Timed and forensic collections
15 min
- Recognize an incomplete or mistimed urine collection before calculation
- Maintain chain of custody for a federal workplace urine specimen
Try first
Get the idea
A timed collection needs every void and the exact interval
A 24-hour urine measures how much of an analyte the patient excreted in one day. The performing laboratory supplies the container, any preservative and the instructions before the start, because some analytes need a preservative from the first void.1
- At the start time, empty the bladder and discard that urine.
- Save every void for the next 24 hours.
- At the end time, empty the bladder and keep that urine.
- Mix the whole collection, measure and record the volume, then take the aliquot.1
Amount collected (mg) = urine concentration (mg/dL) × collection volume (mL) ÷ 100. Divide by collection duration (h) for mg/h. A full-day amount requires the specified complete collection or permitted time normalization. Every number in that calculation depends on the collection. A missed void makes excretion falsely low. A saved start void adds urine formed before the interval and makes it falsely high. The aliquot cannot show either error.1
Two clues point to a missed void. A volume of about 700 mL is low for an adult who is not fluid-restricted. Total creatinine below the expected daily output, about 800 to 2,000 mg/day in men and 600 to 1,800 mg/day in women, suggests missing urine.1,2 Check the recorded times and ask about missed voids before looking for an analytical problem.
A forensic specimen travels with its custody record
Federal workplace urine drug testing uses the Federal Custody and Control Form (Federal CCF). It records every transfer of the specimen and the condition of the primary seal at receipt.3,4
- The donor provides at least 45 mL. The collector pours at least 30 mL into bottle A and at least 15 mL into bottle B.
- The collector reads the temperature within 4 minutes. Outside 32 to 38 °C (90 to 100 °F), a second collection under direct observation follows.
- The donor watches the sealing, initials both seals and signs the donor certification. The collector completes the form and ships the package within 24 hours to a laboratory or instrumented initial test facility (IITF) certified by the Department of Health and Human Services (HHS).
- At receipt, the certified facility records the date, the primary seal's condition and the specimen's release to storage.3,4
A nonfederal program follows its own written requirements, so confirm which program governs the specimen before handling it.5
References
- Clinical and Laboratory Standards Institute. Processes for the Collection of Urine Specimens. 1st ed. CLSI guideline PRE05. Clinical and Laboratory Standards Institute; 2024. Accessed September 27, 2026. https://clsi.org/shop/standards/pre05/
- Bishop ML, Fody EP, Van Siclen C, Mistler JM, Moy M. Clinical Chemistry: Principles, Techniques, and Correlations. 9th ed. Jones & Bartlett Learning; 2023.
- Substance Abuse and Mental Health Services Administration. Urine Specimen Collection Handbook for Federal Agency Workplace Drug Testing Programs. Effective February 1, 2024. Accessed September 27, 2026. https://www.samhsa.gov/sites/default/files/urine-collection-handbook-2024.pdf
- Substance Abuse and Mental Health Services Administration. Guidance for Using the 2026 Federal Custody and Control Form (CCF). Published April 29, 2026. Accessed September 27, 2026. https://www.samhsa.gov/sites/default/files/guidance-using-2026-federal-custody-and-control-form-ccf.pdf
- Mandatory Guidelines for Federal Workplace Drug Testing Programs, Urine. 88 Fed Reg 70768-70810. Published October 12, 2023. Effective February 1, 2024. Accessed September 27, 2026. https://www.govinfo.gov/content/pkg/FR-2023-10-12/pdf/2023-21734.pdf
Watch one
A 24-hour urine for protein arrives from Edwin Salgado, 63, whose last 24-hour protein was 480 mg/24 h. The requisition shows 07:00 to 07:00, and he is not fluid-restricted.
Can a 24-hour protein excretion be reported from this collection?
| Test | Result | Previous | Reference interval | Flag |
|---|---|---|---|---|
| Urine protein | 9 mg/dL | |||
| Urine creatinine | 52 mg/dL |
Specimen: Not measured on urine. 24-hour urine, 700 mL, 07:00 to 07:00
- Check the recorded times: 07:00 to 07:00, exactly 24 hours.
A wrong interval changes every total that follows.
- Check the volume: 700 mL is low enough to raise concern about a missed void.
An adult who drinks normally rarely passes as little as 700 mL in a day.
- Total creatinine = 52 mg/dL × 700 mL ÷ 100 = 364 mg, far below the 800 mg/day lower end expected for a man.
Creatinine output is steady from day to day, so a low total means urine is missing.
- Total protein = 9 mg/dL × 700 mL ÷ 100 = 63 mg, against 480 mg/24 h last time.
The same concentration arithmetic gives the protein total, and it only means something if the collection is complete.
- Ask about missed voids through your procedure before looking for an analytical cause.
The aliquot cannot show a missed void, so the patient's account settles it.
Your turn
Use it
- Two specimens reach your laboratory's receiving desk. The laboratory is HHS-certified for federal workplace testing.
- First, a 24-hour urine for protein from Rosalind Achebe, 61. On the requisition she wrote that she started at 08:00 Tuesday by saving that morning's first void, and ended at 08:00 Wednesday with a final void.
- The container holds 1,650 mL.
- Second, a sealed federal workplace package with its Federal CCF, handed over by a courier.
| Test | Result | Previous | Reference interval | Flag |
|---|---|---|---|---|
| Urine protein | 32 mg/dL |
Specimen: Not measured on urine. 24-hour urine, 1,650 mL, 08:00 to 08:00, start void saved
The clue that settled the 24-hour urine is the patient's note that she saved the 08:00 start void. The volume looked normal, and only the collection record showed that the total included urine from before the interval. For the federal package, the custody record decides what receiving means.
Results
- Recognize an incomplete or mistimed urine collection before calculation
- Maintain chain of custody for a federal workplace urine specimen
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