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Al-Asmari AI. A critical review of workplace drug testing methods for old and new psychoactive substances: Gaps, advances, and perspectives. Saudi Pharm J 2024; 32:102065. [PMID: 38645754 PMCID: PMC11031841 DOI: 10.1016/j.jsps.2024.102065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024] Open
Abstract
Workplace drug testing (WDT) is essential to prevent drug abuse disorders among the workforce because it can impair work performance and safety. However, WDT is limited by many challenges, such as urine adulteration, specimen selection, and new psychoactive substances (NPS). This review examined the issues related to WDT. Various scientific databases were searched for articles on WDT for drug detection published between 1986 (when WDT started) and January 2024. The review discussed the history, importance, and challenges of WDT, such as time of specimen collection/testing, specimen adulteration, interference in drug testing, and detection of NPS. It evaluated the best methods to detect NPS in forensic laboratories. Moreover, it compared different techniques that can enhance WDT, such as immunoassays, targeted mass spectrometry, and nontargeted mass spectrometry. These techniques can be used to screen for known and unknown drugs and metabolites in biological samples. This review assessed the strengths and weaknesses of such techniques, such as their validation, identification, library search, and reference standards. Furthermore, this review contrasted the benefits and drawbacks of different specimens for WDT and discussed studies that have applied these techniques for WDT. WDT remains the best approach for preventing drug abuse in the workplace, despite the challenges posed by NPS and limitations of the screening methods. Nontargeted techniques using high-resolution liquid chromatography-mass spectrometry (MS)/gas chromatography-tandem MS can improve the detection and identification of drugs during WDT and provide useful information regarding the prevalence, trends, and toxicity of both traditional and NPS drugs. Finally, this review suggested that WDT can be improved by using a combination of techniques, multiple specimens, and online library searches in case of new NPS as well as by updating the methods and databases to include new NPS and metabolites as they emerge. To the best of the author's knowledge, this is the first review to address NPS as an issue in WDT and its application and propose the best methods to detect these substances in the workplace environment.
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Affiliation(s)
- Ahmed Ibrahim Al-Asmari
- Special Toxicological Analysis Section, Pathology and Laboratory Medicine Department, King Faisal Special Hospital and Research Center, P.O. Box 3354, Riyadh 11211, Saudi Arabia
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Ramírez Fernández MDM, Wille SMR, Meert N, Eliaerts J, Samyn N. Establishing effective interpretation criteria in hair analysis to distinguish between passive and active cocaine exposure: Insights from authentic hair samples collected from professional individuals exposed to cocaine. Drug Test Anal 2024. [PMID: 38574760 DOI: 10.1002/dta.3692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/24/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
Interpretation results of hair analysis, particularly for cocaine, can be challenging due to the need to differentiate between active use or passive contamination. Our study aimed to assess the impact of varying degrees of passive cocaine exposure hair analysis results and their interpretation. Hair samples (n = 25) were categorized based on the declared cocaine exposure of volunteers: (a) high, involving handling up to several kilograms of cocaine powder from dismantling illegal distribution sites; (b) medium, where staff dealt with cocaine blocks (up to kilograms); and (c) low, with staff in contact with up to grams of cocaine for laboratory analysis. Hair samples were decontaminated using dichloromethane, water, and methanol. The samples and final wash were analyzed for cocaine, benzoylecgonine, norcocaine, cocaethylene, m-OH-benzoylecgonine, and ecgonine methyl ester using a validated UPLC-MS/MS method. Cocaine hair concentrations ranges were as follows (pg/mg): high (n = 53 segments) < LLOQ(32)-7046; medium (n = 91) < LLOQ-939; and low (n = 54) < LLOQ-292. All hair samples had concentrations below the LLOQ for cocaethylene, ecgonine methyl ester, and m-OH-benzoylecgonine. Applying the SoHT cocaine cut-off in combination with a hair/wash ratio criterion identified 97% of the samples as contaminated. This study advocates for a comprehensive approach in evaluating cocaine hair concentrations. This involves integrating the 500 pg/mg decision limit for cocaine with a criterion comparing wash and hair concentration. Additionally, confirming the presence of specific metabolites is crucial. This multifaceted method effectively distinguishes between environmental contamination and active cocaine usage. The research contributes significantly to refining cocaine exposure assessment in professional contexts.
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Affiliation(s)
| | - Sarah M R Wille
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
| | - Natalie Meert
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
| | - Joy Eliaerts
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
| | - Nele Samyn
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
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Salvator H, Lamy E, Roquencourt C, Bardin E, Devillier P, Grassin-Delyle S. Therapeutic drug monitoring of corticosteroids/β 2-agonists in the hair of patients with asthma: an open-label feasibility study. Front Pharmacol 2024; 14:1339835. [PMID: 38269282 PMCID: PMC10807032 DOI: 10.3389/fphar.2023.1339835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Although adherence to inhaled medication is critically important for treatment efficiency, around half of patients taking these drugs are non-adherent or make critical errors when using their delivery device. Segmental hair analysis might be a valuable tool for therapeutic monitoring because hair concentrations reflect exposure from month to month. The objective of the present proof-of-concept study was to establish the feasibility of segmental hair analysis of inhaled budesonide and formoterol in asthma patients. Methods: We conducted a prospective, open-label, interventional study of adult patients being treated with budesonide/formoterol for controlled, moderate-to-severe asthma (CorticHair, NCT03691961). Asthma control, lung function, and medication adherence were recorded. Hair samples were taken 4 months after enrolment and cut into four 1 cm segments. Results: Samples were available from 21 patients (20 women; median age: 53; median budesonide dose: 600 μg/d). Budesonide and formoterol were detected in samples from 18 to 13 patients, respectively. The median hair concentrations were 6.25 pg/mg for budesonide and 0.9 pg/mg for formoterol. The intrapatient coefficient of variation between hair segments was 21% for budesonide and 40% for formoterol. Pearson's coefficients for the correlations between the hair concentration and the self-reported drug dose and the prescribed drug dose were respectively 0.42 (p = 0.08) and 0.29 (p = 0.25) for budesonide and 0.24 (p = 0.44) and 0.17 (p = 0.57) for formoterol. Conclusion: Segmental hair analysis of inhaled medications was feasible, with low intrapatient variability. This innovative, non-invasive means of assessing monthly drug exposure might help physicians to personalize drug regimens for patients with difficult-to-treat asthma.
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Affiliation(s)
- Hélène Salvator
- Exhalomics, Hôpital Foch, Suresnes, France
- Service de Pneumologie, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Elodie Lamy
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
| | | | - Emmanuelle Bardin
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
- Institut Necker Enfants Malades, U1151, Paris, France
| | - Philippe Devillier
- Exhalomics, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire—VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Stanislas Grassin-Delyle
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de La Santé, Montigny-le-Bretonneux, France
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Lallmahomed A, Mercier F, Costet N, Fillol C, Bonvallot N, Le Bot B. Characterization of organic contaminants in hair for biomonitoring purposes. Environ Int 2024; 183:108419. [PMID: 38185045 DOI: 10.1016/j.envint.2024.108419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/06/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Biological monitoring is one way to assess human exposure to contaminants. Blood and urine are often used as biological matrices, but hair is an innovative and effective tool for quantifying more biomarkers over a wider exposure window. In order to improve the use of hair in exposure assessment, this article identifies relevant compounds in the literature to investigate hair contamination. Statistical analysis was performed to correlate the physical-chemical properties of the relevant compounds and their concentration levels in hair. Phthalates, pyrethroids and organophosphate flame retardants were chosen for further study of the interpretation of hair measurements for exposure assessment. No significant correlation was found between the average concentration levels in the literature and the physical-chemical properties of the selected compounds. This work also explores the properties of hair and the analytical process that may impact the quantification of organic contaminants in hair. The sample preparation method (sampling, storage, washing) were also studied and adaptations were suggested to improve the existing methods.
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Affiliation(s)
- Ashna Lallmahomed
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Fabien Mercier
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Nathalie Costet
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Clémence Fillol
- Direction of Environmental and Occupational Health, Santé publique France, Saint Maurice Cedex, France
| | - Nathalie Bonvallot
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Barbara Le Bot
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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Palamar JJ, Cleland CM, Vincenti M, Salomone A. A multivariable analysis delineating hair color, hair dyeing, and hat wearing as predictors of level of cocaine and MDMA detection in human hair samples. Drug Test Anal 2023:10.1002/dta.3607. [PMID: 37986705 PMCID: PMC11102931 DOI: 10.1002/dta.3607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
Research suggests that hair color, hair dyeing, and perspiration can bias hair test results regarding drug exposure, but research is needed to examine such associations in a multivariable manner. In this epidemiology study, adults were surveyed entering nightclubs and dance festivals in New York City, and 328 provided hair samples, which were analyzed using ultra-high-performance liquid chromatography-tandem mass spectrometry to determine the level of detection of cocaine and 3,4-methylenedioxymethamphetamine (MDMA). Reporting use was not an inclusion criterion for analysis. We used two-part multivariable models to delineate associations of hair color, past-year hair dyeing, and frequency of past-month hat wearing (which may increase perspiration) in relation to any vs. no detection of cocaine and MDMA as well as level of detection, controlling for hair length, self-reported past-year cocaine/ecstasy/MDMA use, and age, sex, and race/ethnicity. Those reporting having dyed their hair were at increased odds of having any level of cocaine detected (adjusted odds ratio [aOR] = 3.75, 95% CI confidence interval [CI]: 1.85-6.70), and compared to those with brown hair, those with blond(e) hair on average had lower levels of cocaine (ng/mg) detected (beta = -7.97, p = 0.025). Those reporting having dyed their hair were at increased odds of having any level of MDMA detected (aOR = 3.05, 95% CI: 1.44-6.48), and compared to those who reported never wearing a hat, those who reported wearing a hat daily or almost daily on average had lower levels of MDMA (ng/mg) detected (beta = -6.61, p = 0.025). This study demonstrates the importance of using multivariable models to delineate predictors of drug detection.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Charles M. Cleland
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Marco Vincenti
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano, Italy
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Salomone A, Galletto M, Massano M, Di Corcia D, Palamar JJ, Vincenti M. Detection of fentanyl, synthetic opioids, and ketamine in hair specimens from purposive samples of American and Italian populations. J Forensic Sci 2023; 68:1698-1707. [PMID: 37515395 PMCID: PMC10529932 DOI: 10.1111/1556-4029.15348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023]
Abstract
With the current crisis related to the diffusion of fentanyl and other novel opioids in several countries and populations, new and effective approaches are needed to better elucidate the phenomenon. In this context, hair testing offers a unique perspective in the investigation of drug consumption, producing useful information in terms of exposure to psychoactive substances. In this research, we applied targeted ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) analytical methods to detect novel synthetic and prescription opioids and other common controlled psychoactive drugs in the keratin matrix. A total of 120 hair samples were analyzed from the United States (US) and Italy, segmented when longer than 6 cm, and then analyzed. In the 60 samples (83 segments in total) analyzed from a purposive sample of data collected in the US, fentanyl was detected in 14 cases (16.9%), with no detection of nitazens or brorphine. We also detected fentanyl metabolites, despropionyl-p-fluorofentanyl, and prescription opioids. In the 60 samples collected in Italy (91 segments in total), ketamine was the most prevalent compound detected (in 41 cases; 45.1%), with ketamine demonstrating a strong correlation with detection of amphetamines and MDMA, likely due to co-use of these substances in recreational contexts. Several common drugs were also detected but no exposure to fentanyl or its analogs were detected. Results of this retrospective exploration of drug use add to increasing evidence that hair testing can serve as a useful adjunct to epidemiology studies that seek to determine biologically confirmed use and exposure in high-risk populations.
