Society of Forensic Toxicologists, Inc. June...

ToxTalk EditorsYale Caplan, Ph.D., DABFTVickie Watts, M.S.

Section EditorsDan Anderson, M.S., FTS-ABFTMatthew Barnhill, Ph.D., DABFTDwain Fuller, B.S., DFTCBJ. Robert Zettl, MPA

SOFT 2009 Board of DirectorsPRESIDENT

Anthony Costantino, Ph.D., DABFTVICE PRESIDENT

Bradford Hepler, Ph.D., DABFTSECRETARY

Sarah Kerrigan, Ph.D.TREASURER

Marc LeBeau, Ph.D.DIRECTORS

Peter Stout, Ph.D., DABFTDan Anderson, M.S., FTS-ABFTDwain Fuller, B.S., DFTCBAdam Negrusz, Ph.D.Fiona Couper, Ph.D.

ex officioPast President:

Christine Moore, Ph.D., DABCCWebmaster:

Bruce Goldberger, Ph.D., DABFTToxTalk Editors:

Yale Caplan, Ph.D., DABFTVickie Watts, M.S.

I N S I D E T H S I S S U E :2009 Meeting Information 2-3Case Notes 4-7Drugs in the News 8-10Bits & Pieces 11

Inserts:2009 Fun Run Sign Up Form2009 Silent Auction Donation Form2009 Meeting Registration Worksheet

P R E S I D E N T ’ S M E S S A G E

By Anthony Costantino, Ph.D., D-ABFT

®

Society of Forensic Toxicologists , Inc .Volume 33, Issue 2

June 2009

The committee par-ticipated in threeweb presentations /discussion groups inApril and May.These meetings werehosted by RTI andheld in conjunctionwith SAMHSA advisory group. As youmay know, SAMHSA will allow LC/MS/MS techniques for confirmationtesting in 2010. While the analyte andmatrix scope is more focused for theSAMHSA group than that of the SOFTcommittee, it was great to get the opin-ions on the table for discussion. Nofinal decisions have been made, but thediscussions have accelerated the pro-gress toward guidelines for bothgroups.

Finally, I know that you are allexcited about the upcoming annualmeeting. Many companies and govern-ment agencies have trimmed theirtravel budgets and consequently someof us may need to pay more out of ourown pockets in order to attend thisyear’s meeting in OKC. I think thatsome of these cutbacks actually tend tohurt the economy and result in a spiralof less cash due to higher taxes. Thatthought came to mind as I read the fol-lowing statistic in the often quotedWichita Eagle: “each household wouldpay nearly $988 dollars in additionaltaxes annually if it was not for the $115billion in tax revenue generated by thetravel and tourism industry.” Ourmeetings have always been a terrificvalue and this year is no different. Wewill all have a great time. Have a won-derful summer.

Tony

Last month’s message wasfairly lengthy and I received a lot ofgood feedback. This month however, Iam evidently the last to submit so I amattempting to convey my thoughts andprovide you with some updates within amuch smaller space that was designatedfor me by our editor! In this issue’smessage I would like to follow up onthe Board’s activity with respect to theNAS report and subsequent pursuit tojoin the CFSO. As you may recall, theCFSO (Consortium of Forensic ScienceOrganizations) is a lobbying group thatrepresents several forensic science or-ganizations to policy makers at manylevels including the Federal Govern-ment. The organizations representedare AAFS, ASCLD, ASCLD-LAB,Forensic Quality Services, InternationalAssociation for Identification, andNAME. The intent of joining CFSO isto provide representation within thislobbying group by a practicing forensictoxicologist. As you may recall, a fewof the areas that may become standard-ized in forensic science, and thereforewithin our specialty, are accreditation,certification, continuing education andundergraduate and graduate level col-lege programs. The Board voted unani-mously to join CFSO in the best inter-est of SOFT. We are sharing the mem-bership with ABFT. In the shared mem-bership, SOFT will pay 2/3 of the an-nual dues and have the voting voice inthe organization. SOFT will be repre-sented by Peter Stout. Our participa-tion and the arrangement with ABFTwill be reviewed at the end of the firstyear.

Next, I am happy to report thatthere has been a lot of activity amongthe LC/MS/MS Guidelines Committee.

Volume 33, Issue 2

SOFT 2009 ANNUAL MEETINGOklahoma City, Oklahoma

October 18 – 23, 2009

Hosts: Phil Kemp, Dennis McKinney

Site: Cox Convention Center / Renaissance Hotel

WE L C O M E TO OK L A H O M A C I T Y !Hey Ya’ll. The 2009 Planning

Committee welcomes you toFRIENDLY Oklahoma City. We areso excited to showcase our city to all ofyou. With the Bricktown Entertain-ment District located only a blockaway from our host hotels, there aremany attractions located within an easywalk. Whether its dining, clubs, thea-ters or shopping, it’s all located just ashort stroll from your room. However,for those of you interested in exploringthe Greater OKC Metropolitan Area,we are providing a bus for all SOFT

will be able to hop on-and-off of thebus at any venue that interests you andstay as long as you like (or until thelast pick-up). The bus will run from 10am until 7 pm both days.

