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Glorennec P.,EHESP School of Public Health | Peyr C.,City of Aubervilliers | Poupon J.,Inhalation Toxicology Research Institute | Oulhote Y.,EHESP School of Public Health | Le Bot B.,EHESP School of Public Health
Journal of Occupational and Environmental Hygiene | Year: 2010

Despite a dramatic decrease in children's blood lead levels (BLL), lead exposure remains a public health concern because increasing evidence shows effects at very low doses. Lowering BLL still further requires the identification of lead sources and, therefore, new tools to investigate and thus prevent exposure. We describe a procedure that uses both lead concentrations and isotope ratios (IRs) to identify sources of overexposure in homes. Water, dust, and paint chips were sampled from the homes of 21 children with elevated BLL from Aubervilliers (Paris metropolitan area). Lead concentrations of concern were calculated from reverse physiologically based pharmacokinetic modeling for water and dust. Isotope ratio matching of blood and environmental samples (with a lead content above the concentration of concern) was performed by computation of the distance between their IRs. When the IR of the source did not match that of the blood, the source was eliminated as a source of lead intoxication. The number of sources eliminated (per child) due to lead concentration ranged from 14% to 86% (mean 66%) for dust, and 100% for water samples. The number of remaining potential sources eliminated by IR interpretation varied from 0% to 100% for both dust and paint chips (mean 63% and 58%, respectively). IRs made it possible to eliminate at least one source in 20 of 21 cases and identified a single source in 11 of 21. The number of dust and paint sources not eliminated by concentration or IR varied from 8% to 45% (median 18%). The pilot study supports the usefulness of these procedures and the added value of IRs for identifying sources of lead poisoning. However, systematic use should be supported by cost-effectiveness analysis on a larger and more representative population of elevated BLL. Source


van Nuijs A.L.N.,University of Antwerp | Abdellati K.,University of Antwerp | Bervoets L.,University of Antwerp | Blust R.,University of Antwerp | And 4 more authors.
Journal of Hazardous Materials | Year: 2012

The stability of nine illicit drugs and metabolites in influent wastewater at relevant conditions (20. °C and at pH 7.5) was evaluated during 26. h (in 1. h intervals) to assess whether significant in-sewer processes of degradation or formation occur. This assessment is important for the sewage epidemiology approach, which uses concentrations of illicit drugs and metabolites in influent wastewater to back-calculate amounts of these substances used by a community or population. The results of this study showed that amphetamine, methamphetamine, ecstasy and EDDP (metabolite of methadone) are stable in wastewater for 12. h and longer. For benzoylecgonine and methadone, a modest formation in the course of time was observed (0.2% per h and 0.4% per h, respectively), while for cocaine (40% degradation after 12. h), ecgonine methylester (20% degradation after 12. h), and 6-monoacetylmorphine (20% degradation after 12. h), a clear decrease in concentrations in time was seen. These findings suggest that for compounds with a significant stability issue, it is important to take their behavior into account when performing back-calculations in sewage epidemiology. However, this study also highlights the need of future research regarding transformation pathways of the individual compounds. © 2012 Elsevier B.V.. Source


Ingels A.S.M.E.,Ghent University | Ingels A.S.M.E.,National Institute of Criminalistics and Criminology | Neels H.,University of Antwerp | Neels H.,Inhalation Toxicology Research Institute | And 2 more authors.
Journal of Chromatography A | Year: 2013

A headspace-trap gas chromatography-mass spectrometry (HS-trap GC-MS) method was developed to determine GHB, a low molecular weight compound and drug of abuse, in various biological fluids. Combining this relatively novel and fully automated headspace technique with "in-vial" methylation of GHB allowed for a straightforward approach. One single method could be used for all biofluids (urine, plasma, serum, whole blood or lyzed blood), requiring only 100. μl of sample. Moreover, our approach involves mere addition of all reagents and sample into one vial. Following optimization of headspace conditions and trap settings, validation was performed. Although sample preparation only consists of the addition of salt and derivatization reagents directly to a 100. μl-sample in a HS-vial, adequate method sensitivity and selectivity was obtained. Calibration curves ranged from 5 to 150. μg/ml GHB for urine, from 2 to 150. μg/ml for plasma, and from 3.5 to 200. μg/ml for whole blood. Acceptable precision and accuracy (<13% bias and imprecision) were seen for all quality controls (QC's) (LLOQ-level, low, medium, high), including for the supplementary serum- and lyzed blood-based QC's, using calibration curves prepared in plasma or whole blood, respectively. Incurred sample reanalysis demonstrated assay reproducibility, while cross-validation with another GC-MS method demonstrated that our method is a valuable alternative for GHB determination in toxicological samples, with the advantage of requiring only 100. μl and minimal hands-on time, as sample preparation is easy and injection automated. © 2013 Elsevier B.V. Source


Swortwood M.J.,Florida International University | Boland D.M.,Inhalation Toxicology Research Institute | Decaprio A.P.,Florida International University
Analytical and Bioanalytical Chemistry | Year: 2013

Recently, clandestine drug lab operators have attempted to bypass controlled substances laws and regulations with "designer" compounds chemically and pharmacologically similar to controlled substances. For example, "bath salts" have erupted onto the scene as "legal highs" containing cathinone analogs that have produced severe side effects in users worldwide. These products have sparked concern among law enforcement agencies, and emergency bans have been placed on the sale of such items. Despite the increasing number of designer drugs available, there are few comprehensive screening techniques for their detection and quantification in biological specimens. The liquid chromatography triple quadrupole tandem mass spectrometry (LC-QQQ-MS/MS) method presented here encompasses over thirty important compounds within the phenethylamine, tryptamine, and piperazine designer drug classes. Analytes were determined by LC-QQQ-MS/MS in the multiple-reaction monitoring mode after mixed-mode solid-phase extraction. The bioanalytical method was fully validated according to recommended international guidelines. The assay was selective for all analytes with acceptable accuracy and precision. Limits of quantification were in the range of 1-10 ng/mL for each compound with limits of detection near 10 pg/mL. In order to evaluate its applicability in a forensic toxicological setting, the validated method was used to analyze post-mortem specimens from two cases that were suspected of containing designer drugs. The method was able to identify and quantify seven of these compounds at concentrations as low as 11 ng/mL. The method should have wide applicability for rapid screening of important new drugs of abuse at high sensitivity in both post- and ante-mortem forensic analysis. © 2012 Springer-Verlag Berlin Heidelberg. Source


Montiel V.,Cliniques St Luc | Gougnard T.,Inhalation Toxicology Research Institute | Hantson P.,Cliniques St Luc | Hantson P.,Catholic University of Louvain
European Journal of Emergency Medicine | Year: 2011

Intravenous lipid emulsion (ILE) has been proposed as a rescue therapy for severe local anesthetic drugs toxicity, but experience is limited with other lipophilic drugs. An 18-year-old healthy woman was admitted 8 h after the voluntary ingestion of sustained-release diltiazem (3600 mg), with severe hypotension refractory to fluid therapy, calcium salts, and high-dose norepinephrine (6.66 μg/kg/min). Hyperinsulinemic euglycemia therapy was initiated and shortly after was followed by a protocol of ILE (intralipid 20%, 1.5 ml/kg as bolus, followed by 0.25 ml/kg over 1h). The main finding attributed to ILE was an apparent rapid decrease in insulin resistance, despite a prolonged serum diltiazem elimination half-life. Diltiazem is a lipophilic cardiotoxic drug, which could be sequestered in an expanded plasma lipid phase. The mechanism of action of ILE is not known, including its role in insulin resistance and myocardial metabolism in calcium-channel blocker poisoning. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

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