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Affiliation(s)
- Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| | | | - Marta Massano
- Department of Chemistry, University of Turin, Turin, Italy
| | | | - Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Marco Vincenti
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
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7
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Palamar JJ, Salomone A. Trends and correlates of discordant reporting of drug use among nightclub/festival attendees, 2019-2022. Clin Toxicol (Phila) 2023; 61:665-673. [PMID: 37988115 PMCID: PMC10664866 DOI: 10.1080/15563650.2023.2273770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/17/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION People who attend nightclubs and festivals are known for high prevalence of party drug use, but more research is needed on underreporting in this population, in part because unintentional drug exposure through adulterated drug products is common. We examined the prevalence of drug use in this population, based both on self-reporting and on hair test results, with a focus on the detection of underreported use. METHODS Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2019-2022 (n = 1,953), with 328 providing an analyzable hair sample for testing. We compared trends in self-reported drug use, drug positivity, and "corrected" prevalence, adjusting for unreported use, and delineated correlates of testing positive for ketamine and cocaine after not reporting use (discordant reporting). RESULTS Of the 328 who provided a sample, cocaine and ketamine were the most frequently detected drugs (55.2% [n = 181] and 37.2% [n = 122], respectively), but these were also the two most underreported drugs, with 37.1% (n = 65) and 26.4% (n = 65), respectively, testing positive after not reporting use. Between 2019 and 2022, positivity decreased for cocaine, ketamine, 3,4-methylenedioxy-metamfetamine, and amfetamine, and underreported exposure to cocaine and ketamine also decreased (P < 0.05). Underreporting of the use of these drugs was common, but we also detected underreported exposure to ethylone, fentanyl, 3,4-methylenedioxyamfetamine, metamfetamine, and synthetic cannabinoids. Prevalence of discordant reporting of cocaine use was higher among those testing positive for ketamine exposure (adjusted prevalence ratio = 2.63; 95% CI: 1.48-4.69) and prevalence of discordant reporting of ketamine use was lower post-coronavirus disease caused by the SARS-CoV-2 virus (adjusted prevalence ratio = 0.39; 95% CI: 0.16-0.91) and among those reporting cocaine use (adjusted prevalence ratio = 0.53; 95% CI: 0.32-0.89). DISCUSSION Underreporting of drug use was common, suggesting the need for researchers to better deduce intentional underreporting versus unknown drug exposure via adulterants. CONCLUSIONS Researchers should consider both self-report and toxicology results from biological samples when examining trends in use.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
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8
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Mestria S, Odoardi S, Biosa G, Valentini V, Strano Rossi S. Hair analysis: Assessment of homemade hair treatment effects on drug concentrations in the keratin matrix. Drug Test Anal 2023. [PMID: 37419869 DOI: 10.1002/dta.3541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 07/09/2023]
Abstract
Hair is the matrix of choice for investigating a subject's drug history over time, usually with specific forensic applications (license renewal, workplace drug testing, toxicological evaluation), and it is generally considered difficult to be tampered with. Nevertheless, some treatments promising to lower drug concentrations in hair are described online as how to "pass" a drug test. We selected three of these practices, claiming to be effective in decreasing drug concentrations-Treatment 1: (A) baking soda, (B) salicylic acid, (C) bleach; Treatment 2: (A) bleaching and (B) dyeing; Treatment 3: (A) white vinegar, (B) salicylic acid moisturizer, (C) liquid cleanser, and (D) dyeing. Quantitative results were compared with those of untreated hair strands, used as reference. We evaluated the efficacy of the treatment on drugs of abuse and benzodiazepines. Treatment 1 proved to be the most effective, since drug concentrations in treated hair were significantly lower than in untreated ones, although methadone and tetrahydrocannabinol (THC) seemed to be less affected than cocaine and 6-monoacetylmorphine (MAM). The mean percentage values of treatment-induced decrease were up to 90% for cocaine, 81% for benzoylecgonine, 77% for morphine, 89% for MAM, 37% for methadone, 67% for ketamine, 80% for MDMA, 76% for methamphetamine, and 60% for THC, compared with the reference samples. There was no noticeable damage or discoloration of the keratin matrix, making it difficult for the technicians to determine if there was a treatment. This could be an issue for the application of cutoffs or when low concentrations of drugs are incorporated into the keratinic matrix.
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Affiliation(s)
- Serena Mestria
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Sara Odoardi
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Giulia Biosa
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Valeria Valentini
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
| | - Sabina Strano Rossi
- Department of Healthcare Surveillance and Bioethics, Forensic Toxicology Laboratory, Università Cattolica del Sacro Cuore F. Policlinico Gemelli IRCCS, Rome, Italy
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Rubicondo J, Scuffi L, Pietrosemoli L, Mineo M, Terranova F, Bartucca M, Trignano C, Bertol E, Vaiano F. A New Multi-Analyte LC-MS-MS Screening Method for the Detection of 120 NPSs and 49 Drugs in Hair. J Anal Toxicol 2023; 46:e262-e273. [PMID: 36453750 DOI: 10.1093/jat/bkac093] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
Liquid chromatography coupled with mass spectrometry (LC-MS) has been increasingly used for screening purposes in forensic toxicology. High versatility and low time/resource consumption are the main advantages of this technology. Numerous multi-analyte methods have been validated in order to face the analytical challenge of new psychoactive substances (NPSs). However, forensic toxicologists must focus the attention also on "classical" NPSs and medicines, such as benzodiazepines (BDZs) and prescription opioids. In this paper, a new method for the simultaneous detection of 169 substances (120 NPSs and 49 other drugs) in hair by LC-MS-MS is described. After the decontamination of hair samples with dichloromethane, a 20-mg aliquot of the sample was mixed with 1 mL of methanol (MeOH; 0.1% of formic acid) and then sonicated at room temperature for 2 h. The mixture was then dried under nitrogen stream and reconstituted with 100 µL of MeOH. LC separation was achieved with a 100-mm-long C18 column in 35 min, and mass acquisition was performed in dynamic multiple reaction monitoring mode and in positive ionization. The analysis results were very sensitive, with the limit of quantification ranging from 0.07 to 10.0 pg/mg. Accuracy and precision were always within the acceptable criteria. Matrix effect and recovery rate ranges were from -21.3 to + 21.9% and from 75.0 to 99.3%, respectively. The new method was successfully applied in a preliminary study on the prevalence of NPSs, BDZs and other substances in case of driving license issuance. In 14% of cases, BDZs/antidepressants (mainly trazodone, diazepam/nordiazepam and flunitrazepam) were found. Codeine, ketamine, methylone and mephedrone were also detected.
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Affiliation(s)
- J Rubicondo
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - L Scuffi
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - L Pietrosemoli
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - M Mineo
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - F Terranova
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - M Bartucca
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - C Trignano
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, Sassari 07100, Italy
| | - E Bertol
- U.R.I.To.N.-Unit of Research, University of Florence, L.go Brambilla 3, Florence 50134, Italy
| | - F Vaiano
- Forensic Toxicology Unit, Department of Health Science, University of Florence, L.go Brambilla 3, Florence 50134, Italy.,U.R.I.To.N.-Unit of Research, University of Florence, L.go Brambilla 3, Florence 50134, Italy
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10
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Sabbioni G, Castaño A, Esteban López M, Göen T, Mol H, Riou M, Tagne-Fotso R. Literature review and evaluation of biomarkers, matrices and analytical methods for chemicals selected in the research program Human Biomonitoring for the European Union (HBM4EU). Environ Int 2022; 169:107458. [PMID: 36179646 DOI: 10.1016/j.envint.2022.107458] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
Humans are potentially exposed to a large amount of chemicals present in the environment and in the workplace. In the European Human Biomonitoring initiative (Human Biomonitoring for the European Union = HBM4EU), acrylamide, mycotoxins (aflatoxin B1, deoxynivalenol, fumonisin B1), diisocyanates (4,4'-methylenediphenyl diisocyanate, 2,4- and 2,6-toluene diisocyanate), and pyrethroids were included among the prioritized chemicals of concern for human health. For the present literature review, the analytical methods used in worldwide biomonitoring studies for these compounds were collected and presented in comprehensive tables, including the following parameter: determined biomarker, matrix, sample amount, work-up procedure, available laboratory quality assurance and quality assessment information, analytical techniques, and limit of detection. Based on the data presented in these tables, the most suitable methods were recommended. According to the paradigm of biomonitoring, the information about two different biomarkers of exposure was evaluated: a) internal dose = parent compounds and metabolites in urine and blood; and b) the biologically effective = dose measured as blood protein adducts. Urine was the preferred matrix used for deoxynivalenol, fumonisin B1, and pyrethroids (biomarkers of internal dose). Markers of the biological effective dose were determined as hemoglobin adducts for diisocyanates and acrylamide, and as serum-albumin-adducts of aflatoxin B1 and diisocyanates. The analyses and quantitation of the protein adducts in blood or the metabolites in urine were mostly performed with LC-MS/MS or GC-MS in the presence of isotope-labeled internal standards. This review also addresses the critical aspects of the application, use and selection of biomarkers. For future biomonitoring studies, a more comprehensive approach is discussed to broaden the selection of compounds.
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Affiliation(s)
- Gabriele Sabbioni
- Università della Svizzera Italiana (USI), Research and Transfer Service, Lugano, Switzerland; Institute of Environmental and Occupational Toxicology, Airolo, Switzerland; Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University Munich, Munich, Germany.