The Oklahoma Museum of Artopened in 2002 and is located in theheart of Downtown OKC Arts District.Accredited by the American Associa-tion of Museums, the Museum serves170,000 visitors annually. The Mu-seum is home to an extensive perma-nent collection of European andAmerican art, including the most com-

and SO-SOFT attendees to get out andabout in OKC. On Monday and Tues-day (Oct 19th & 20th), a free – YES, ISAID FREE - tour bus will providetransportation with stops at numerousattractions in the OKC Metro. Fea-tured attractions at these stops includethe Oklahoma City Museum of Art,the Oklahoma City National Memorial& Museum, Penn Square Mall, Na-tional Cowboy and Western HeritageMuseum, Remington Park Horse Rac-ing and Casino, Oklahoma City Zoo,and Science Museum Oklahoma. You

Bricktown Entertainment District in Downtown Oklahoma City

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noma, etc. The mall also includes amulti-screen cinema showing the latestmovies. Also, an extensive food courtis available inside the mall. Four fullservice restaurants are also available:Cantina Laredo, Elephant Bar and Res-taurant, Pepperoni Grill and TheCheesecake Factory.

The National Cowboy andWestern Heritage Mu-seum is the next excit-ing stop on our tour.This site will alsoserve as the venue ofour President’s Recep-tion on Tuesday nightbut the Galleries will only be openfrom 7 to 10 pm. Because of this lim-ited viewing time, each person willreceive a free admission ticket in theirwelcome packet so you can enjoy theexhibits at your leisure. This Museumis a must-see for anyone visiting Okla-homa. It’s permanent collections in-clude: The American Cowboy Gallery,American Rodeo Gallery, Arts of theAmerican West, Fine Arms Gallery(Rick Mueller will probably set upcamp here), Native American Gallery,and many others.

Next stop is OKC’s AdventureZone. This encompasses the RaceTrack/Casino, Zoo, and Science Mu-seum.Reming-ton ParkRaceTrack andCasino isone ofAmerica’smost exciting race tracks. Whether itslive races, simulcasts from tracksaround the world, or dropping a quarterin one of the many slots available,there’s something for all those willingto take a chance. Remi’s buffet is alsoavailable for both lunch and dinner.

The OKC Zoo is one of Amer-ica’s finest. In the last 15 years, nu-merous attractions have been added.The Cat Forest/Lion Overlook is spec-

OK L AH O M A NE W S (CO N T I N U E D )prehensive collectionof Dale Chihuly glassin the world. It alsohouses the Midwest’spremiere repertoirecinema, which pre-sents the finest inter-national, independentand classic films. A

special exhibition will be featured dur-ing our meeting: The Dutch Italian-ates: 17th Century Masterpieces fromDulwich Picture Gallery, London. TheMuseum also contains the MuseumCafé, whose French-fusion cuisine issome of the best in OKC. Afternoontea is also provided in the full-servicebar. The Museum Café will be openboth Monday and Tuesday but sadly,the museum itself is closed on Mon-days.

The Oklahoma City NationalMemorial and Museum was created tohonor thosewho werekilled, thosewho survivedand thosechanged for-ever by the1995 bombingof the Alfred P.Murrah FederalBuilding inOklahomaCity. The Me-morial and Museum are dedicated toeducating visitors about the impact ofviolence, informing about events sur-rounding the bombing and inspiringhope and healing through lessonslearned by those affected. This truly isone of the most thought provoking andinspiring sites in America.

Next stop is for the SHOP-PERS in our group. Penn Square Mallis OKC premiere shopping center be-cause of its excellent mix of specialtyshops, comfortable atmosphere, andplush landscapes and furnishings. Fea-tured stores include Macys, Dillards,JC Penny, Pottery Barn, Williams So-

tacular. Get upclose to ourclosest rela-tives at theGreat EscApe.The newestexhibit is theeight acre Oklahoma Trails. This$10.3 million habitat showcases over800 animals native to our GREAT statewhile allowing visitors to enjoy theeleven distinct life zones unique toOklahoma.Travel the sus-pended board-walk and ex-plore thegrassy terrainof BlackMesa, the roll-ing hills of the Ozark Highlands, andfeel the mist from the Zoo’s 25-ft rep-lica of Turner Falls located at Big Riv-ers. These will only make you want tocome back to visit the two new exhib-its under construction, The Asian Ex-hibit and the Children’s Zoo is set toopen in the next two years.

Last but not least is ScienceMuseum Oklahoma. This hands-onmuseum houses many fascinating ex-hibits to stimulate all of our senses.Also located in the museum is TheDome Theater showing the most recentIMAX mov-ies. Forthose of youinterested inour nightsky, thePlanetariumis a greatway to sitback and enjoy the view.

As you can see, OKC offers avast array of sites and activities for all.Once again, WELCOME TO OKC andwe look forward to seeing YA’LL inOctober.

Submitted by:Frank Johnson, SO-SOFT Chair

Submitted by Section Editor, Matthew Barnhill, Ph.D., DABFT

Send interesting “Case Notes” to Section Editor, Matthew Barnhill, Ph.D. at [email protected]

The following is a case ofsudden death of an eleven monthold female found face-down andunresponsive in bed by her grand-mother. The decedent was droppedoff by her mother, already asleep, ataround 2100 hrs and placed intobed. The grandmother laid downwith the decedent at approximately2330 hrs and recalled seeing herstill laying face up and snoringlightly. It was around 0330 hrswhen the grandmother awoke tofind the decedent face down andunresponsive next to her.

stated the decedent had beenslightly congested, the past twodays, but without a fever. She saidthe decedent had been less activeand sleeping more than usual sinceabout noon the day before. It was atthat time that the decedent wasgiven several drops of Infant Tyle-nol.

