
chlorochromate (PCC) found in the product
'Urine Luck'.
PCC is an effective adulterant for urine drug testing of THC
and opiates. Identification of PCC use can be
accomplished with use of a spot test for the oxidant.

Info Taken From:http://www.york.ac.uk/inst/crd/pdf/report25.pdf

If you aren't cross-eyed by now, I hope someone finds this info useful...