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III (ISCIII), Majadahonda, Spain.
| | - Marta Esteban López
- National Centre for Environmental Health, Instituto de Salud Carlos III (ISCIII), Majadahonda, Spain.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg (IPASUM), Erlangen, Germany.
| | - Hans Mol
- Wageningen Food Safety Research, Part of Wageningen University & Research, Wageningen, the Netherlands.
| | - Margaux Riou
- Department of Environmental and Occupational Health, Santé publique France, The National Public Health Agency, Saint-Maurice, France.
| | - Romuald Tagne-Fotso
- Department of Environmental and Occupational Health, Santé publique France, The National Public Health Agency, Saint-Maurice, France.
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11
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Xu D, Ji J, Xiang P, Yan H, Duan G, Shen M. Time course of estazolam in single-strand hair based on micro-segmental analysis after controlled oral administration. Front Chem 2022; 10:996857. [PMID: 36324520 PMCID: PMC9619365 DOI: 10.3389/fchem.2022.996857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
The mechanism of estazolam incorporation into hair was investigated by studying the time course of estazolam along single-strand hair after two oral administration of estazolam at 28 days interval. Estazolam in single hair segments 0.4 mm in length was verified and quantified by ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). The distributions of estazolam within a strand of hair (collected at 12 h, 28 days, and 56 days post-administration) were visualized by micro-segmental analysis. The highest estazolam concentration (1.5–9.9 pg/mm) was detected in the hair bulb region (S1), and it then decreased through the hair shaft to the distal end, with a small fluctuation (0.3–3 pg/mm) near the junction of the hair roots and shafts (S4–S7) 12 h after drug intake. These findings suggested that the incorporation of estazolam occurred in two regions, mainly in the hair bulb and to a lesser extent in the upper dermis zone. Models using internal temporal markers (TIMs) and temporal intervals (TIs) were constructed to estimate the day of estazolam ingestion. The estimation accuracy was within an average error of 1.7 mm and 3.0 mm between the calculated and actual positions, based on the TIMs and TIs 56 days after estazolam intake. These findings can help in further elucidation of the drug incorporation mechanism, which is crucial for interpreting hair analysis results used to reveal individual drug-use history.
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Affiliation(s)
- Duoqi Xu
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, China
| | - Jiaojiao Ji
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, China
- Department of Forensic Medicine of Shanghai Medical College, Fudan University, Shanghai, China
| | - Ping Xiang
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, China
| | - Hui Yan
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, China
| | - Gengli Duan
- Department of Phamaceutical Analysis, School of Phamacy, Fudan University, Shanghai, China
| | - Min Shen
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, China
- *Correspondence: Min Shen,
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Staufer K, Huber-Schönauer U, Strebinger G, Pimingstorfer P, Suesse S, Scherzer TM, Paulweber B, Ferenci P, Stimpfl T, Yegles M, Datz C, Trauner M. Ethyl glucuronide in hair detects a high rate of harmful alcohol consumption in presumed non-alcoholic fatty liver disease. J Hepatol 2022; 77:918-930. [PMID: 35605744 DOI: 10.1016/j.jhep.2022.04.040] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/05/2022] [Accepted: 04/21/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) cannot reliably be distinguished by routine diagnostics, and the role of alcohol consumption in metabolic dysfunction-associated fatty liver disease (MAFLD) remains unclear. We investigated alcohol consumption in patients with presumed NAFLD and ALD using novel objective alcohol markers. METHODS In total, 184 consecutive patients were included in this prospective observational study. Alcohol intake was assessed by ethylglucuronide in hair (hEtG) and urine (uEtG); the utility of these measures for alcohol detection was compared to Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), carbohydrate deficient transferrin (CDT), mean corpuscular volume (MCV), gamma-glutamyltransferase (GGT), and ALD/NAFLD index (ANI). Clinical characteristics of patients with NAFLD and ALD were re-assessed after reclassification based on repeated moderate (≥10 g <60 g EtOH/day) and excessive (≥60 g EtOH/day) alcohol consumption, and patients were retrospectively reclassified based on MAFLD criteria. RESULTS Repeated moderate to excessive alcohol consumption was detected in 28.6%, 28.5%, and 25.0% of patients with presumed NAFLD, ALD or MAFLD, respectively. ANI score, AUDIT-C, uEtG, and hEtG showed AUCs of 0.628, 0.733, 0.754, and 0.927 for the detection of repeated moderate to excessive alcohol consumption, respectively. The indirect markers CDT, MCV and GGT were not reliable. Patients with repeated moderate or excessive alcohol consumption were significantly more often male, had a significantly lower BMI, and suffered significantly less often from type 2 diabetes or impaired glucose tolerance. CONCLUSIONS In total, 28.6% of patients with presumed NAFLD, and 25.0% with MAFLD are at risk of alcohol-related liver damage. AUDIT-C, uEtG and hEtG should be used to screen for alcohol consumption in patients with fatty liver disease. LAY SUMMARY Fatty liver disease can be caused by metabolic factors and/or alcohol consumption. The diagnosis of non-alcoholic fatty liver disease (NAFLD) is based on the exclusion of harmful alcohol consumption, while metabolic dysfunction-associated fatty liver disease (MAFLD), which has been proposed as a new name for NAFLD, is based on the presence of metabolic comorbidities and allows for alcohol consumption. Herein, we show that up to 29% of patients diagnosed with NAFLD and 25% with MAFLD are at risk of alcohol-related liver damage. We show that ethyl glucuronide (a metabolite of alcohol) in the hair and urine can accurately detect potentially harmful alcohol consumption in these patients - as such, these tests should be integrated into routine diagnostic work-up for patients with fatty liver disease.
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Affiliation(s)
- Katharina Staufer
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria; Department of General Surgery, Division of Transplantation, Medical University of Vienna, Vienna, Austria.
| | - Ursula Huber-Schönauer
- Department of Internal Medicine, Krankenhaus Oberndorf, Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Oberndorf, Austria
| | - Georg Strebinger
- Department of Internal Medicine, Krankenhaus Oberndorf, Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Oberndorf, Austria
| | - Philipp Pimingstorfer
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria; Department of Internal Medicine 2 for Nephrology, Endocrinology, Rheumatology, and Gastroenterology, Johannes Kepler University Linz, Med Campus III, Linz, Austria
| | | | | | - Bernhard Paulweber
- First Department of Medicine, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Peter Ferenci
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria
| | - Thomas Stimpfl
- Department of Laboratory Medicine, Division of Toxicology, Medical University of Vienna, Vienna, Austria
| | - Michel Yegles
- Laboratoire National de Santé, Service de Toxicologie médico-légale, Dudelange, Luxembourg
| | - Christian Datz
- Department of Internal Medicine 2 for Nephrology, Endocrinology, Rheumatology, and Gastroenterology, Johannes Kepler University Linz, Med Campus III, Linz, Austria
| | - Michael Trauner
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of Vienna, Vienna, Austria
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13
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Xu D, Ji J, Xiang P, Yan H, Shen M. Two DFSA cases involving midazolam clarified by the micro-segmental hair analyses. Forensic Toxicol 2022; 40:374-382. [PMID: 36454413 DOI: 10.1007/s11419-022-00621-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/23/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE In this study, an analytical procedure to identify trace amounts of drug in hair based on micro-segmental hair analysis was presented. The method also can be used to estimate the time of drug ingestion at daily precision by cutting a single hair into sub-millimeter segments which correspond to daily hair growth. METHODS A method was established for efficient extraction of midazolam, one of the most frequently detected compound in drug-facilitated sexual assault (DFSA) cases, from each 0.4-mm hair segment and validated by ultra-high performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS). Moreover, two DFSA cases were used to compare the micro-segmental hair analysis with the 1- cm segmental analysis method. RESULTS The validation showed a lower limit of quantification of 0.5 pg/mm for midazolam, with intraday and interday accuracies (bias) from - 5.2 to 0.9%. The micro-segmental hair analysis method was applied to proximal 1-cm hair segment including hair bulbs in two DFSA cases. The micro-segmental hair analysis results in case 1 showed midazolam in the S15-S17 (5.6-6.8 mm from hair bulb) in a concentration range from 0.5 to 0.9 pg/mm, and the concentrations of midazolam in all hair micro-segments (0-1 cm from the scalp) in case 2 were from 0.5 to 2.0 pg/mm. CONCLUSIONS Comparison with the conventional method revealed that micro-segmental hair analysis may enhance the utility of hair drug testing and strengthen probative force in DFSA cases.
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Affiliation(s)
- Duoqi Xu
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, 200063, China
| | - Jiaojiao Ji
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, 200063, China.,Department of Forensic Medicine of Shanghai Medical College, Fudan University, 138 Medical College Road, Shanghai, 200433, China
| | - Ping Xiang
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, 200063, China
| | - Hui Yan
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, 200063, China
| | - Min Shen
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai, 200063, China.
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Kintz P, Gheddar L. Identification par LC-MS/MS de la testostérone acétate dans la crinière d’un cheval de course. Toxicologie Analytique et Clinique 2022. [DOI: 10.1016/j.toxac.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Luo Y, Zhang C, Ma L, Zhang Y, Liu Z, Chen L, Wang R, Luan Y, Rao Y. Measurement of 7-dehydrocholesterol and cholesterol in hair can be used in the diagnosis of Smith-Lemli-Opitz syndrome. J Lipid Res 2022; 63:100228. [PMID: 35577137 PMCID: PMC9207299 DOI: 10.1016/j.jlr.2022.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/06/2022] [Accepted: 05/08/2022] [Indexed: 11/20/2022] Open
Abstract
7-dehydrocholesterol (7-DHC) and cholesterol (CHOL) are biomarkers of Smith-Lemli-Opitz Syndrome (SLOS), a congenital autosomal recessive disorder characterized by elevated 7-DHC level in patients. Hair samples have been shown to have great diagnostic and research value, which has long been neglected in the SLOS field. In this study, we sought to investigate the feasibility of using hair for SLOS diagnosis. In the presence of antioxidants (2,6-ditert-butyl-4-methylphenol and triphenylphosphine), hair samples were completely pulverized and extracted by micro-pulverized extraction in alkaline solution or in n-hexane. After microwave-assisted derivatization with N,O-Bis(trimethylsilyl)trifluoroacetamide, the analytes were measured by GC-MS. We found that the limits of determination for 7-DHC and CHOL were 10 ng/mg and 8 ng/mg, respectively. In addition, good linearity was obtained in the range of 50–4000 ng/mg and 30–6000 ng/mg for 7-DHC and CHOL, respectively, which fully meets the requirement for SLOS diagnosis and related research. Finally, by applying the proposed method to real hair samples collected from 14 healthy infants and two suspected SLOS patients, we confirmed the feasibility of hair analysis as a diagnostic tool for SLOS. In conclusion, we present an optimized and validated analytical method for the simultaneous determination of two SLOS biomarkers using human hair.
