Dilute Specimen
A drug test specimen with creatinine and specific gravity values below normal range, indicating excessive fluid intake before the test.
Key Facts
- Creatinine level between 2–20 mg/dL and specific gravity 1.0001–1.0029
- Can be positive-dilute or negative-dilute
- Employer may (but is not required to) order a single retest
- Creatinine below 2 mg/dL is "substituted" — treated as refusal
- Excessive fluid intake is the most common cause
A dilute specimen occurs when a drug test sample has a creatinine concentration between 2 and 20 mg/dL and a specific gravity between 1.0001 and 1.0029. This typically results from drinking excessive fluids before the test. A dilute result can be either positive-dilute (substance detected despite dilution) or negative-dilute (no substance detected). Under DOT rules, a positive-dilute is treated as a positive result. For negative-dilute results, the employer may direct the employee to take another test immediately, but only one retest is allowed. If creatinine is below 2 mg/dL, the specimen is considered "substituted" and treated as a refusal to test.
Drug Test Results & Specimen Issues Compared
Understanding the different outcomes and specimen-related issues in drug testing.
| Type | Meaning | Reported By | Next Steps | MRO Role |
|---|---|---|---|---|
| Positive | Confirmed presence above cutoff | Laboratory → MRO | MRO interview, then report to employer | Verify with donor — medical explanation? |
| Negative | No substances detected above cutoff | Laboratory → MRO | Employee cleared | Review and release result |
| Dilute | Creatinine 2–20 mg/dL & SG 1.0001–1.0029 | Laboratory → MRO | Employer may request retest (one time) | Report as negative-dilute or positive-dilute |
| Shy Bladder / Shy Lung | Unable to provide sufficient specimen | Collector | Medical evaluation within 5 days | Evaluate medical explanation |
Related Services
Related Industries
50
States Covered
Need This Service?
Find certified occupational health providers offering this service in your area. Over 20,000 locations nationwide.
Simplify Occupational Health
BlueHive manages occupational health services so you can focus on your workforce.