In DOT-regulated safety-sensitive roles, alcohol testing is a critical component of ensuring employees are fit for duty. While breath alcohol testing is the standard method, situations like shy lung—difficulty providing sufficient breath—require special procedures. This blog explains shy lung protocols, the role of saliva testing, and how refusals are handled.
Shy Lung Procedures
When an employee is unable to provide sufficient breath for an alcohol test, DOT regulations outline a shy lung procedure similar to the shy bladder process for drug testing.
- Notification
The Breath Alcohol Technician (BAT) must notify the Designated Employer Representative (DER). - Medical Evaluation
The employee must visit a medical specialist within five days to determine if there is a valid medical explanation for the inability to provide a breath sample. - Burden of Proof
The employee is responsible for providing medical documentation.
If there is no valid medical explanation, the incident is classified as a refusal to test, which can result in serious consequences under DOT regulations.
Saliva Testing for Alcohol
In shy lung cases, saliva testing may be used for the initial alcohol screen. The process follows the same general steps as breath testing.
- Screening by Saliva
The Screening Test Technician (STT) explains the procedure, opens the swab in front of the employee, and hands it to them. The employee then moves the swab around in their mouth until it activates. If the swab does not activate after two attempts, the employee must take the test using an Evidential Breath Testing (EBT) device. - Positive Saliva Screen
If the saliva test result is positive, it must be confirmed with an EBT device. The confirmatory test must be conducted within 15 to 30 minutes after the initial screen. - Challenges with Saliva Testing
Many employers do not have the equipment or staff to perform both saliva and follow-up breath testing on site unless they operate a medical clinic. This makes saliva testing less feasible in some industries.
Timing and Metabolism: Alcohol Positives
Because alcohol metabolizes quickly, timing is essential when interpreting test results.
- Detection Window
Breath alcohol testing can detect alcohol for 12 to 24 hours, depending on the concentration. - Example Scenario
If an employee tests positive at 0.04 BAC during a random test at 9:00 AM, their alcohol use from the night before should be considered. A claim of having only two drinks ending at 11:00 PM likely doesn’t align with typical alcohol metabolism unless significant medical issues like liver failure are present. - Level of Care Recommendations
When assessing next steps, consider both the time and the BAC level of the test result.
Refusals for Alcohol Testing
Refusals for alcohol testing follow the same general structure as drug testing refusals.
- Refusal Criteria
- The employee fails to appear for testing or leaves before completing the test
- The employee cannot provide sufficient breath or saliva without valid medical justification
- The employee refuses to comply with the testing process
- Argumentative or Threatening Behavior
BATs or STTs may document aggressive or confrontational behavior on the Custody and Control Form. In some cases, this may be considered a refusal to test if properly supported and documented under DOT regulations.
Final Thoughts: Navigating Shy Lung and Refusals
DOT alcohol testing procedures aim to protect public safety while ensuring employees are treated fairly. Understanding how to respond to shy lung cases and potential refusals is key for maintaining compliance.
For employers, consider saliva testing as an option in shy lung situations and make sure refusals are clearly documented.
For employees, Cooperate fully with testing procedures and be prepared to provide medical documentation if needed.
When everyone understands their role in the process, workplaces can remain both compliant and safe.