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16
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Freni F, Moretti M, Scardo S, Carelli C, Vignali C, Monti MC, Morini L. Ethyl glucuronide in hair: a 5-years retrospective cohort study in subjects sanctioned for driving under the influence of alcohol and psychoactive substances. Drug Test Anal 2022; 14:1417-1428. [PMID: 35355418 PMCID: PMC9543301 DOI: 10.1002/dta.3265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The evaluation of drinking behaviours can help in limiting high-risk situation, such as driving under the influence (DUI). We investigate ethyl glucuronide in hair (hEtG) levels to evaluate alcohol consumption behaviour in subjects followed up after having been charged for DUI of psychoactive substances and/or alcohol. METHODS We performed a retrospective observational cohort study on 4328 subjects over 18 years old who underwent hEtG analysis in the period 2015-2019 in the Italian Province of Pavia. hEtG level was used as a proxy for the alcohol consumption behaviour. Effects of age, sex and district on alcohol drinking behaviour were investigated with an ordinal logit model. A state sequence analysis was used to study people's alcohol consumption behaviour over time. RESULTS hEtG was found ≥7.0 pg/mg in 22.2% of the drivers (of which 7% has an hEtG ≥30.0 pg/mg). Among positive cases, a prevalence of males (96.3%) aged 35-44 (32.6%), coming from main city and hinterland (38.2%) was observed. The propensity to drink was higher for males (OR≈2.28, p<0.001) and for subject coming from the district devoted to the cultivation of vineyards. Young age classes have a reduced drinking risk if compared to the drivers over 55 years old (p<0.001). A general decreasing trend over time in hEtG values was observed. CONCLUSION Being male, age ≥ 55 years, and coming from rural areas are potential risk factors related to alcohol drinking habits among drivers. Ethyl glucuronide in hair test in the driving license reissuing protocol contributed to decrease alcohol misuse behaviours.
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Affiliation(s)
- Francesca Freni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Sara Scardo
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Claudia Carelli
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
| | - Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine, University of Pavia, Pavia, Italy
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17
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Vermeulen L, van Nuijs AL, Crunelle CL, Jacobs W, Neels H. Ethyl glucuronide and alcohol abstinence: a correlation study in hair and fingernails to establish a cut-off value in fingernails for teetotalers. Forensic Sci Int 2022. [DOI: 10.1016/j.forsciint.2022.111278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/21/2022]
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18
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Ramírez Fernández MDM, Wille SMR, Yegles M, Samyn N. Evaluation of decontamination procedures for drug testing in undamaged vs damaged hair. Drug Test Anal 2022; 14:1155-1165. [PMID: 35148467 DOI: 10.1002/dta.3237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Although substances incorporated by ingestion are strongly bound to hair, their loss may occur if aggressive decontamination procedures are applied, especially in highly damaged/porous hair. AIMS Evaluation of cleaning procedures using hair samples with different porosity obtained from ethanol or drug users (cocaine, heroin, methamphetamine, methadone, fentanyl, tramadol, diazepam, buprenorphine, dihydrocodeine, citalopram and trazodone). The effect of washing time and multiple wash steps with water and methanol were evaluated. METHODS Hair samples (n=16) were selected and evaluated according to: a) the drug pattern consumption, b) available amount, and c) hair porosity (c1 'cosmetic treatment', c2: storage time). Six of them were soaked with an aqueous deuterated analogue solution. The samples were cut in 1 cm segments and homogenized. All hair samples were then decontaminated one or six times with 1.5 mL of water or methanol during 1, 5, 15, 30, 60 and/or 90 min (n=1 to 3/sample, depending on the available amount of hair). Hair extracts were then cleaned up via an SPE or LLE extraction, while the washes were evaporated to dryness. All were thereafter reconstituted and analysed with routine UPLC-MS/MS methods. RESULTS AND DISCUSSION Although concentrations of parent drugs and/or metabolites presented a negative trend along the washing time with methanol (up to 80%), the compounds were relatively well retained in hair even after a 90 min wash in most samples. Their retention would depend mostly on the hair nature rather than their physicochemical properties (whether incorporated by ingestion and/or from external contamination). Moreover, parent drugs and/or metabolites were detected in the washes in most samples, and the ratio between hair and washes decreased along the washing time. More than 50% of the deuterated analogues soaked into hair were still present after the different washing steps. CONCLUSION Generally, the substances analysed were well retained in hair samples after different washing steps with water or methanol. Losses were observed more frequently for long term stored hair samples, after decontamination with methanol for more than 30 min. Therefore, prolonged or repeated cleaning with methanol should be avoided in general procedures.
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Affiliation(s)
| | - Sarah M R Wille
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
| | - Michel Yegles
- Laboratoire National de Santé, Dudelange, Luxembourg
| | - Nele Samyn
- Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium
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Cobo-Golpe M, de-Castro-Ríos A, Cruz A, Páramo M, López-Rivadulla M, Lendoiro E. Determination of antidepressants and benzodiazepines in paired hair and nail samples. Forensic Sci Int 2021; 326:110935. [PMID: 34333195 DOI: 10.1016/j.forsciint.2021.110935] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
Hair and nails are keratinized matrices that can be used in Toxicology as matrices for the long-term detection of substances. Whereas hair is an established matrix with decades of use in this field, nails have been less studied, especially including a comparison to hair samples. Specifically in the case of antidepressant and benzodiazepine drugs, very few publications analyzing these drugs in nail samples exist as of yet. For this reason, in the present study a method for the detection of 12 antidepressant and benzodiazepine drugs in hair and nail samples was developed. Samples were decontaminated with 3 washes of dichloromethane, and 25 or 30 mg of hair and nails, respectively, were pulverized. Then, the samples were incubated with 1.5 mL water:ACN (50:50, v/v) with horizontal agitation for 90 min. The supernatant was evaporated and reconstituted in 200 µL of methanol and 2 mL of 2% FA in water, submitted to solid phase extraction (SPE) using Oasis MCX cartridges and analyzed by LC-MS/MS. The method was satisfactorily validated in nail and hair samples for the following parameters: linearity, LOD (0.005-0.02 ng/mg), LOQ (0.01-0.02 ng/mg), selectivity, carryover, accuracy, imprecision, matrix effect, extraction efficiency, process efficiency and autosampler stability. Matched fingernail, toenail and hair samples were obtained from 21 patients under treatment with any of the studied drugs and analyzed with the developed method. The most frequently detected drugs were venlafaxine (n = 11), trazodone (n = 6), zolpidem (n = 5), alprazolam (n = 5) and nordiazepam (n = 5). Concentrations in hair, fingernails and toenails, respectively, were 44.31 ng/mg, 8.05-43.35 ng/mg and 7.02-22.69 ng/mg for venlafaxine; 5.40-19.08 ng/mg, 0.13-1.00 ng/mg and 0.42-1.04 ng/mg for trazodone; 13.86 ng/mg, 5.19 ng/mg and 9.11 ng/mg for fluoxetine; 7.42 ng/mg, 1.85 ng/mg and 0.03-2.81 ng/mg for sertraline; 0.40-1.42 ng/mg, 0.12 ng/mg and 0.16 ng/mg for zolpidem; and 0.02-0.11 ng/mg, 0.07-1.07 ng/mg and 0.05 ng/mg for alprazolam for the patients under active treatment. Hair concentrations were higher than nail concentrations for most drugs in patients under active treatment, with the exception of diazepam (n = 1; 0.12 ng/mg in hair and 0.41 ng/mg in fingernails). Fingernail concentrations were lower than toenail concentrations in patients under active treatment in most compared cases. Comparison of fingernails and toenails of a patient with antifungal treatment did not show an observable effect in concentrations.
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Affiliation(s)
- María Cobo-Golpe
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Ana de-Castro-Ríos
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Angelines Cruz
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Mario Páramo
- Servizo de Psiquiatría, Complexo Hospitalario Universitario de Santiago (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Manuel López-Rivadulla
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain
| | - Elena Lendoiro
- Servicio de Toxicología, Instituto de Ciencias Forenses, Universidade de Santiago de Compostela, San Francisco s/n, 15782 Santiago de Compostela, Spain.
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20
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Cardoso MS, Lanaro R, Dolores RC, Morais DR, Arantes ACF, Oliveira KD, Costa JL. Determination of Drugs of Abuse in Hair by LC-MS/MS: Application to Suicide Attempts Investigation. J Anal Toxicol 2021; 46:577-581. [PMID: 34050658 DOI: 10.1093/jat/bkab058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/12/2021] [Accepted: 05/28/2021] [Indexed: 11/14/2022] Open
Abstract
Considering that the use of psychoactive substances (PS) is a risk factor to either higher intensity or frequency of suicidal behavior, hair analysis was conducted to investigate the most consumed PS (opiates, amphetamine stimulants, marijuana, cocaine, and heroin) in patients who attempted suicide and received urgent care at Emergency Service. Hair samples were extracted using methanol and sonicated under heating, and then analyzed using liquid chromatography-tandem mass spectrometry. During validation, the method complied with international recommended criteria, with limits of detection between 0.0025 and 0.05 ng/mg and linearity between 0.1 to 4 ng/mg for methamphetamine, MDMA, morphine, amphetamine, 6-acetylmorphine, MDA, fenproporex, diethylpropion, codeine; between 0.025 to 1 ng/mg for THC, benzoylecgonine and cocaethylene; and between 0.25 to 10 ng/mg for cocaine and mazindol. A total of 109 hair samples were analyzed and segmented in 404 parts. Among all analyzed samples, 30.3% were positive for at least one PS (n=33), such as: cocaine (90.9%), codeine (12.1%), morphine (3.0 %), MDMA (3.0%) and THC (3.0%). In segmental analysis of cocaine positive samples (n=30), 76.7% of the samples indicated recent exposure to cocaine (<1 month). This same behavior was observed when analyzing codeine (n=4) and morphine (n=1). THC positive samples indicated exposure dated approximately 4 months prior. In conclusion, the method was validated following international recommendations for the twelve most consumed psychoactive substances in Brazil, as well as two of the most common found metabolites.
