Urinalysis

A urinalysis (UA), also known as routine and microscopy (R&M), is an array of tests performed on urine, and one of the most common

methods of medical diagnosis.

A urine test strip or dipstick is a basic diagnostic tool usually used to test for glucose, ketones, leukocyte esterase, protein, blood, and bilirubin. Others are completed using microscopic evaluation in a laboratory. It is proven to be a cheap, easy to use and helpful test. It is an established test in fitness for work for many types of professions.

USPSTF, Recommendation: for Bacteriuria, All pregnant women Screen with urine culture.

For Men and no-pregnant women: Do not screen.

The USPSTF concludes the current evidence is insufficient to assess the balance of benefits and harms of screening for bladder cancer in asymptomatic adults. 

(USPSTF 2014).

International standards:

  1. Offshore: Urinalysis is required.
  2. (Norwegian Directorate of Health 2012)

b-    Offshore; Medical examination is always including urinalysis.

 (The United Kingdom Offshore Oil and Gas 2008)

c-    Offshore: Dip-stick urinalysis is necessary (for glucose, protein, blood).

(GoM BP 2012)

  1. Firefighters; Urinalysis, is required, Dipstick test for glucose, ketones, leukocyte esterase, protein, blood, and bilirubin.
  2. (NFPA 2012)
  3. Firefighters; RFT is a necessary test as part of the minimum requirements (AFAC 2006).
  4. Divers, Initial and annual medical examinations should include dipstick urinalysis for blood, protein and glucose. Abnormal results require investigation.
  5. (HSE UK, MA1, 2011)
  6. Hazardous Occupations, Urinalysis is required for employment involving exposure to benzene, arsenic, cadmium, lead and mercury.
  7. (Hong Kong 2004)

i-     OSHA Standard; Hazardous Waste Operations and Emergency Responses (HAZWOPER): urinalysis is required for HAZMAT team members and emergency response team.

In addition, for employment involving exposure to benzene, cadmium and lead.

(OSHA 2009)

j-     Drivers; for drug misuse:

Independent medical assessment and urine screen arranged by DVLA may be required (UK DVLA 2014).

k-    Commercial drivers;

Urinalysis is required. Protein, blood or sugar in the urine may be an indication for further testing to rule out any underlying medical problem (US. Physical Qualifications for Drivers 2015).

 

Suggested indications: it is required for all types of fitness assessment; it is not required for office-job pre-employment medical.

 

 

References

  1. Kronick, R. (2014). The Guide to Clinical Preventive Services. USPSTF. Retrieved from http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/cpsguide.pdf
  2. Guidelines - health requirements for persons working on installations offshore. Norwegian Directorate of Health 2012.
  3. Medical Aspects of Fitness for Work Offshore ( 2008 The United Kingdom Offshore Oil and Gas)
  4. GoM Medical Aspects of Fitness for Offshore Work Safety Work Practice (BP 2012)
  5. NFPA 1582, Chapter 6 Medical Evaluations of Candidates - 2012
  6. Australasian Fire Authorities Council (AFAC) Medical Guidelines for Firefighters, March 2006
  7. HSE UK, The medical examination and assessment of divers (MA1) 2011, http://www.hse.gov.uk/Diving/ma1.pdf
  8. Doctors’ Guide to Medical Examinations for Workers engaged in Hazardous Occupations in Industrial Undertakings - Occupational Safety and Health – 2004, Hong Kong 
  9. OSHA, Screening and Surveillance: A Guide to OSHA Standards, 2009 https://www.osha.gov/Publications/osha3162.pdf 
  10. At a glance Guide to the current Medical Standards of Fitness to Drive'. Drivers Medical Group, DVLA, UK, May 2014
  11. U.S. Code of Federal Regulations. 391.41 Physical Qualifications for Drivers,From: http://www.ecfr.gov/cgi-bin/text-idx?node=49%3A5.1.1.2.34.5&%3Brgn=div6#se49.5.391_141
  12. Medical Examination Report, For Commercial Driver Fitness Determination 2015.

 

 

 

Parent Category: Fitness for Work