FOR SOME, DRUG TESTS ARE ALMOST IMPOSSIBLE

Joseph Kinneary's inability to urinate in close proximity to other people
almost cost him his job. Even now, he is fighting sanctions that have
relegated him to desk work from his old perch as a boat captain for New
York City.

It might sound like the stuff of late-night comedy, but the anxiety
disorder that plagues Mr. Kinneary is a harsh reality for a surprisingly
large number of men. For some of them, it can be a career killer because it
deprives them of the ability to produce urine for random drug tests.

Now, though, those who suffer from the syndrome, technically called
paruresis but more commonly referred to as shy bladder syndrome, are
beginning to fight back. They argue that penalties exacted against them by
their employers, from demotions to dismissals, violate antidiscrimination
laws. They are demanding the right to request alternate forms of drug
testing. And a few are risking ridicule by going public.

Mr. Kinneary, 48, is one of them. As a sludge tanker captain for the New
York City Environmental Protection Department, he would often put in
12-hour days piloting a 320-foot-long vessel through the waters surrounding
the city. Then, in late December, he was ordered to produce urine for an
on-the-job drug test, a routine procedure required by virtually all public
employers and many private ones.

He could not comply. Paruresis can render its victims incapable of
urinating in public places, like crowded theater bathrooms or airplane
stalls. In extreme cases, the fear is so strong that victims can relieve
themselves only at home, meaning that they either have to work at home or
find a job that is a quick drive away.

It was not the first time that Mr. Kinneary had to undergo the test, but he
managed to finesse his way through three previous ones. The first time, in
1992, he actually managed to produce a sample after trying for two days. On
two other occasions, he sneaked tap water into the cup. In December, he
sought unsuccessfully to get results by drinking three quarts of water.

Early last winter, both the Environmental Protection Department and the
Coast Guard accused him of misconduct for failing to take a drug test; the
city also put him on leave without pay or benefits. It reinstated him in
late March but gave him a desk job. Meantime, the Coast Guard has begun
proceedings to suspend his marine license.

"I'm still being asked to give a urine test" by the city, he said. "I feel
like I'm stuck in the middle, and neither the city nor the Coast Guard
seems willing to move on my case."

So is his predicament a workplace anomaly? Not according to Steven Soifer,
an associate professor of social work at the University of Maryland and a
founder of the International Paruresis Association (www .shybladder.org)
six years ago with Carl Robbins, a Maryland therapist. Professor Soifer
says the group has received more than 100 phone calls or e-mail messages
from shy-bladder sufferers about workplace drug testing, about a quarter
from people who had lost their jobs or were in jeopardy of losing them.

Though hard numbers on the incidence of shy-bladder syndrome are hard to
come by, Professor Soifer says some studies suggest that 7 percent of
Americans and Canadians suffer some form of it.

"Most employers simply assume that the person is making the symptoms up,"
said Professor Soifer, who has himself had the condition since he was a
teenager.

Though most paruresis suffers who seek treatment are men, women suffer from
it, too. Theresa Baker, a social worker in Lancaster, Pa., suspects hers
originated when she was yelled at by a bus driver at the age of 7, an
incident so frightening that she was unable to urinate the next day before
going to school.

Ms. Baker voiced a common complaint of paruresis victims: They are shut out
from other forms of drug testing. In applying for a job at a hospital in
June 2000, she says, she tried but failed three times to produce a urine
sample. Her prospective employer treated her kindly but still would not
allow her to substitute a blood test or undergo a catheterization. In
desperation, she had a urologist teach her how to catheterize herself so
that she could produce the urine.

Professor Soifer says most employers and most drug-testing clinics have no
idea how traumatic it can be for a shy-bladder sufferer to try to urinate
in a public place. Many mistakenly assume that drinking large quantities of
water will solve the problem.

"I've known people who have held their bladder for 24 hours," he said.
"Once the fear kicks in, these people literally are locked up, and usually
require catheterization in a hospital."

James Murphy, a former maintenance worker for Dallas Area Rapid Transit,
says he believes that his shy bladder cost him his job. In a six-hour
effort to produce a urine sample in May 1999, he says, he drank a 20-ounce
soft drink and about three quarts of water, to no avail. The pain became so
severe that he found himself screaming, he says, provoking jeers from his
supervisor and the drug tester.

Over the next 10 months, Mr. Murphy says, he wrote two letters to his
employer demanding an apology. In one, he remarked -- tongue in cheek, he
says -- that he could "see how a person could lose control of himself and
kill somebody." He says he was forced to resign in June 2000 at age 57.

Dwain Keltner, a manager at Mr. Murphy's old department, says he was let go
partly because of poor performance, including threats to the agency. Mr.
Murphy disputes that assertion. "They just kept telling me to drink more
water, drink more water," he said. "I couldn't stand the abuse."

Mr. Kinneary is angry too. Since December, he says, he was found to be drug
free in one blood test and two hair tests that he paid for and in a saliva
test that was ordered by his employer after a failed four-and-a-half-hour
effort to produce a urine sample.

The New York City Environmental Protection Department declined to comment
on his case. Ken Edgell, a senior drug enforcement official at the
Transportation Department, which oversees the Coast Guard, says regulations
allow shy-bladder sufferers who can document their condition to undergo an
alternative evaluation by a physician.

But paruresis sufferers say it is often impossible to document their
condition because they are frequently unaware that they have a medical
problem until they must produce a urine sample. Richard Elliott, an
investigating officer at the Coast Guard, said that Mr. Kinneary was given
five days to produce documentation this past winter, but "what he came up
with was not adequate."

It is an open question whether the Americans With Disabilities Act covers
people with paruresis, legal specialists say, because they must show that
their disorder significantly interferes with a major life activity, and
neither the federal government nor the courts have ruled on whether
urination fits that category.

While alternative tests to urine sampling exist, experts say it will be
years before the federal government adopts rules governing them. So those
afflicted with shy bladder have little option but to hope for the best and
go to court if they must.

In Connecticut, a 28-year-old scientist and shy-bladder sufferer who
applied for a job with a large beverage company last spring says that he
threatened to sue his prospective employer when he learned it would not
accept the results of a pre-employment blood test. The company hired him
last summer, but he says he is afraid to go public for fear of losing his job.

Still, in a recent e-mail message, he urged people who find themselves in
his shoes to fight back, "In the end," he said, "you will win."