High risk of misinterpreting hair analysis results for children tested for methadone

Kintz, Pascal; Farrugia, Audrey; Ameline, Alice; Eibel, Aude; Raul, Jean‐Sébastien

doi:10.1016/j.forsciint.2017.10.013

Cited by 30 publications

(15 citation statements)

References 18 publications

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“…The hair analysis data showed higher levels of exposure occurring in younger children, which is consistent with the expectation that younger children will have higher levels of exposures due to more common floor play, poorer washing of hands, and mouthing of hands and objects [ 8 , 31 ]. In addition, young children have more porous hair than adults, which would make the hair more susceptible to environmental contamination [ 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

Environmental Methamphetamine Exposures and Health Effects in 25 Case Studies

Wright

Kenneally

Ross

et al. 2020

Toxics

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The clandestine manufacture and use of methamphetamine can result in contamination of residential properties. It is understood that this contamination remains in homes for a significant period, however there are a lack of data available to understand the health effects of exposure to environmental methamphetamine contamination (third-hand exposure). Our study collected information from 63 individuals in 25 separate case studies where the subjects had unwittingly suffered third-hand exposure to methamphetamine from former manufacture, use, or both. Data included environmental contamination data, information on subjects’ health effects, and evidence of exposure using hair analysis. This study identified a range of health effects that occur from residing in these properties, including behavioural effects or issues, sleep issues, respiratory effects, skin and eye effects, and headaches. Methamphetamine was detected in hair samples from some individuals, including children. The exposures and concomitant reported health effects covered a wide range of environmental methamphetamine levels in the properties, including low levels close to the current Australian guideline of 0.5 µg methamphetamine/100 cm2. There were no discernible differences between health effects from living in properties contaminated from former manufacture or use. This study demonstrates that residing in these properties can represent a serious public health risk.

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Section: Resultsmentioning

confidence: 99%

Environmental Methamphetamine Exposures and Health Effects in 25 Case Studies

Wright

Kenneally

Ross

et al. 2020

Toxics

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“…Segmental hair analysis is a useful tool for determining the longer history of drug use in an individual (Kintz et al, ), and for estimating and corroborating the timeframes of an alleged single drug exposure. The basic principles of segmental hair analysis rely on two assumptions, i.e., (a) drugs and their metabolites are incorporated into the hair shaft while it grows, and (b) rate of hair growth is approximately 1 cm per month for every individual person.…”

Section: Stage 3 Variables: the Analyst And The Methodsmentioning

confidence: 99%

“…Harkey () described the now accepted average growth rate of hair of 1 cm per month as an oversimplification as hair growth can be affected by variables that include age, gender and ethnicity. However, particular attention to interpretation should be applied to adolescent cases, as hair has been shown to grow at asynchronous rates (Kintz, ). It has been acknowledged that the rate of growth of hair can vary during the growth cycle and between hairs of the same region of the head (Kintz, Villain, Dumestre‐Toulet, & Ludes, ; LeBeau et al, ).…”

Section: Stage 2 Variables: Drug and Metabolite‐hair Interactionsmentioning

confidence: 99%

“…However, as discussed in Section 4.2, one must also consider the suitability of the wash solution, so as to minimize leaching of the drug from the hair itself. Another route of passive exposure in the case of children may occur from in utero exposure due to parental consumption, and it has also been noted that adolescent hair is more porous than adult hair leading to easier incorporation from external sources such as sweat (Kintz, Farrugia, Ameline, Eibel, & Raul, ). Cuypers et al () have demonstrated that certain wash procedures may promote external drug contaminants to enter the hair matrix (Section 4.2).…”

Section: Stage 2 Variables: Drug and Metabolite‐hair Interactionsmentioning

confidence: 99%

“…Analysis of hair from children has been shown to be particularly problematic in determining single or prolonged repeated drug exposure. Kintz et al () demonstrated that methadone detection in the hair of four children was approximately the same in each consecutive hair segment for each individual, likely due to absorption from sweat. Alvarez et al () recently reported that the distribution of drugs along the hair shaft was extensive among children under the age of 36 months yet reduces after this age.…”

Section: Stage 2 Variables: Drug and Metabolite‐hair Interactionsmentioning

confidence: 99%

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Variability associated with interpreting drugs within forensic hair analysis: A three‐stage interpretation

Davies

Gautam

Grela

et al. 2020

J of Applied Toxicology

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Hair analysis is capable of determining both an individual's long-term drug history and a single exposure to a drug, which can be particularly important for corroborating incidents of drug-facilitated crimes. As a source of forensic evidence that may be used in a court of law, it must be credible, impartial and reliable, yet the pathways of drug and metabolite entry into hair are still uncertain. Many variables may influence drug analysis results, most of which are outside of the control of an analyst. An individual's pharmacokinetic and metabolic responses, hair growth rates, drug incorporation routes, axial migration, ethnicity, age and gender, for example, all display interpersonal variability. At present there is little standardization of the analytical processes involved with hair analysis. Both false positives and negative results for drugs are frequently encountered, regardless of whether a person has consumed a drug or not. In this regard, we have categorized these variables and proposed a three-stage analytical approach to facilitate forensic toxicologists, hair analysis experts, judiciaries and service users in the analytical and interpretation process. K E Y W O R D S axial migration, data interpretation, drug-facilitated sexual assault, drug hair analysis, hair growth rate, segmental analysis

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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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High risk of misinterpreting hair analysis results for children tested for methadone

Cited by 30 publications

References 18 publications

Environmental Methamphetamine Exposures and Health Effects in 25 Case Studies

Environmental Methamphetamine Exposures and Health Effects in 25 Case Studies

Variability associated with interpreting drugs within forensic hair analysis: A three‐stage interpretation

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

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