Hair analysis interpretation in post-mortem situations: Key considerations and proposals to overcome main hurdles

Benhalima, Ilyes; Castex, Eugénie; Dumont, Guy A.; Gish, Alexandr; Hakim, Florian; Allorge, Delphine; Gaulier, Jean-Michel

doi:10.1016/j.legalmed.2022.102032

Cited by 8 publications

(7 citation statements)

References 44 publications

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“…The sister's hair results (TR presence, hair concentrations pattern, and low MRs) confirm the existence of environmental contamination by TR in the children's living area. This route of external contamination involves substance residues (e.g., dust settling on surfaces and touching drug‐contaminated surfaces before touching one's own hair or the infant hair), as well as contamination by sweat or other biological fluids of user parents 19,30 . In this reported case, the existence of a contaminated environment is quite plausible because of the mother's addiction to TR, who (as she confessed) crushed TR tablets every day to prepare her daily mixture.…”

Section: Resultsmentioning

confidence: 92%

“…The question of the “in between” situation arises when concentrations in hair and wash baths are of similar magnitude. In our practice, the second dichloromethane wash solution is analyzed and the results obtained in the wash residue are compared with those observed in the hair samples: When the wash/hair ratio is higher than 0.1, the possibility of external contamination is considered (without distinguishing between recent and acute contamination, e.g., by sweat/sebum during the agony phase in case of acute intoxication 18 and repeated external contamination including contamination by powder residues in environment or transfer of drugs by sweat from other) although it is not possible to be definitive 19 …”

Section: Resultsmentioning

confidence: 99%

“…This route of external contamination involves substance residues (e.g., dust settling on surfaces and touching drugcontaminated surfaces before touching one's own hair or the infant hair), as well as contamination by sweat or other biological fluids of user parents. 19,30 In this reported case, the existence of a contaminated environment is quite plausible because of the mother's addiction to TR, who (as she confessed) crushed TR tablets every day to prepare her daily mixture. There is therefore no doubt that there were TR residues on the surfaces in the living environment of the child and his sister.…”

Section: Keratinized Samplesmentioning

confidence: 87%

“…It is clear that analysis of keratinized matrices and the use of MRs helped differentiate TR use from external contamination. This case highlights the value of analyzing the keratinized matrices (hair and nails) 19,33 of the entire family to document the past exposure/consumption of each family member in a drug exposure-related infant death case.…”

Section: Discussionmentioning

confidence: 99%

“…In our practice, the second dichloromethane wash solution is analyzed and the results obtained in the wash residue are compared with those observed in the hair samples: When the wash/hair ratio is higher than 0.1, the possibility of external contamination is considered (without distinguishing between recent and acute contamination, e.g., by sweat/sebum during the agony phase in case of acute intoxication 18 and repeated external contamination including contamination by powder residues in environment or transfer of drugs by sweat from other) although it is not possible to be definitive. 19 TR concentrations in the infant's hair increase from the root to the tip. Segmental analysis is strongly recommended by international consensus, particularly to help to differentiate endogenous from exogenous incorporation.…”

Section: Keratinized Samplesmentioning

confidence: 99%

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Interpretation of hair and nails findings in an infant death case related to maternal addiction to tramadol

Gish

Richeval

Wiart³

et al. 2023

Drug Testing and Analysis

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An 11‐month‐old boy was found dead. Autopsy findings (cyanosis and polyvisceral congestion) and blood tramadol (TR) concentration of 6240 μg/L were consistent with an acute TR intoxication. In this poisoning situation, owing to the mother's statements (TR addiction leading to daily TR‐orange juice mixture preparation accidentally used for the baby bottle preparation by the mother's partner), and the question of possible previous TR administrations to the infant, hair and/or nails (infant, mother, partner, 6‐year‐old sister) analysis was performed. Hair (2‐cm‐long hair segments from proximal [S1] to distal [S3]) and nails concentrations (pg/mg; nd: not detected) were as follows: Infant (hair: TR 1420 [S1], 1622 [S2], 2736 [S3]; O‐DMT 16–38; N‐DMT 34–100 [TR in significant quantities in the hair decontamination bath]—toenails: TR 584; O‐DMT 8; N‐DMT 15), mother (hair: TR 2340 [S1], 2150 [S2], 2500 [S3]; O‐DMT 704–1170; N‐DMT 827–1360), mother's partner (fingernails: TR 72; O‐DMT nd; N‐DMT nd) and sister (hair: TR 261 [S1], 524 [S2]; O‐DMT 15 [S1], 16 [S2]; N‐DMT 20 [S1], 38 [S2]). Metabolite ratio (infant and sister hair) was comparable to those observed in hair of pharmaceutical industry employees manufacturing tramadol. TR in washing baths, low observed nail concentrations (infant and partner) confirm (i) TR‐related mother's addiction and (ii) external contamination issues (TR in sweat of the child at the time of death and in living environment) to explain the infant's keratinized samples results. This case report illustrates the interest of analyzing keratinized matrices of the whole family in such a situation.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Keratinized Samplesmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Keratinized Samplesmentioning

confidence: 99%

See 3 more Smart Citations

Interpretation of hair and nails findings in an infant death case related to maternal addiction to tramadol

Gish

Richeval

Wiart³

et al. 2023

Drug Testing and Analysis

Self Cite

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Hair analysis in postmortem investigations: Case of a skeletonized body

Pelissier‐Alicot,

Ameline,

Kintz

et al. 2024

Drug Testing and Analysis

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Analysis of hair collected from putrefied or skeletal bodies is always complex and must take into account several pitfalls, such as external contamination and contamination by biological fluids. This work presents a case of particular complexity. A skeletonized body was discovered on a country road. A tuft of brown hair, detached from the scalp, irregular in length, non‐oriented, in contact with soil and vegetation, was removed. An anthropological examination was carried out and genetic samples were taken from the right femoral shaft. After about 10 washes with warm water and dichloromethane, the tuft of hair was analyzed without segmentation. General unknown screening was performed by liquid chromatography system coupled to a high‐resolution mass spectrometry (LC‐HRMS) after incubation in pH 9.5 borate buffer and liquid–liquid extraction. Specific Multiple Reaction Monitoring (MRM) methods for date rape drugs were carried out by liquid chromatography system coupled to a tandem mass spectrometry (LC‐MS/MS). The anthropological examination allowed to determine that the victim was a female individual, over 60 years old, the death dating from 3 months to 1 year. Comparison of the DNA results with the Missing Persons Index led to the identification, a 60‐year‐old woman who disappeared 5 months earlier. Hair analysis showed the presence of oxazepam (361 pg/mg), nordiazepam (54 pg/mg), and alimemazine (5 pg/mg). The interpretation of these concentrations is extremely difficult due to the risk of degradation of the hair cuticle during prolonged stay in the soil, as well as of contamination by putrefactive fluids. The authors discuss the value of using multiple biological and non‐biological matrices in this context to improve the interpretation of the results.

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Possibility of drug-distribution measurement in the hair of drowned bodies: evaluation of drug stability in water-soaked hair using micro-segmental analysis

et al. 2022

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Hair analysis interpretation in post-mortem situations: Key considerations and proposals to overcome main hurdles

Cited by 8 publications

References 44 publications

Interpretation of hair and nails findings in an infant death case related to maternal addiction to tramadol

Interpretation of hair and nails findings in an infant death case related to maternal addiction to tramadol

Hair analysis in postmortem investigations: Case of a skeletonized body

Possibility of drug-distribution measurement in the hair of drowned bodies: evaluation of drug stability in water-soaked hair using micro-segmental analysis

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