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Affiliation(s)
- Marilia S Cardoso
- Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil
- Campinas Poison, Control Center, University of Campinas, R. Vital Brasil, 251 Barão Geraldo, Campinas, São Paulo 13083-881, Brazil
| | - Rafael Lanaro
- Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil
- Campinas Poison, Control Center, University of Campinas, R. Vital Brasil, 251 Barão Geraldo, Campinas, São Paulo 13083-881, Brazil
| | - Raul C Dolores
- Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil
- R. Mário Giordano, 146 Antiga 33, Jardim America, Paulínia, São Paulo 13140-614, Brazil
| | - Damila R Morais
- Shimadzu Brazil, Av. Tambore, 576 Tamboré, Barueri, São Paulo 06460-000, Brazil
| | - Ana Carolina Furiozo Arantes
- Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil
- Campinas Poison, Control Center, University of Campinas, R. Vital Brasil, 251 Barão Geraldo, Campinas, São Paulo 13083-881, Brazil
| | - Karina Diniz Oliveira
- Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil
| | - Jose Luiz Costa
- Campinas Poison, Control Center, University of Campinas, R. Vital Brasil, 251 Barão Geraldo, Campinas, São Paulo 13083-881, Brazil
- Faculty of Pharmaceutical Sciences, University of Campinas, R. Cândido Portinari, 200 Cidade Universitária, Campinas, São Paulo 13083-871, Brazil
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21
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Hakim F, Nassibou S, Gish A, Lima B, Wiart JF, Richeval C, Outreville J, Quétard V, Allorge D, Gaulier JM. Exhumation of a Methamphetamine Body-Packer: Pitfalls of Hair Result Interpretation. J Anal Toxicol 2021; 46:bkab040. [PMID: 33851701 DOI: 10.1093/jat/bkab040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 11/14/2022] Open
Abstract
Carrying out toxicological investigations in biological samples (e.g. hair) collected from extensively decomposed bodies and even more interpretation of subsequently obtained results is challenging, even more in some particular circumstances of death. In order to illustrate these pitfalls, we report the case of the exhumation of a methamphetamine body-packer. Autopsy examination of a 41-year-old man, one year after his burial, revealed the presence of 44 green pellets (7 out of 44 were torn) along all the gastrointestinal tract. A 6-cm long dark hair strand and pellets were sampled for toxicological analyses. Large toxicological screenings were applied to hair and pellets using both LC-MS/MS and LC-HRMS. Intact pellets contained around 10 g of methamphetamine (MA) with a purity ranging from 29 to 35 %. Positive hair results were amiodarone (4.12 ng/mg), desethylamiodarone (5.29 ng/mg) and methamphetamine (7.63 ng/mg). Methamphetamine pellets in gastrointestinal tract were consistent with the autopsy conclusion, i.e. fatal intoxication due to in corpore pellet rupture in a body-packer (the victim was initially deemed to have died from heart failure). In the absence of available data in the literature, amiodarone and metabolite presence in hair could putatively be the consequence of a chronic treatment. Methamphetamine hair concentration was similar to those observed in regular consumers. However, interpreting this hair result is challenging due to (i) the possibility of contamination by sweat at the time of death, and (ii) the probable contamination by putrefaction fluids. This latter hypothesis (artifactual contamination during the post-mortem period) is highly supported by high concentration of methamphetamine in decontamination bath, and even more by the absence of the major methamphetamine metabolite (amphetamine) in hair. As a conclusion, in this particular situation, the hair analysis result (presence of MA and concomitant absence of amphetamine) is in agreement with the previously-established cause of death.
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Affiliation(s)
- Florian Hakim
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
| | - Shanti Nassibou
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
| | - Alexandr Gish
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
| | - Benjamin Lima
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
| | | | - Camille Richeval
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
| | | | | | - Delphine Allorge
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
| | - Jean-Michel Gaulier
- CHU Lille, Unité Fonctionnelle de Toxicologie, F-59000 Lille, France
- Univ. Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
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22
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Alladio E, Visintin L, Lombardo T, Testi R, Salomone A, Vincenti M. The Impact of COVID-19 Pandemic and Lockdown on Alcohol Consumption: A Perspective From Hair Analysis. Front Psychiatry 2021; 12:632519. [PMID: 33889098 PMCID: PMC8055823 DOI: 10.3389/fpsyt.2021.632519] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/05/2021] [Indexed: 01/20/2023] Open
Abstract
Introduction and Aims: The increase in stress levels, social confinement, and addiction's physical consequences play an essential role in the proliferation of drug abuse. In this context, the Covid-19 pandemic produced remarkable effects on those individuals prone to addictions, especially to alcohol. Alcohol is linked to multiple dangerous conditions such as social issues, severe medical conditions, and road accidents. The determination of ethylglucuronide (EtG) in hair is frequently performed to test and monitor chronic excessive alcohol intake conditions, as it allows differentiation among low-risk/moderate drinkers, and excessive/chronic drinkers. Our study aimed to explore hair EtG levels in a controlled population to assess the impact of Covid-19 lockdown on alcohol intake along March-May 2020. Materials and Methods: EtG levels were measured in all hair samples collected in the months following April 2020 to evaluate the behaviors related to alcohol intake along with the time frame from March to May 2020. The measured concentration distributions for each month were compared with those reported in the same month during the previous 4 years (2016-2019). The dataset was built to highlight possible differences between genders, and the different categories of alcohol consumption, separately. Results: The samples collected from April to August 2020 (500 < N <1,100 per month) showed an increase in the percentage of subjects classified as abstinent/low-risk drinkers (from 60 up to 79%) and a decrease of subjects classified as moderate and chronic drinkers (-12 and -7%, respectively) when compared to the previous 4 years. A decrease in the overall mean value of EtG in the period April-June 2020 was observed, while the EtG levels of both June and July 2020 provided an increasing trend for chronic/excessive consumers (+27 and +19% for June and July 2020, respectively). A peculiar rise in the EtG levels of moderate and chronic/excessive female consumers was observed along April-June 2020, too. Discussion and Conclusions: Behavioral and social studies generally report a decrease in alcohol consumption during the Covid-19 lockdown. However, people already suffering from drug or alcohol addictions before Covid-19 pandemic seemingly enhance their harmful behavior. Our data from April to August 2020 are consistent with both suppositions. Our observations confirm once again the utility of EtG to investigate the patterns of alcohol consumption in the population.
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Affiliation(s)
- Eugenio Alladio
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Lia Visintin
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Tonia Lombardo
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Torino, Italy
| | - Roberto Testi
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Torino, Italy
| | - Alberto Salomone
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Torino, Italy
| | - Marco Vincenti
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Torino, Italy
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23
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Gerace E, Bakanova SP, Di Corcia D, Salomone A, Vincenti M. Determination of cannabinoids in urine, oral fluid and hair samples after repeated intake of CBD-rich cannabis by smoking. Forensic Sci Int 2020; 318:110561. [PMID: 33172758 DOI: 10.1016/j.forsciint.2020.110561] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
Cannabidiol prevalent (CBD-rich) cannabis derivatives are increasingly popular and widely available on the market as replacement of THC, tobacco substitutes or therapeutics for various health conditions. In this paper, we evaluate the impact of a repeated CBD-rich cannabis intake on levels of cannabinoids in biological samples. Urine, oral fluid and hair (pubic and head) samples were obtained from a naive user during a 26-day smoking period of one 250-mg CBD-rich cannabis joint/day containing 6.0% cannabidiol (CBD; 15mg) and 0.2% delta-9-tetrahydrocannabinol (THC; 0.5mg). In total, 35 urine, 8 oral fluid and 4hair sample were collected. Cannabinoids concentrations were quantified by a UHPLC/MSn technique. The results suggested that the repeated exposure to CBD-rich cannabis (containing small amounts of THC) can generate positive results in biological samples. Urinary concentrations of 11-nor-9-carboxy-delta-9-tetrahydrocannabinol (THC-COOH) were quantitatively detected after 8 days from the smoking start and exceeded the 15ng/mL cut-off limit on day-15 even in the urine sample collected 12h after the last intake. In the oral fluid collected on day-26, no cannabinoids were found before the cannabis intake, thus excluding accumulation, while THC was detectable up to 3h after the cannabis intake, at concentrations progressively decreasing from about 18 to 6ng/mL. Hair samples collected one week after the end of the study turned out negative for THC and THC-COOH, suggesting that this matrix is suitable to discriminate the chronic consumption of CBD-rich cannabis from THC-prevalent products. The obtained findings are relevant for the interpretations of cannabinoids levels in biological fluids, also in light of the legal implications of a positive result.
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Affiliation(s)
- Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia"A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy.
| | | | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia"A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia"A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy; Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia"A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy; Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
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24
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Salomone A, Di Corcia D, Negri P, Kolia M, Amante E, Gerace E, Vincenti M. Targeted and untargeted detection of fentanyl analogues and their metabolites in hair by means of UHPLC-QTOF-HRMS. Anal Bioanal Chem 2020; 413:225-233. [PMID: 33063167 PMCID: PMC7801321 DOI: 10.1007/s00216-020-02994-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022]
Abstract
Detection of new psychoactive substances and synthetic opioids is generally performed by means of targeted methods in mass spectrometry, as they generally provide adequate sensitivity and specificity. Unfortunately, new and unexpected compounds are continuously introduced in the illegal market of abused drugs, preventing timely updating of the analytical procedures. Moreover, the investigation of biological matrices is influenced by metabolism and excretion, in turn affecting the chance of past intake detectability. In this scenario, new opportunities are offered by both the non-targeted approaches allowed by modern UHPLC-HRMS instrumentation and the investigation of hair as the matrix of choice to detect long-term exposure to toxicologically relevant substances. In this study, we present a comprehensive and validated workflow that combines the use of UHPLC-QTOF-HRMS instrumentation with a simple hair sample extraction procedure for the detection of a variety of fentanyl analogues and metabolites. A simultaneous targeted and untargeted analysis was applied to 100 real samples taken from opiates users. MS and MS/MS data were collected for each sample. Data acquisition included a TOF-MS high-resolution scan combined with TOF-MS/MS acquisition demonstrating considerable capability to detect expected and unexpected substances even at low concentration levels. The predominant diffusion of fentanyl was confirmed by its detection in 68 hair samples. Other prevalent analogues were furanylfentanyl (28 positive samples) and acetylfentanyl (14 positive samples). Carfentanil, methylfentanyl, and ocfentanil were not found in any of the analyzed samples. Furthermore, the retrospective data analysis based on untargeted acquisition allowed the identification of two fentanyl analogues, namely β-hydroxyfentanyl and methoxyacetylfentanyl, which were not originally included in the panel of targeted analytes.