The pathologist found evi-dence of chronic tracheobronchitis,but no anatomic cause of death.Heart and femoral blood sampleswere submitted to the laboratory fortoxicological analysis. The femoralblood was tested for alcohol by GCdual column headspace FID and a20-drug panel ELISA drug screenwas conducted on a Dynex DSX.Alcohol results were negative, butthe specimen was positive for opi-ates. The ELISA was negative forTHC, however, the specimen dem-onstrated activity near the positivecutoff calibrator. The pathologistwas notified of preliminary resultsand requested testing on multiplespecimens for opiate confirmation.In addition, the pathologist ordereda Basic, Acid, Neutral screen and aTHC confirmation by GCMS onheart blood and urine. The reportedcause of death was morphine over-dose and the manner of death unde-termined. The Bureau of Indian Af-fairs was notified, but it is unknownif there was any further investiga-tion into the child’s death.

Submitted by: Amy Goedert, B.A., Ginger Baker, M.S., Rong-Jen Hwang, Ph.D. of the New Mexico Dept. ofHealth, Scientific Laboratory Division, Toxicology Bureau, Albuquerque, New Mexico.

C A S E N O T E S #1 :M O R P H I N E T O X I C I T Y I N A N I N FA N T

According to the report ofdeath, the mother had neversmoked, used drugs or consumedalcohol. She had prenatal checkupsbeginning in the first trimester andgave birth full term without com-plications. Since her birth, the de-cedent had been evaluated and re-leased from the local ER on twooccasions, at 2 months of agewhen she aspirated formula andagain at 6 months for an ear infec-tion. The decedent had all requiredvaccinations (none recently) andno history of trauma. The mother

C A S E N O T E S

Volume 33, Issue 2

Drug ConcentrationSampleType

Morphine (unconjugated) 0.96 mg/L femoral blood

0.10 mg/L vitreous

1.8 mg/L heart blood

Present urine

Carboxy-THC <5 ng/mL heart blood

Present urine

Ibuprofen Present heart blood and urine

Nicotine Present urine

Cotinine Present urine

Toxicological Results of Heart and Femoral Blood Samples:

Sodium azide (NaN3), a color-less highly reactive and toxic salt, iswidely used in industry. It is used inthe manufacture of explosives and is acomponent in many airbag systems;therefore, industrial and occupationalexposure is common, but fatal inges-tion is rare. Toxicology laboratoriesare occasionally challenged to detectand quantify substances for whichthey have no previous experience.We describe this very situation in apostmortem case arising from an ap-parent intentional ingestion of sodiumazide, as evidenced by a containerlabeled “sodium azide” discovered atthe scene of death. We present a tech-nique and method for detecting thepresence of sodium azide in gastriccontents obtained from autopsy.

Case History and ToxicologyA young male (~ 30 years of

age) was found dead in his privateresidence. There were no obvioussigns of trauma or foul play observedon the body, nor the premises; how-ever, a container labeled sodium azidewas found on the kitchen table. Theautopsy was unremarkable as to ananatomical cause of death. Femoralblood, urine, vitreous humor and gas-tric contents were submitted for toxi-cological analyses. Volatile analysesrevealed a blood ethanol concentra-tion of 0.09% and a vitreous humorethanol concentration of 0.15%; nev-ertheless, all of the other toxicologytesting which included drugs of abusein blood (ELISA), urine (EMIT) and afull scan GCMS screen for alkalineextractable drugs was negative.

NaN3 By Conway MicrodiffusionThe technique employs diffu-

sion of hydrazoic acid (hydrogen

mL so, based on the analytical find-ings, approximately 280 mg(centrifuged aqueous fraction) to 340mg of sodium azide remained in thegastric contents. The urine testednegative. Blood was not provided fortesting. The absence of detectablecyanide in urine may be explained byrapid death and/or binding of azide.The metabolic rate of azide in vivo isuncertain; however, cyanide is con-sidered to be a minor metabolite andmay also be produced in vitro duringincubation of azide in whole blood.

Acute poisonings with so-dium azide secondary to intentionalingestions during suicide gestures arereported for several cases.1,2,3 Coma,metabolic acidosis, respiratory de-pression, ARDS (acute respiratorydistress syndrome), acute cardiacfailure and ventricular fibrillation aredescribed as toxic manifestations.Azide inhibits cytochrome oxidase bybinding irreversibly to the heme co-factor in a process similar to the ac-tion of carbon monoxide.4 Organsundergoing high rates of respiration(e.g., heart, brain) are particularlyprone to the toxicity of azide which,because of its similar symptomatol-ogy, is often compared to cyanide.

The use of Conway cellsharkens to earlier days in forensictoxicology. Notwithstanding, diffu-sion techniques are valuable today asillustrated in our case which de-scribes screening and testing for so-dium azide. Although simple to setup, the diffusion test followed by acolor test provides reasonable speci-ficity for azide and excludes potentialinterferences from cyanide and sali-cylate.

azide or HN3) into a Conway diffusionthree-well cell followed by reactionwith ferric chloride. An intense red-brown color is produced which ismeasured by spectrophotometer at 460nm.The detection limit is 0.02 mg/mL.

