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Joel R. L. Ehrenkranz, MD
Columbia University College of Physicians and Surgeons New York, NY

JAMA. 1991;265(11):1393.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

In preemployment drug screening it is important to ensure against urine sample substitution. Documenting specimen authenticity is most frequently done by measuring urine temperature.^1,2

Zwerling et al³ state that urine temperature measurements were performed as part of the procedure of collecting urine specimens. The authors claim that detection of substituted urine was a "rare event." However, the article does not specify how urine temperature was measured. This is important because most methods used to determine urine temperature in commercial drug testing are unable to discriminate fresh from substituted specimens.⁴ The cutoff value of 32.8°C used by Zwerling et al has been shown to provide almost no discrimination between real and bogus specimens.⁵ Such a lack of precision on the part of the authors could have led to a systematic misclassification of subjects due to a large number of falsenegative drug test results. . . . [Full Text PDF of this Article]

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