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Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy. .,Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy.
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy
| | | | - Maria Kolia
- Department of Chemistry, University of Ioannina, Ioannina Campus, 1186, Ioannina, 45500, Greece
| | - Eleonora Amante
- Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy
| | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia, Regione Gonzole 10/1, 10043, Orbassano, TO, Italy.,Department of Chemistry, University of Turin, Via Pietro Giuria 5, 10125, Torino, Italy
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25
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Hill VA, Schaffer MI, Paulsen RB, Stowe GN. Hydroxycocaines as Metabolic Indicators of Cocaine Ingestion. Forensic Sci Int 2020; 317:110516. [PMID: 33010562 DOI: 10.1016/j.forsciint.2020.110516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/08/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Abstract
Hydroxycocaines in hair were investigated with many hundreds of head and body hair samples. All samples were washed by a published extensive aqueous method prior to confirmation by LC-MS/MS. Concentrations, percent of cocaine, and ratios of para- and meta-hydroxycocaines to ortho-hydroxycocaine are presented. Hydroxycocaines as percent of cocaine did not appear to be affected by cocaine concentrations, but were shown to increase with cocaethylene concentrations. Stability of hydroxycocaines over a year of ambient storage was demonstrated. Ortho-hydroxycocaine was shown to be formed by exposure of cocaine-positive hair to peroxide, while para- and meta-hydroxycocaines were not. Presence of para- or meta-hydroxycocaine at > 0.05% of cocaine is proposed as indicating ingestion of cocaine. This indicator prevents black hair from being more likely interpreted as positive for ingestion than lighter colored hair.
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Affiliation(s)
- Virginia A Hill
- Psychemedics Corporation, 5832 Uplander Way, Culver City, CA 90230, United States.
| | - Michael I Schaffer
- Psychemedics Corporation, 5832 Uplander Way, Culver City, CA 90230, United States.
| | - Ryan B Paulsen
- Psychemedics Corporation, 5832 Uplander Way, Culver City, CA 90230, United States.
| | - G Neil Stowe
- Psychemedics Corporation, 5832 Uplander Way, Culver City, CA 90230, United States.
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26
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Müller VV, Hahn RZ, Lizot LDLF, Schneider A, da Silva CP, Gerbase FE, Pereira D, Linden R, Antunes MV. Validation of an analytical method for the simultaneous determination of 16 drugs and metabolites in hair in the context of driving license granting. Forensic Sci Int 2020; 315:110428. [DOI: 10.1016/j.forsciint.2020.110428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 11/17/2022]
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27
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Eisenbeiss L, Binz TM, Baumgartner MR, Kraemer T, Steuer AE. Towards Best Practice in Hair Metabolomic Studies: Systematic Investigation on the Impact of Hair Length and Color. Metabolites 2020; 10:381. [PMID: 32993123 PMCID: PMC7601250 DOI: 10.3390/metabo10100381] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022] Open
Abstract
Untargeted metabolomic studies are used for large-scale analysis of endogenous compounds. Due to exceptional long detection windows of incorporated substances in hair, analysis of hair samples for retrospective monitoring of metabolome changes has recently been introduced. However, information on the general behavior of metabolites in hair samples is scarce, hampering correct data interpretation so far. The presented study aimed to investigate endogenous metabolites depending on hair color and along the hair strand and to propose recommendations for best practice in hair metabolomic studies. A metabolite selection was analyzed using untargeted data acquisition in genuine hair samples from different hair colors and after segmentation in 3 cm segments. Significant differences in metabolites among hair colors and segments were found. In conclusion, consideration of hair color and hair segments is necessary for hair metabolomic studies and, subsequently, recommendations for best practice in hair metabolomic studies were proposed.
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28
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Rosado T, Gallardo E, Vieira DN, Barroso M. New miniaturized clean-up procedure for hair samples by means of microextraction by packed sorbent: determination of cocaine and metabolites. Anal Bioanal Chem 2020; 412:7963-76. [PMID: 32960286 DOI: 10.1007/s00216-020-02929-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/20/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
Cocaine is still one of the most commonly used illicit substances worldwide, with an estimated 4 million users in Europe in the last year. Hair samples have been widely used for the determination of episodic or repeated consumption of this substance, but the use of miniaturized techniques for hair sample clean-up has been challenging due to the sample complexity. Despite hair's complex matrix, MEPS provides a method that is fast, reduces the volume of extraction solvents used, and offers low-cost options (since extraction beds may be reused several times). Microextraction by packed sorbent using a mixed-mode sorbent was optimized for hair sample clean-up in order to determine cocaine, benzoylecgonine, ecgonine methyl ester, norcocaine, cocaethylene and anhydroecgonine methyl ester by gas chromatography coupled to tandem mass spectrometry. The method was fully validated according to internationally accepted criteria, presenting good linearity between the limits of quantification (0.01-0.15) and 5 ng/mg. Precision and accuracy resulted in coefficients of variation typically lower than 15%, with mean relative errors within ±15% for all compounds, except for the limit of quantification (±20%). The present work describes the first application of microextraction by packed sorbent for the concentration of cocaine and metabolites extracted from hair samples. Graphical abstract.
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29
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Salomone A, Bigiarini R, Palamar JJ, McKnight C, Vinsick L, Amante E, Di Corcia D, Vincenti M. Toward the Interpretation of Positive Testing for Fentanyl and Its Analogs in Real Hair Samples: Preliminary Considerations. J Anal Toxicol 2020; 44:362-369. [PMID: 31776578 DOI: 10.1093/jat/bkz102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 11/14/2022] Open
Abstract
The detection of new psychoactive substances (NPS) in hair has become extensively researched in recent years. Although most NPS fall into the classes of synthetic cannabinoids and designer cathinones, novel synthetic opioids (NSO) have appeared with increasing frequency in the illicit drug supply. While the detection of NSO in hair is now well documented, interpretation of results presents several controversial issues, as is quite common in hair analysis. In this study, an ultra-high-performance liquid chromatography-tandem mass spectrometry method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair was applied to 293 real samples. Samples were collected in the USA between November 2016 and August 2018 from subjects who had reported heroin use in the past year or had already tested positive to hair testing for common opiates. The range, mean and median concentrations were calculated for each analyte, in order to draw a preliminary direction for a possible cut-off to discriminate between exposure to either low or high quantities of the drug. Over two-thirds (68%) of samples tested positive for fentanyl at concentrations between LOQ and 8600 pg/mg. The mean value was 382 pg/mg and the median was 95 pg/mg. The metabolites norfentanyl and 4-ANPP were also quantified and were found between LOQ and 320 pg/mg and between LOQ and 1400 pg/mg, respectively. The concentration ratios norfentanyl/fentanyl, 4-ANPP/fentanyl and norfentanyl/4-ANPP were also tested as potential markers of active use and to discriminate the intake of fentanyl from other analogs. The common occurrence of samples positive for multiple drugs may suggest that use is equally prevalent among consumers, which is not the case, as correlations based on quantitative results demonstrated. We believe this set of experimental observations provides a useful starting point for a wide discussion aimed to better understand positive hair testing for fentanyl and its analogs in hair samples.
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Affiliation(s)
- A Salomone
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano TO, Italy
| | - R Bigiarini
- Dipartimento di Chimica, Università di Torino, Torino, Italy
| | - J J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - C McKnight
- New York University, Department of Epidemiology, College of Global Public Health, New York, NY, USA
| | | | - E Amante
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano TO, Italy
| | - D Di Corcia
- Centro Regionale Antidoping e di Tossicologia, Orbassano TO, Italy
| | - M Vincenti
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano TO, Italy
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30
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Madry MM, Kraemer T, Baumgartner MR. Large scale consumption monitoring of benzodiazepines and z-drugs by hair analysis. J Pharm Biomed Anal 2020; 183:113151. [DOI: 10.1016/j.jpba.2020.113151] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/24/2020] [Accepted: 02/05/2020] [Indexed: 02/06/2023]
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31
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Dinis-Oliveira RJ, Magalhães T. Abuse of Licit and Illicit Psychoactive Substances in the Workplace: Medical, Toxicological, and Forensic Aspects. J Clin Med 2020; 9:E770. [PMID: 32178358 DOI: 10.3390/jcm9030770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/01/2020] [Accepted: 03/10/2020] [Indexed: 01/23/2023] Open
Abstract
About one-third of adult life is spent in the workplace. The use of psychoactive substances is a major preventable cause of morbidity and mortality. The consumption of psychoactive substances during or outside working hours greatly increases the frequency and severity of labor accidents, as well as the workers’ poor general state of health and productivity, implying higher costs for enterprises. It is the responsibility of organizations to ensure the safety and health of their workers. These cannot be limited to traditional routine clinical exams, as other aspects also have an impact on health. Thus, prevention and intervention in the consumption of psychoactive substances (e.g., ethanol, opioids, central nervous system stimulants or depressants, hallucinogens, Cannabis derivatives, dissociative substances, and inhalants) in labor activity should be considered as an investment of organizations and not as a cost, in view of the professional, personal, and family advantages for workers and employers, with a potential impact on productivity, security, health, and quality of life at work. Despite the extensive literature on the subject, each article generally focuses on one or another aspect of a very specific nature, not tackling the problem in a holistic way by confronting clinical, safety, and legal issues. This article presents a reflection on the legal, laboratorial, clinical, ethical, forensic, and safety concerns related to the consumption of psychoactive substances in the workplace, and can be a cross-cutting contribution to occupational medicine, forensic medicine, and insurance medicine, as well as for entrepreneurs, lawyers, judges, workers, and technicians from the public and private sectors that develop projects in this area. This discussion is based on general principles established internationally and highlights the role of the occupational healthcare system and other decision-making actors in the prevention and supervision of workplace psychoactive consumption.
