Immunoassay screening in urine for synthetic cannabinoids - an evaluation of the diagnostic efficiency.

BACKGROUND: The abuse of synthetic cannabinoids (SCs) as presumed legal alternative to cannabis poses a great risk to public health. For economic reasons many laboratories use immunoassays (IAs) to screen for these substances in urine. However, the structural diversity and high potency of these designer drugs places high demands on IAs regarding cross-reactivity of the antibodies used and detection limits. METHODS: Two retrospective studies were carried out in order to evaluate the capability of two homogenous enzyme IAs for the detection of currently prevalent SCs in authentic urine samples. Urine samples were analyzed utilizing a 'JWH-018' kit and a 'UR-144' kit. The IA results were confirmed by an up-to-date liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) screening method covering metabolites of 45 SCs. RESULTS: The first study (n=549) showed an 8% prevalence of SCs use (LC-MS/MS analysis) among inpatients of forensic-psychiatric clinics, whereas all samples were tested negative by the IAs. In a second study (n=200) the combined application of both IAs led to a sensitivity of 2% and a diagnostic accuracy of 51% when applying the recommended IA cut-offs. Overall, 10 different currently prevalent SCs were detected in this population. The results can be explained by an insufficient cross-reactivity of the antibodies towards current SCs in combination with relatively high detection limits of the IAs. CONCLUSIONS: In light of the presented study data it is strongly recommended not to rely on the evaluated IA tests for SCs in clinical or forensic settings. For IA kits of other providers similar results can be expected.

Bioaccessibility of pesticides and polychlorinated biphenyls from house dust: in-vitro methods and human exposure assessment.

Semi-volatile chemicals like pesticides and polychlorinated biphenyls (PCB) tend to accumulate in house dust. This may result in residues of some parts per million (p.p.m.), closely associated with health impairments and diseases like cancer. To explain these associations, we must establish whether a relevant absorption from house dust into human organisms occurs, and most crucially the release of chemicals, that is, their bioaccessibility. Digestive as well as dermal bioaccessibilities were examined using in-vitro methods. On average, the digestive bioaccessibility was ~40% for the pesticides and ~60% for the PCB. The dermal penetration availability reached ~60% for the pesticides and ~70% for the PCB (percentages of the concentrations in the dust). Based on the bioaccessibility, an estimate of internal exposure was calculated and expressed as percentages of acceptable or tolerable daily intake (ADI/TDI) values. Exposure via the respiratory tract proved to be very low. Exposure via the digestive tract had maximum values of 4% for pesticides and 12% for PCB. Dermal exposure was much higher. Even for average concentrations in house dust (≈0.5 p.p.m.), children exposed to DDT and PCB showed up to 300% of the ADI/TDI values, and adults about 60%. With high concentrations of contaminants in house dust, the maximum doses absorbed through the skin reached 5000%.