Reaction:

H2SO4+2NaN-N-N → 2H-N-N-N+Na2SO4

Azide+Ferric Ion Red-Brown Chelate

Place 0.1N H2SO4 in outer well forseal, filling the “moat”. Place 1 to 2mL of test specimen or calibrator inthe middle well and add 0.25 mL of3N H2SO4. To the center well add 0.1mL of 0.1 N NaOH to trap the hydra-zoic acid and convert again to azideion; add 0.25 mL of 0.5% aqueousFeCl3 to a small test tube and 0.05 mLof center well diffusate. Azide plusferric ion produces a chelate ringwhich has an intense red-brown color.The reaction can be carried out withTrinders reagent (used for salicylate),giving about the same intensity of re-action. Salicylate gives a purplecolor and diffuses very slowly com-pared to hydrazoic acid. Hydrogencyanide, which will also diffuse if pre-sent, does not produce a color reac-tion. The detection limits of the assaymay be improved by using additionalvolume of specimen, or alternatively,measuring color intensity in 0.1 mLmicrocells. Aqueous azide calibratorsare prepared (0.10 to 2.0 mg/mL),along with positive and negative con-trol solutions.

The gastric contents contained1.7 mg/mL of sodium azide by thediffusion test. A direct test on a cen-trifuged gastric aqueous aliquotyielded 1.4 mg/mL. The total volumeof gastric contents at autopsy was 200

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C A S E N O T E S #2 : A N A LY T I C A L D O C U M E N TAT I O N O F T H E

I N G E S T I O N O F S O D I U M A Z I D E : Q U A L I TAT I V E A N D S E M I -Q U A N T I TAT I V E A N A LY S I S O F S O D I U M A Z I D E I N A S U I C I D E

Submitted by: Theodore J. Siek, Ph.D., DABFT, former Director, Analytic Bio-Chemistries, Feasterville, PAand George S. Behonick, Ph.D., DABFT, UMass Forensic Toxicology Laboratory, Worcester, MA

References

1. Senda, T., Nishio, K., Hori, Y.,Baba, A., Suzuki, Y., Asari, Y.and Tsuchimoto, K. A Case ofFatal Acute Sodium Azide Poi-soning. Chudoku Kenkyu 14(4):339-42 (2001)

2. Marquet, P., Clement, S., Lotfi,H. Dreyfuss, M.F., Debord, J.,Dunmont, D. and Lachatre, G.Analytical Findings in a SuicideInvolving Sodium Azide. JAT 20(2): 134-8 (1996)

3. Abrams, J., el-Mallakh, R.S. and

Meyer, R. Suicidal Sodium AzideIngestion. Ann Emerg Med, 16(12):1378-80 (1987)

4. Baselt, R.C., ed. In: Disposition ofToxic Drugs and Chemicals in Man,7th edition, Biomedical Publications,Foster City, CA., pp. 95-6, (2004)

C A S E N O T E S #2 : (C O N T I N U E D )

Volume 33, Issue 2

IntroductionVolatile organic compounds are

often encountered in DUI and medicole-gal investigations. The most notablecompound is ethanol, although otherhousehold or industrial products canalso supply the seeker with a variety ofintoxicating liquids or vapors.Headspace gas chromatography is cur-rently the most widely applied tech-nique in the detection of such volatileintoxicants. However, this method doesnot often provide sufficient physicaldata to allow identification of a general“unknown”. In these cases headspacegas chromatography / mass spectrome-try is most advantageous.

Together, these techniques canbe used to identify, quantify, and verifycommon and uncommon volatile sub-

stances found in forensic specimens.In this submission, we report an un-usual case involving methanol intoxi-cation and the challenging analyticaland toxicological contributions of ni-tromethane, which required the con-certed use of GC-FID and GC-MSassays.

Case HistoryA 56-year-old white male

with the history of chronic alcohol usewas found dead in his car in the park-ing lot of a gym. He had been knownto use the grassy field next to the gymto fly model airplanes. Prior to hisdeath, the decedent had an argumentwith his wife and was told to be soberor leave the house. When she returnedhome, he was gone. After being un-able to locate him, she filed a missing

persons report.Two days later,he was founddead in his carin the parkinglot of the gym.According tothe investiga-tor’s report, thecar was litteredwith emptiedbeer cans. Acan of modelairplane fuelwas near hishand. One ofthe witnesses

who had last seen him alive stated thatthe decedent appeared to be very in-toxicated during their last encounter.

Postmortem ToxicologyFemoral blood specimens

were screened by headspace gas chro-matography for alcohols using a dualcolumn BAC-1 and BAC-2 system.Common drugs of abuse such as co-caine, phencyclidine, amphetamines,and opiates were screened by ELISA.Clinical chemistries involving glu-cose, creatinine, urea nitrogen, so-dium, potassium, and chloride weretested in vitreous humor. Carbonmonoxide was screened in blood byCO-Oximetry and confirmed by UV-Vis spectrophotometry.

ResultsHeadspace gas chromatogra-

phy analysis of blood, vitreous, andurine gave peaks at 0.977 and 1.601minutes, corresponding to methanoland acetone plus a late-eluting, un-known peak at 2.278 minutes on theBAC-1 column (Figure 1). Ethanolwas not detected in any of the speci-mens, and acetone was attributed tothe ketosis associated with a history ofchronic ethanolism. Further confirma-tions using quantitative headspace gaschromatography determined methanollevels to be 0.33, 0.47 and 0.40 g/dLin femoral blood, urine, and vitreoushumor, respectively. However, thelate-eluting peak at 2.278 minutesremained unidentified.

