February 15, 2004 - Arizona Republic (AZ)

Drug Test Unsettling For 'Shy' Workers

Tom Smith Lost A Job Because He Was Unable To Urinate For A Spot Drug Test

By Adam Geller, AP

Tom Smith worried he was in for trouble last November, when a supervisor pulled the assembly-line worker aside and told him to report to the nurse's station.

There, with a plastic specimen cup in hand, 40 ounces of water sloshing inside him and the nurse waiting expectantly, Smith says he spent three hours straining to do what most people barely think about. When the time allotted for the random drug test was finished, the cup was empty, and Smith was out of a job.

Though the story sounds like the makings of a bad joke, Smith and workers like him say they are tired of being the punch line.

Their problem, a little-known phobia known as paruresis or shy bladder syndrome, isn't new. The intensely personal malady is getting unwelcome exposure, an unforeseen consequence of widespread workplace testing.

Employers conduct 45 million drug tests each year, the vast majority by collecting a urine sample. Many workers object, but inability to fill a specimen cup is rarely the issue. However, workers like Smith, who says he was fired from a Caterpillar Inc. generator plant in Griffin, Ga., are labeled as refusing to comply with the drug test.

"You tell me I have three hours to urinate, and I'm going to lose my job, hey man, I'm frozen. I can't do anything," said Smith, who lives in Pike County, Ga., about an hour south of Atlanta and worked at the plant for three years.

A Caterpillar spokeswoman, who confirmed Smith is a former employee, said that she could not comment about the situation because of privacy concerns.

"The safety of our employees is our primary concern," Lori Porter said. "Caterpillar follows the collection guidelines that are outlined by the Department of Transportation and the DOT guidelines have been tried and tested in many ways and are proving to be the standard in the U.S."

Problems like Smith's, while unusual, are not limited to Caterpillar. In one of the more visible examples, in early 2002, the captain of a ship operated by New York City was suspended without pay after he failed to provide the urine needed for a drug test.

Some employers have ordered workers to undergo examination by a doctor to determine if blockage of the urinary tract might be to blame. Experts say paruresis is psychological, not physical, and that it is far more widespread than most people realize.

"The bladder's full, they're sweating bullets, but they can't open up" the muscle that allows urination to take place, said Dr. Michael Chancellor, a professor of urology at the University of Pittsburgh.

For some people, the answer is to go into a restroom stall. More serious cases can require therapy and are not easily solved, Chancellor said.

That has led to a host of problems as drug testing has become widespread, said Steven Soifer, president of the International Paruresis Association.

"I get an e-mail a week or a call a week" from people unable to urinate for a drug test, said Soifer, an associate professor of social work at the University of Maryland in Baltimore who has contended with paruresis since childhood.

"It's in every situation you can imagine: schools, prison probation, pre-employment testing and employment testing," he said.

When nurse Lee Attema moved from Massachusetts to Houston last year, a local hospital offered him a job, along with a signing bonus. Still, Bayshore Medical Center's requirement that he take a urine test before his May start date became the source of friction.

Attema says he has struggled since childhood to urinate in public and asked the Pasadena, Texas, hospital's personnel department whether alternative tests were available. He says he offered to provide and pay for a blood sample.

Hospital officials grew increasingly annoyed at him for refusing to cooperate with testing procedures, eventually suggesting he look for work elsewhere, Attema says.

"It turned out to be a big issue," said Attema, who has found a job at another hospital that agreed to test him using a blood sample. "What it came down to is if you can't give a urine sample under supervised conditions, we just won't hire you."

A hospital executive, Tommy Doss, would not comment, citing privacy concerns.

Even in situations where employers are accommodating, workers with shy bladder say the phobia can make the job stressful.

In his job as a marine engineer on New York's Staten Island Ferry service, Michael Capparo has long been subject to spot drug tests. He's so worried about not being able to provide a specimen that he carries a catheter in his work bag every day and leaves another in his locker just in case.

When he was called for his last test, three years ago, Capparo says he inserted a catheter himself to ensure he could provide a sample.

"To be honest with you, every time I leave the door to go to work, I worry about being tested," said Capparo, who has informed both his employer and labor union of his problem.

Some workers with shy bladder are putting their hopes on the growing use of alternative screening methods that test specimens of hair, saliva or sweat. The alternative methods are used by many employers, including casinos and police departments.

"I have nothing to hide," Smith said. "All I ask for is a reasonable accommodation based on my disability.