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32
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Wiart JF, Hakim F, Andry A, Eiden C, Drevin G, Lelièvre B, Rougé-Maillart C, Decourcelle M, Lemaire-Hurtel AS, Allorge D, Gaulier JM. Pitfalls of toxicological investigations in hair, bones, and nails in extensively decomposed bodies: illustration with two cases. Int J Legal Med 2020; 134:1339-1344. [DOI: 10.1007/s00414-020-02267-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/21/2020] [Indexed: 12/01/2022]
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33
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Musshoff F, Schwarz G, Sachs H, Skopp G, Franz T. Concentration distribution of more than 100 drugs and metabolites in forensic hair samples. Int J Legal Med 2020; 134:989-95. [DOI: 10.1007/s00414-020-02259-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
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34
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Scholz C, Quednow BB, Herdener M, Kraemer T, Baumgartner MR. Cocaine Hydroxy Metabolites in Hair: Indicators for Cocaine Use Versus External Contamination☆. J Anal Toxicol 2020; 43:543-552. [PMID: 30927360 DOI: 10.1093/jat/bkz022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/28/2018] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
Given that external contamination must be considered in hair analysis, there is still a demand for reliable tools to differentiate between incorporation of drugs into the hair as a result of drug consumption and of the hair shaft by external contamination. With the aim of establishing alternative discrimination parameters, some of the hydroxy metabolites of cocaine i.e., para- and meta-hydroxycocaine and para- and meta-hydroxybenzoylecgonine were measured together with cocaine, benzoylecgonine, cocaethylene, and norcocaine in five seized street cocaine samples and in hair samples from different cohorts: cohort 1 (in vivo external contamination study, n = 28), cohort 2 (individuals with self-reported cocaine use, n = 92), and cohort 3 (individuals with suspected cocaine use or contamination, n = 198). Statistical evaluation of the data of cohort 1 and 2 using ROC curves yielded metabolic ratios indicating cocaine use. Based on these results, a decision workflow was established for the discrimination between cocaine use and external contamination. The power of this approach was finally statistically validated across the different cohorts.
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Affiliation(s)
- Clementine Scholz
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Switzerland
| | - Thomas Kraemer
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
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Salomone A, Palamar JJ, Vincenti M. Should NPS be included in workplace drug testing? Drug Test Anal 2020; 12:191-194. [PMID: 31840414 DOI: 10.1002/dta.2749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Marco Vincenti
- Dipartimento di Chimica, Università di Torino, Turin, Italy.,Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", , Orbassano, Turin, Italy
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36
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Casati S, Angeli I, Ravelli A, Del Fabbro M, Minoli M, Orioli M. 11-OH-THC in hair as marker of active cannabis consumption: Estimating a reliable cut-off by evaluation of 672 THC-positive hair samples. Forensic Sci Int 2019; 304:109951. [DOI: 10.1016/j.forsciint.2019.109951] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 11/15/2022]
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Meier U, Colledge F, Imfeld S, Briellmann T, Mercer-Chalmers-Bender K, Scheurer E, Dussy F. Distribution pattern of common drugs of abuse, ethyl glucuronide, and benzodiazepines in hair across the scalp. Drug Test Anal 2019; 11:1522-1541. [PMID: 31407516 DOI: 10.1002/dta.2679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/05/2019] [Accepted: 08/05/2019] [Indexed: 11/09/2022]
Abstract
While hair analysis is important and accepted in forensic applications, fundamental knowledge gaps still exist, exacerbated by a lack of knowledge of the incorporation mechanisms of substances into hair. The influence of the hair sampling location on the head on ethyl glucuronide (EtG) and cocaine concentrations was investigated by measuring the complete scalp hair of 14 (2 EtG, 4 cocaine, 8 both EtG and cocaine) study participants in a grid pattern for EtG, drugs of abuse, and benzodiazepines. Head skin perfusion and sweating rates were investigated to rationalize the concentration differences. For EtG, ratios between maximum and minimum concentrations on the scalp ranged from 2.5 to 7.1 (mean 4.4). For cocaine, the ratios ranged from 2.8 to 105 (mean 17.6). EtG concentrations were often highest at the vertex, but the distribution was strongly participant dependent. Cocaine and its metabolites showed the lowest concentrations at the vertex and the highest on the periphery, especially at the forehead. These differences led to hair from some head parts being clearly above conventional cut-offs and others clearly below. In addition to EtG and cocaine, the distributions of 24 other drugs of abuse and benzodiazepines/z-substances and metabolites are described. No clear pattern was observed for the head skin perfusion. Sweating rate measurements revealed higher sweating rates on the periphery of the haircut. Therefore, sweat could be a main incorporation route for cocaine. Concentration differences can lead to different interpretations depending on the sampling site. Therefore, the results are highly relevant for routine forensic hair analysis.
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Affiliation(s)
- Ulf Meier
- Department of Forensic Chemistry and Toxicology, University of Basel Institute of Forensic Medicine, Basel, Switzerland
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Stephan Imfeld
- Department of Angiology, University Hospital Basel, Basel, Switzerland
| | - Thomas Briellmann
- Department of Forensic Chemistry and Toxicology, University of Basel Institute of Forensic Medicine, Basel, Switzerland
| | - Katja Mercer-Chalmers-Bender
- Department of Forensic Chemistry and Toxicology, University of Basel Institute of Forensic Medicine, Basel, Switzerland
| | - Eva Scheurer
- University of Basel Institute of Forensic Medicine, Basel, Switzerland
| | - Franz Dussy
- Department of Forensic Chemistry and Toxicology, University of Basel Institute of Forensic Medicine, Basel, Switzerland
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Cruvinel VRN, Marques CP, Cardoso V, Novaes MRCG, Araújo WN, Angulo-Tuesta A, Escalda PMF, Galato D, Brito P, da Silva EN. Health conditions and occupational risks in a novel group: waste pickers in the largest open garbage dump in Latin America. BMC Public Health 2019. [PMID: 31096940 DOI: 10.1186/s12889-019-6879-x/tables/2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND The inadequate management of solid waste impacts populations' health and quality of life, and disproportionately affects developing countries. This study aims to describe a protocol for epidemiological diagnosis, the purpose being to estimate the prevalence of chronic and communicable and non communicable diseases in waste pickers, and the occupational and environmental risk factors to which these are exposed. METHODS This is a cross-sectional study, based on survey design in an area of extreme social vulnerability - the largest garbage dump in Latin America. Using a multidimensional research protocol, divided in three stages: 1- The identification of the subjects, and the scheduling of tests; 2- Situational diagnosis through interviews, anthropometric evaluation, measuring blood pressure, collecting hair and nail samples to detect exposure to heavy metals and undertaking laboratory tests; 3- The return of the waste pickers to receive the test results, followed by referral to the health team and to report occupational accidents. RESULTS One thousand twenty-five waste pickers undertook tests and interviews. The majority were women (67.0%), with 36-45 years old (45.7%), and 96.0% had children. In total, 27.3% of the participants did not attend to any school and 47.7% were educated only up to primary level. The majority of waste pickers (68.70%) reported accidents and most of them (89.69%) were related to sharp objects. The mean time working in this open dump was 15 years. According the anthropometric measure, 32.6% were overweight and 21.1% were obese. The most common reported diseases were: osteomuscular disorders (78.7%); arboviruses (28.6%); episodic diarrhea (24.9%); hypertension (24.2%); bronchitis (14.3%); intestinal worms (12.6%) and diabetes (10.1%). According to the blood tests, the values outside the reference limits were: Uric acid (23.89%); creatinine (54.06%); GGT range (16.04%); SGOT - Serum Glutamic Oxaloacetic Transaminase (5.29%); SGPT - serum Glutamic-Pyruvic Transaminase (35.52%). CONCLUSIONS This study is the first to evaluate multiple risks and diseases in the majority of waste pickers working in the largest garbage dump of a continent. These findings highlight the importance to address urgently the environmental, social and health impacts related to the management of solid waste in developmental countries to protect these workers and their families.
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Affiliation(s)
| | | | - Vanessa Cardoso
- School of Health Sciences and State Secretariat of Health of the Federal District, Brasília, Brazil
| | | | | | | | | | - Dayani Galato
- University of Brasília, Faculty of Ceilandia, Brasília, Brazil
| | - Petruza Brito
- School of Health Sciences and State Secretariat of Health of the Federal District, Brasília, Brazil
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Cruvinel VRN, Marques CP, Cardoso V, Novaes MRCG, Araújo WN, Angulo-Tuesta A, Escalda PMF, Galato D, Brito P, da Silva EN. Health conditions and occupational risks in a novel group: waste pickers in the largest open garbage dump in Latin America. BMC Public Health 2019; 19:581. [PMID: 31096940 PMCID: PMC6521552 DOI: 10.1186/s12889-019-6879-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 04/22/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The inadequate management of solid waste impacts populations' health and quality of life, and disproportionately affects developing countries. This study aims to describe a protocol for epidemiological diagnosis, the purpose being to estimate the prevalence of chronic and communicable and non communicable diseases in waste pickers, and the occupational and environmental risk factors to which these are exposed. METHODS This is a cross-sectional study, based on survey design in an area of extreme social vulnerability - the largest garbage dump in Latin America. Using a multidimensional research protocol, divided in three stages: 1- The identification of the subjects, and the scheduling of tests; 2- Situational diagnosis through interviews, anthropometric evaluation, measuring blood pressure, collecting hair and nail samples to detect exposure to heavy metals and undertaking laboratory tests; 3- The return of the waste pickers to receive the test results, followed by referral to the health team and to report occupational accidents. RESULTS One thousand twenty-five waste pickers undertook tests and interviews. The majority were women (67.0%), with 36-45 years old (45.7%), and 96.0% had children. In total, 27.3% of the participants did not attend to any school and 47.7% were educated only up to primary level. The majority of waste pickers (68.70%) reported accidents and most of them (89.69%) were related to sharp objects. The mean time working in this open dump was 15 years. According the anthropometric measure, 32.6% were overweight and 21.1% were obese. The most common reported diseases were: osteomuscular disorders (78.7%); arboviruses (28.6%); episodic diarrhea (24.9%); hypertension (24.2%); bronchitis (14.3%); intestinal worms (12.6%) and diabetes (10.1%). According to the blood tests, the values outside the reference limits were: Uric acid (23.89%); creatinine (54.06%); GGT range (16.04%); SGOT - Serum Glutamic Oxaloacetic Transaminase (5.29%); SGPT - serum Glutamic-Pyruvic Transaminase (35.52%). CONCLUSIONS This study is the first to evaluate multiple risks and diseases in the majority of waste pickers working in the largest garbage dump of a continent. These findings highlight the importance to address urgently the environmental, social and health impacts related to the management of solid waste in developmental countries to protect these workers and their families.