C A S E N O T E S #3 : A F ATA L I T Y I N V O LV I N G M E T H A N O L A N D

N I T R O M E T H A N E C O N S U M P T I O N

Submitted by: Toxicology Laboratory, Harris County Medical Examiner’s Office, 1885 Old Spanish Trail,Houston Texas 77054, Email: [email protected]

Figure 1: Headspace Gas Chromatograph of Femoral Blood(BAC-1, retention times: methanol; 0.977 min, acetone, 1.601min; IS 1.720 min; unknown peak, 2.278 min)

C A S E N O T E S #3 ( C O N T I N U E D )

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ELISA screens conducted onblood were negative. Vitreous chemis-tries were unremarkable, except forabnormally high postmortem concen-trations of 48 mg/dL urea nitrogen and18.5 mg/dL creatinine. CO-Oximetryindicated 11.8 % carboxyhemoglobinand 10.6 % methemoglobin, but confir-matory retesting by UV-Vis spectro-photometry discounted the carboxyhe-moglobin reading as methemoglobininterference.

Methanol and nitromethane arecommon to many brands of model air-plane fuel. The proximity of fuel to thedecedent supported the possibility thatthe source of the methanol was fromingesting the airplane fuel. Further-more, an unknown volatile peak possi-bly attributable to nitromethane waspresent in the headspace FID gas chro-matograms of post-mortem blood,urine and vitreous humor.

Analysis of the blood speci-men by headspace GC/MS was per-formed to resolve the identity of thisunknown peak. In this system, metha-nol eluted at1.5 minutesand acetone at2.6 minutes. Alater elutingpeak appearedat 3.6 minutes,whereby itsretention timerelative tomethanol wasconsistent withthe late-elutingsubstance in theearlier alcoholheadspaceanalyses(Figure 2). Themass spectra ofthis substancehad ions at 61,45 and 30 m/z,which is con-sistent withnitromethane.

Leigh Champion and Kasey Wilson ofthe Georgia Bureau of Investigationhave recounted their experiences in test-ing for volatile compounds in forensicspecimens. As we have also shown, suchtesting can have application in a varietyof cases with unusual volatile sub-stances.

References

1. Cook MD and Clark RF. CreatinineElevation Associated with Nitro-Methane Exposure: A Marker ofPotential Methanol Toxicity. J.Emerg. Med. 33:249-53 (2007).

2. Leonard CP and Akhtar J.Co-ingestion of Methanol and Nitro-methane: Using Falsely ElevatedCreatinine as Indicator for MethanolAntidote Use. Pediatr. Crit. CareMed. 9:392-3 (2007).

3. Champion L and Wilson K. CaseNotes 3: Volatiles Testing at theGeorgia Bureau of Investigation,Div. of Forensic Sciences. ToxTalk.32-4:17-8 (2008).

ConclusionThe presence of the methanol

peak on headspace gas chromatogramand nitromethane in the GC/MS chro-matogram, plus elevated levels ofcreatinine and methemoglobin point tothe probable ingestion of model air-plane fuel containing methanol andnitromethane.

Creatinine was elevated 14 –15 fold over normal levels and litera-ture reports have suggested that thismay be a marker of nitromethane /methanol exposure.1,2 The activemethyl group of nitromethane can reactwith picric acid to produce a chromo-phore that inflates creatinine determi-nations by the Jaffe reaction, as wasemployed in our methods. Also, expo-sure to organonitrates such as nitro-methane can induce formation ofmethemoglobin, as we have also ob-served.

This case report adds our ex-perience to support more routine test-ing for volatile substances in postmor-tem specimens. In a recent Case Note3,

Figure 2: Headspace Gas Chromatogram of Case Blood (Upper Panel) and Mass Spectrum of peak at3.6 min (Lower Panel).

Volume 33, Issue 2

D R U G S I N T H E N E W S

L E A D P O I S O N I N G I N C H I L D R E N :A R E N E W E D I N T E R E S T I N A N O L D N E M E S I S

they were so enamored with themetal they minimized the hazards itimposed. The ancient upper classregarded their limited direct expo-sure to lead as an acceptable risk.They did not realize that their eve-ryday low level exposure to leadand lead products made them vul-nerable to the effects of chroniclead poisoning. They had little con-cern of the horrific effects of acutelead poisoning which occurredamong the slave miners of lead.

Centuries later, decisions byfederal and local officials haveforced nearly one million Americanfamilies to live in neighborhoodspolluted by lead smelters. The peo-ple are disproportionately minorityand poor. As the Romans of old,public health officials know of thedangers of lead poisoning but thou-sands of families continue to live inpublic housing with lead pollutedenvironments.

A recent headline in a localnewspaper read “Librarians fightto get all children’s books ex-empted from new rules.”

The main concern involvesbooks printed before 1985 using inkthat contained lead pigments. Thequestion is, “can small children beharmed by licking and consumingthe ink?” Although the law is af-fecting libraries for now, booksfound in bookstores and other shopsmay be the next to be targeted.How lead poisoning is affecting oureveryday lives has a far reachingimpact.

The use of lead and its ef-fect can be traced back to the Ro-mans who used lead pipes for theirvast network of plumbing. Theword “plumbing” comes from theLatin word for lead “plumbum”

from whichthe elemen-tal symbolPb is alsoderived.Lead wasalso used asa key com-ponent in

face powders, rouges and mascaras.Paint pigments also contained lead;hence the term “crazy as a painter”to signify the demented behavior oflead poisoned painters. Lead wasalso used as the ultimate spermi-cide, it being the metal used in mostchastity belts. Even though the an-cients were fully aware of the seri-ous health problems lead caused,

From these auspicious be-ginnings, we come to America in1980 where the U.S. utilized 1.3million tons of lead which repre-sented 40% of the world’s supply oflead. This calculates to 5221 gramsof lead per American, compared tothe Romans’ utilization of 550grams per person.

Children are at the greatestrisk for lead poisoning betweenbirth and age 6, when their neuro-logical systems are developing.The Centers for Disease Controlrecommend levels of less than 10micrograms of lead per deciliter ofblood.

It is estimated that morethan 3 million children 6 years ofage and younger have lead poison-ing. This represents almost one outof every six children under the ageof 7. Lead poisoning has no obvi-ous signs and most children do notexhibit any abnormal symptoms.

Submitted by: Robbie Pisana, B.S. MT(ASCP)

Send interesting “Drugs In The News” to Section Editor, Dwain Fuller, B.S., DFTCB, at [email protected]

Some children with lead poisoning,however, report stomachaches, lossof appetite, hyperactivity, sleepingproblems and irritability. Childrenwith high levels of lead may sufferfrom learning disabilities, mental re-tardation, behavioral problems, low-ered IQ, stunted growth and learningimpairments. Coma, convulsionsand even death may occur at extremehigh levels of lead.

In 1985 a lower limit of 25ug/dL of lead was set as the point forintervention of treatment in children.Even though the scientific commu-nity was aware that lower levels oflead could cause damage, this repre-sented the lower limit of detection ofinstrumentation at the time. Nowwith major advancements in instru-mentation, such as the use of theICP/MS, lead levels below 1.0 ug/dLcan be detected and lower limits be-low 10 ug/dL can be set for interven-tion in children.

There are five classes that theCenters for Disease Control classifychildren according to their blood leadlevel.

Class 1: ≤9 ug/dL: Childrenconsidered having normal blood leadlevels.

Class 2: 10-19 ug/dL: Chil-dren with blood lead levels in thisrange should receive nutritional andeducational interventions and morefrequent screenings.

Class 3: 20-44 ug/dL: Chil-dren in this range should receive en-vironmental evaluation, remediationand a medical evaluation and further-more may also need pharmacologicaltreatment for lead poisoning.

Class 4: 45-69 ug/dL: Chil-dren in this range will need bothmedical and environmental interven-tions, including chelation therapy.Chelating agents used in treating

D R U G S I N T H E N E W S (C O N T I N U E D )children are edetate disodium cal-cium, dimercaprol, D-penicillamineand succimer.

Class 5: ≥70 ug/dL: Chil-dren in this range are considered amedical emergency and medicaland environmental managementmust begin immediately.

Lead poisoning preventionprograms targeted at children havehad a tremendous impact on reduc-ing the occurrence of lead poison-ing in the United States. Due tothese programs, the number of leadpoisoning deaths and lead encepha-lopathy are now rare. Most of the

programs have dealt with childrenat a high risk for lead poisoning,overseeing periodic screening, pro-viding education to caretakers aboutthe causes, effects, symptoms andtreatments for lead poisoning, andensuring medical treatment and en-vironmental remediation is pro-vided to the children.

Nevertheless, lead environ-mental sources and oral and respira-tory pathways still remain in oursociety. The primary source andpathways for lead exposure in chil-dren are lead-based paints and leadcontaminated dusts and soils.

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150µg/dL

100µg/dL

50 µg/dL

40 µg/dL

30 µg/dL

20 µg/dL

10 µg/dL

Death--

Encephalopathy--

Nephropathy--

Frank Anemia--

Colic--

Decreased Hemoglobin Synthesis--

Decreased Vitamin D Metabolism--Decreased Nerve Conduction Velocity--Increased Erythrocyte Protoporphyrin--

Developmental Toxicity (IQ, Hearing, Growth)--Transplacental Transfer--

Lowest Observed Effect Levels of Inorganic Lead in Children*

*Note: The levels in thisdiagram do not necessarilyindicate the lowest levels atwhich lead exerts an effect.These are the levels atwhich studies have ade-quately demonstrated aneffect.

Source: ATSDR, 1990.

In 2007 it was discoveredthat Chinese-made products con-tained high levels of lead. Themain concern of the Food andDrug Administration were Chineseproducts of children’s jewelry,toys, baby bibs, etc. This caused anumber of new laws to be writtento control the spread of lead poi-soning among U.S. children. TheConsumer Product Safety Com-mission recalled millions of chil-dren’s items all imported fromChina.

At least 10% of Chinesechildren suffer from lead poison-ing due to the excessive use of leadbased products. The formation ofthe Healthy People Program wascreated in response to the lead poi-soning outbreak due to the spreadof lead poisoning from Chineseimported children toys. The maingoal of the Healthy People Pro-gram is to eliminate lead poisoningin children by 2010.

The public and private sec-tors must continue to work to-

D R U G S I N T H E N E W S (C O N T I N U E D )gether to eradicate lead poisoningin children. Public agencies mustwork with private health care pro-viders to provide lead screening andidentify unusual sources of lead.Public housing and private housingowners must work for lead abate-ment in all structures. These are justa few examples of the cooperationthat is needed between public andprivate sectors to protect our soci-ety from the spread of lead poison-ing. Enough is known about thesources of lead and the pathways oflead exposure that primary preven-tion efforts, that is, elimination oflead hazards before children arepoisoned, should be the main focusof permanently eradicating leadpoisoning in children.

The renewed interest in leadquantification has brought about theuse of new techniques and the useof state of the art instrumentationsuch as, inductively coupled plasmamass spectrometry (ICP/MS), totest for trace metals at lower con-centrations and higher specificity.