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Affiliation(s)
| | | | - Vanessa Cardoso
- School of Health Sciences and State Secretariat of Health of the Federal District, Brasília, Brazil
| | | | | | | | | | - Dayani Galato
- University of Brasília, Faculty of Ceilandia, Brasília, Brazil
| | - Petruza Brito
- School of Health Sciences and State Secretariat of Health of the Federal District, Brasília, Brazil
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40
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Matey JM, Moreno de Simon MD, García-Ruiz C, Montalvo G. A validated GC-MS method for ketamine and norketamine in hair and its use in authentic cases. Forensic Sci Int 2019; 301:447-54. [PMID: 31153676 DOI: 10.1016/j.forsciint.2019.04.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 11/21/2022]
Abstract
This work has shown that it is a valid method for determining ketamine, norketamine and amphetamines derivates in hair samples of forensic cases. This method was validated meeting the criteria of sensitivity and accuracy for detecting repeated consumption of ketamine in hair samples of forensic interest, according to the proposed cut-off for ketamine of 0.5 ng/mg. The detection of norketamine allowed discriminating between active uses and external contamination. The assessed method was applied for analyzing 1189 hair samples of judicial interest received in the INTCF along 15 months, obtaining 62 positive in ketamine consumption. This means a 5.2% of positivity. Ketamine consumers present a profile of young age (21-30 years old), polydrug use with consumption of synthetic substances preferably MDMA and, then, amphetamine. As consumer is collective, prone to consume new psychoactive substances, requires special attention due to they show a consumer profile with higher prevalence in MDMA than amphetamine, indicating that ketamine consumers belong to a subgroup with a different profile within the INTCF casuistry. The results of the exercises of the proficiency tests performed satisfactorily in all cases. In conclusion, it is a suitable method also to evaluate the chronic consumption of ketamine, in addition to amphetamines in the same method of analysis.
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41
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Matey JM, Moreno de Simón MD, Garcia-Ruiz C, Montalvo G. Evaluation of the analytical performance of a HPLC-MS/MS method for determining ketamine and norketamine in real forensic hair samples. Reanalyzing a selection of positive cases with high resolution LC-MS for seeking other arylcyclohexylamines. Toxicologie Analytique et Clinique 2019. [DOI: 10.1016/j.toxac.2019.03.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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42
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Salomone A, Palamar JJ, Bigiarini R, Gerace E, Di Corcia D, Vincenti M. Detection of Fentanyl Analogs and Synthetic Opioids in Real Hair Samples. J Anal Toxicol 2019; 43:259-265. [PMID: 30462247 PMCID: PMC6460334 DOI: 10.1093/jat/bky093] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/17/2018] [Accepted: 10/23/2018] [Indexed: 11/13/2022] Open
Abstract
Novel synthetic opioids include various analogs of fentanyl and emerging non-fentanyl compounds with different chemical structures, such as AH-7921, MT-45 and U-47700. In recent years, these drugs have rapidly emerged on the drug market, and their abuse has been increasing worldwide. The motivations for use of these new compounds include their legal status, ready availability, low cost, users' curiosity or preference for their particular pharmacological properties and the intention to avoid detection. Furthermore, more common drugs like heroin are now increasingly being replaced or cut with fentanyl or new designer opioids; thus, many drug users are unintentionally or unknowingly using synthetic fentanyl analogs. In this scenario, the detection of new psychoactive substances in hair can provide insight into their current diffusion among the population and social characteristics of these synthetic drug users. In this manuscript, we describe a simple, fast, specific and sensitive UHPLC-MS-MS method able to detect 13 synthetic opioids (including fentanyl analogs) and metabolites in hair samples. Furthermore, the method includes the detection of 4-anilino-N-phenethyl-piperidine (4-ANPP), which is considered both a precursor and a metabolite of several fentanyl analogs. The method was applied to 34 real hair samples collected in New York City from subjects who had reported past-year non-medical opioid and/or heroin use. In total, 17 samples tested positive for at least one target analyte, with oxycodone (nine samples) and tramadol (eight samples) being the most common. Among these, the method was able to quantify furanyl-fentanyl and fentanyl in the pg/mg range in two samples. Simultaneously, also 4-ANPP was detected, giving evidence for the first time that this compound can be selected as a marker of fentanyl analogs use via hair testing. In conclusion, this study confirmed the increasing diffusion of new synthetic opioids and "fentalogs" with high potency among non-medical opioid users.
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Affiliation(s)
- Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center
- Center for Drug Use and HIV/HCV Research, New York University College of Nursing New York, NY, USA
| | | | - Enrico Gerace
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Daniele Di Corcia
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Orbassano, Turin, Italy
- Dipartimento di Chimica, Università di Torino, Turin, Italy
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43
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Musshoff F. Aktuelles zur forensisch-toxikologischen Haaranalytik. Rechtsmedizin (Berl) 2019; 29:137-153. [DOI: 10.1007/s00194-019-0309-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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44
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Affiliation(s)
- Pascal Kintz
- Institut de Médecine légale Strasbourg France
- X‐Pertise Consulting Oberhausbergen France
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45
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Kintz P. Results from hair testing in putrefied bodies should not be used to document long-term exposure to drugs. Toxicologie Analytique et Clinique 2018. [DOI: 10.1016/j.toxac.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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46
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Salomone A, Bozzo A, Di Corcia D, Gerace E, Vincenti M. Occupational Exposure to Alcohol-Based Hand Sanitizers: The Diagnostic Role of Alcohol Biomarkers in Hair. J Anal Toxicol 2018; 42:157-162. [PMID: 29206963 DOI: 10.1093/jat/bkx094] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 11/16/2017] [Indexed: 01/19/2023] Open
Abstract
Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair are effective direct biomarkers of ethanol ingestion, whose analytical determination can be used to discriminate between chronic and occasional ethanol intake. Ethanol is a compound widely used in some workplaces (e.g., clinics, hospitals) and is present in considerable amounts in mouthwash for oral cleaning, medications, cosmetic products, hydro-alcoholic disinfectants and antiseptics for hands. This study examined the ethyl alcohol exposure derived from hand disinfectants (in gel form) by simulating the typical occupational situation of medical-health workers (healthcare workers, nurses, surgeons, etc.) who frequently wash their hands with antiseptic sanitizer. Two types of hand disinfectants with 62% w/w of ethanol content were daily applied to the hands of a teetotaler for 20 times a day, for 4 consecutive weeks, thus simulating a typical workplace situation and a cumulative dermal exposure to ethanol of ~1,100 g. Different matrices (head, chest and beard hair, urine) were regularly sampled and analyzed using a ultra high-performance liquid chromatography tandem massspectrometry validated method for EtG and a (HS)SPME-GC-MS validated technique for FAEEs. The data obtained showed that a significant dermal absorption and/or inhalation of ethanol occurred, and that the use of detergents produce urinary EtG concentrations both higher than the cut-offs normally used for clinical and forensic analyses (either 100 and 500 ng/mL, depending on the context). The concentrations of the ethanol metabolites in the keratin matrices were, respectively, below the cut-off of 7 pg/mg for EtG and below 0.5 ng/mg for FAAEs (0.35 ng/mg for ethyl palmitate). In conclusion, the regular use of alcohol-based hand sanitizers can affect the concentration of urinary EtG and lead to positive analytical results, particularly when specimens are obtained shortly after sustained use of ethanol-containing hand sanitizer. On the other hand, direct biomarkers of alcohol abuse in the keratin matrix are capable of distinguishing between ethanol consumption and incidental exposures.
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Affiliation(s)
- A Salomone
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - A Bozzo
- Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
| | - D Di Corcia
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - E Gerace
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - M Vincenti
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy.,Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
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47
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Kieliba T, Lerch O, Andresen-Streichert H, Rothschild MA, Beike J. Simultaneous quantification of THC-COOH, OH-THC, and further cannabinoids in human hair by gas chromatography-tandem mass spectrometry with electron ionization applying automated sample preparation. Drug Test Anal 2018; 11:267-278. [DOI: 10.1002/dta.2490] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Tobias Kieliba
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne; Cologne Germany
| | | | | | - Markus A. Rothschild
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne; Cologne Germany
| | - Justus Beike
- Institute of Legal Medicine, Faculty of Medicine, University of Cologne; Cologne Germany
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48
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Własiuk P, Alladio E, Salomone A, Vincenti M, Zadora G. Evidence of seasonal variation of ethyl glucuronide in hair: Modeling a seven-year data series. Drug Test Anal 2018; 11:77-85. [PMID: 30051649 DOI: 10.1002/dta.2470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/06/2018] [Accepted: 07/18/2018] [Indexed: 11/09/2022]
Abstract
The assessment of chronic excessive alcohol consumption by ethyl glucuronide (EtG) determination in hair is generally based on a cut-off value of 30 pg/mg recognized by regulatory authorities and scientific societies that guide the decision process. The ongoing debate about the risks connected with the straightforward application of this cut-off refers to the factors that may influence the detected EtG concentration. The present contribution to this debate evaluates the seasonal variation of the averaged EtG values along a seven-year period. Over 65 000 data points have been statistically analyzed to provide a mathematical model that interprets the data, gives insight into several influencing factors, and forecasts progressive data-points of the time series. This model shows that there is an annual pattern in the data exhibiting lower EtG concentrations during warm seasons and higher values in cold seasons. The estimated EtG cycles are characterized by the seasonal variation of ±2.78 pg/mg above and below the overall mean (with 5.56 pg/mg absolute difference overall). This seasonal factor associated with EtG quantification might result in a potential source of bias, at least in the regional/climatic conditions observed in the samples' collection area. Moreover, the EtG time series reveals that the change in the sample pre-treatment procedure has an effect on the modeled pattern as an abrupt increment (+38%) in the mean value of the EtG concentration. This change corresponds to the time when the former protocol of cutting hair into small segments before extraction was substituted by pulverization with a ball mill.
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Affiliation(s)
- Patryk Własiuk
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University in Kraków, Poland.,Institute of Forensic Research, Kraków, Poland
| | - Eugenio Alladio
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, (TO), Italy.,Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Alberto Salomone
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, (TO), Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, (TO), Italy.,Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | - Grzegorz Zadora
- Institute of Forensic Research, Kraków, Poland.,Department of Analytical Chemistry, Institute of Chemistry, The University of Silesia in Katowice, Poland
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Biedermann A, Taroni F, Bozza S, Augsburger M, Aitken C. Critical analysis of forensic cut-offs and legal thresholds: A coherent approach to inference and decision. Forensic Sci Int 2018; 288:72-80. [DOI: 10.1016/j.forsciint.2018.04.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 02/18/2018] [Accepted: 04/16/2018] [Indexed: 10/17/2022]
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50
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Franz T, Scheufler F, Stein K, Uhl M, Dame T, Schwarz G, Sachs H, Skopp G, Musshoff F. Determination of hydroxy metabolites of cocaine from hair samples and comparison with street cocaine samples. Forensic Sci Int 2018; 288:223-6. [DOI: 10.1016/j.forsciint.2018.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 11/24/2022]
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