Furthermore, elemental speciationhas become extremely important inclinical work. An element’s toxic-ity, environmental persistence,bioavailability, volatility, andchemical reactivity often depend onthe species, or chemical form, ofthe element present.

As testing continues toevolve with the use of hyphenatedinstrumentation (LC-ICP/MS, LC-MS, etc.) and methodologies be-come more sophisticated with thespeciation of trace metals, the fo-rensic toxicologist will be calledupon to provide their expertise intesting and interpretation.

References:

Recent Developments in Low-Level Exposure and Intellectual Im-pairment in Children. Karin Koller,Eviron Health Perspect 112(9):987-994, 2004.

Toxic Neighbors. Craig Flourney,The Dallas Morning News. October1, 2004.

Librarians Fight To Get Children’sBooks Exempted From Lead Rules.Anna M. Tinsley, Star-Telegram,March 5, 2009.

China Exports Lead Poisoning.World Net Daily, March 11, 2009.

Lead Poisoning: A Historical Per-spective. Jack Lewis, EPA Journal,May 1985.

Preventing Lead Poisoning inYoung Children. Centers for Dis-ease Control, 1990.

Disposition of Toxic Drugs andChemicals in Man. Randall C.Baselt, Seventh Edition, 600-602.

Volume 33, Issue 2

Due to a continuing hot issuecirculating in the arena of defense ofDUI’s, it is important to reiterate thatthe committee adopted the followingposition statement regarding access tothe Source Code of the software forevidential breath-alcohol analyzers:

It is the position of the NationalSafety Council’s Committee on Al-cohol and Other Drugs that accessto the Source Code of the softwareof an evidential breath-alcoholanalyzer is not pertinent, required,or useful for examination orevaluation of the analyzer’s accu-racy, scientific reliability, forensicvalidity, or other relevant charac-teristics, or of the trustworthinessand reliability of analysis resultsproduced by the analyzer. Thesematters can be and have been fullyassessed and examined by multipleother well established and recog-nized methods and procedures incommon use worldwide; and manyother adequate and appropriatemeans exist to challenge evidentialbreath-alcohol analysis results.

In February 08 the committeealso adopted new recommendations for“Acceptable Practices for EvidentialBreath Alcohol Testing”. The com-mittee found that forensic breath alco-hol programs differ widely in their ap-proach to instrumentation protocols,personnel training and responsibility,administrative rules and subject testingprotocols.

For a copy of the full state-ment including introduction, commentand references, please contact LauraLiddicoat, [email protected].

The Drugs & Driving Com-mittee is continuing its Special Ses-sions. Amy Cochems([email protected]) willcoordinate the SOFT 2009 session inOklahoma City. Michael Corbett([email protected]) will do the AAFS 2010session in Seattle. Information onmethods, laboratory programs, statis-tics, and especially case reports are allvaluable information to share withyour colleagues. If you are interestedin presenting, please contact Amy orMichael. Presentations go through thenormal meeting submission and re-view process, including adherence toall deadlines.

Redacted from the May/June2009 “Academy News”. Source JeriRopero-Miller, PhD, Section Chair(Misprinted as Kenneth Ferslew, PhD,Section Secretary).

Ken Ferslew was Section Pro-gram Chair and he put together a won-derful and worthwhile program alongwith Phil Kemp who was the WorkshopChair. Their hard work was rewardedwith a number of great workshops.

The Tox Section had special ses-sions on Drugs and Driving and one onPostmortem Pediatric Toxicology and aMultidisciplinary Session with Path/Bio.

Tox Section Awards:Dr. Barry Levine was presented theAlexander O. Gettler Award. Dr. Timo-thy Rohrig was presented the Rolla N.Harger Award, and Teresa Gray wasgiven the June K. Jones Award.

Jeri Ropero-Miller was electedSection Chair and Ken Ferslew waselected Section Secretary. Congratula-tions to the new Section Officers.

This year’s Tox Section Work-shop Chair is Ruth Winecker. PhilKemp is Program Chair. Submissiondeadline for both Workshop and Scien-tific Abstracts is August 1st, so don’t de-lay. Please submit abstracts and work-shop proposals through the AAFS web-site (AAFS website), however, pleasenotify Dr. Winecker([email protected]) in addition tosubmitting a workshop proposal elec-tronically so she can facilitate Tox Sec-tion submissions. If you are interested involunteering for the 2010 AAFS meetingplease contact the program chair, Dr.Phil Kemp ([email protected]).

If you are not a member ofAAFS Toxicology Section, you are wel-come to join. If you are a member andneed to update your membership to Fel-low, see one of the Section Officers.

ToxTalk

N AT I O N A L S A F E T Y

C O U N C I L —C O M M I T T E E O N

A L C O H O L A N D O T H E R

D R U G SSubmitted by Laura Liddicoat, B.S.

A A F S N E W S

T O X I C O L O G Y S E C T I O NSubmitted by Jeri Ropero-Miller, Ph.D.

TO X I C O L O G Y - B I T S & P I E C E SSection Editor, J. Robert Zettl, MPA

A A F S /S O F TJ O I N T

D R U G S &D R I V I N G C O M M I T T E ESubmitted by Jennifer Limoges, M.S.

T I A F T N E W S

The International Associationof Forensic Toxicologists welcomesall to their 2009 annual meeting in Ge-neva Switzerland, August 23-27, 2009.Refer to website, www.tiaft2009.orgfor further information.

S AT N E W S

The Southwestern Associationof Toxicologists will hold their annualFall Business Meeting in OklahomaCity in conjunction with SOFT’s an-nual meeting. The SAT Spring Busi-ness Meeting will be located in Dallas.

D U I D W O R K S H O P

The SOFT Continuing Educa-tion Committee recently completed aDUID Workshop in Houston, involv-ing 34 attendees, one traveling all theway from New Zealand to attend. Spe-cial thanks to Ashraf Mozayani forChairing this very successful event.

Future S.O.F.T. Meeting Info

2009: Oklahoma City, OK………Oct. 18-23, 2009…………..Phil Kemp, Dennis McKinney

2010: Richmond, VA……………Oct. 18-22, 2010….…..Michelle Peace, Lisa Tarnai Moak

2011: San Francisco, CA………...Aug. 29-Sep. 2, 2011………….………….Nikolas Lemos

2012: Boston, MA……………….June 30-July 6, 2012….……….……...…Michael Wagner

2013: Orlando, FL……………….Oct. 26-Nov.3, 2013 ……….…….Bruce Goldberger

Committee Committee Chair

Nominating…………………………Christine Moore, Ph.D., DABCCMembership……………………..….Sarah Kerrigan, Ph.D.Strategic Planning…………………..Marc LeBeau, Ph.D.Budget, Finance, and Audit………...Robert Turk, Ph.D., DABFTToxTalk Co-Editors………....……...Yale Caplan, Ph.D., DABFT

Vickie Watts, M.S.ByLaws……………………...……..Yale Caplan, Ph.D., DABFTPublications (JAT Special Issue) ….Jennifer Limoges, M.S., DABCAwards...…………………………...Philip Kemp, Ph.D., DABFTDrugs & Driving…………...………Jennifer Limoges, M.S., DABCMeeting Resource…………...……..Bradford Hepler, Ph.D., DABFTMeeting Guidelines ………………..Bradford Hepler, Ph.D., DABFTPolicy and Procedure…………...….William Anderson, Ph.D.SOFT Internet Web-Site……...……Bruce Goldberger, Ph.D., DABFTContinuing Education………...……Ann Marie Gordon, M.S.Web Based Continuing Ed………...Peter Stout, Ph.D., DABFTLaboratory Guidelines…...………...W. Lee Hearn, Ph,D.Ethics………………………...…….Aaron Jacobs, Ph.D.Drug Facilitated Rape &

Sexual Assault………...………..Marc LeBeau, Ph.D.MS/MS Guidelines………………...Dennis Crouch, M.S.

February 1 for March Issue

May 1 for June Issue

August 1 for September Issue

November 1 for December Issue

Phil Kemp, [email protected]

Dennis McKinney, [email protected]

Laurel Farrell, [email protected]

John Soper, Workshop [email protected]

Jesse Kemp, Workshop [email protected]

David von Minden,Scientific Program [email protected]

Robert Bost, Student [email protected]

Deb Denson ([email protected])has once again sported her angel haloand agreed to coordinate the hefty listof volunteers who take a shift or two atthe annual meeting. Please contact herif you would like to be included in themany available openings that will cu-mulatively pull the annual meeting inOklahoma together. Thank you to boththe seasoned volunteers and fresh will-ing enlisters!

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ToxTalk Deadlines for Contributions

The fun and very popular (4thannual) Dr. Irving Sunshine / Dr. FredricRieders Silent Auction is being plannedfor a repeat memorial event during the2009 annual meeting in Oklahoma. Thisannual tradition keeps the Sunshine /Rieders names alive and funds studentenrichment programs into the future.Company or individuals may donate anyvariety of items for competing write-inbids. A separate “Silent Auction Dona-tion Form” is included with this mailingof ToxTalk for those who would like toparticipate. Thank you, Laurie Toblerfor kindly agreeing to chair this event.

Tom Kupiec, Events &Scientific Program [email protected]

Jeri Ropero-Miller,Exhibitor [email protected]

Peter Stout,Exhibitor [email protected]

Bruce Goldberger,SOFT [email protected]

Jared Cooper, SOFT 2009,Website [email protected]

SOFT 2009 Planning Committee

S.O.F.T. Administrative OfficeOne Macdonald Center1 N. Macdonald St., Suite 15Mesa, AZ 85201

Phone: 888-866-SOFT (7638)Fax: 480-839-9106E-mail: [email protected]

Society of ForensicToxico logists , Inc.

ToxTalk is the official publication of the Society of Forensic Toxicologists, Inc., mailed quar-terly (bulk mail) to its members. It is each member’s responsibility to report changes ofaddress to the SOFT Administrative Office. Non-members may receive ToxTalk for $15 percalendar year. Checks payable to SOFT may be mailed to the SOFT Administrative Office.To submit articles or address ToxTalk issues please email to [email protected].

The Renaissance Hotel is accepting reservations (1-405-228-8000). For SOFT room rate use code: socsoca. The on-linelink is: http://www.marriott.com/hotels/travel/OKCBRgroupCode=socsoca&app=resvlink&fromDate=10/16/09&toDate=10/24/09

In memory of the late KarlaMoore, the annual SOFT Fun RunEvent will don the name “The KarlaMoore Annual Fun Run” in honor ofits creator. A separate Fun Run SignUp Sheet for 2009 has been includedwith this mailing of ToxTalk for thosewho wish to reserve a commemorativetee shirt in a specified shirt size. Thisevent has grown larger and larger eachyear to approximately 100 participants(both athletes and the not so serious).Much appreciation is sent to LindaHarty, who has generously volun-teered to chair this fun event in 2009.

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