How can immunochemical methods contribute to the implementation of the Water Framework Directive?

Immunochemical methods (in particular immunoassays) have been applied to spring and surface water samples, respectively, which were set-up as reference materials (RM) within two proficiency testing campaigns. For the first set of proficiency tests (PTs) described here (which were actually the second round of PTs organized, spring 2005), three ELISAs (enzyme-linked immunosorbent assays) were employed in the enzyme tracer format for isoproturon, diuron, and atrazine, respectively. Results were evaluated in comparison with conventional reference methods (LC, GC). Based on their Z-score laboratory performances, the results for isoproturon and diuron were satisfactory, both for fortified spring water and for the blind solution. The results for atrazine were strongly influenced by other triazines present and needed detailed interpretation. For the second set of PTs described here (which were actually the third round of PTs organized, spring 2006), two ELISAs in the coating antigen format were used for isoproturon and diuron, and the result was included with the results obtained by conventional methods during the PTs. The results (the Z-scores) for isoproturon were again classified as satisfactory, in both fortified surface water and blind solution. The results for diuron in ELISA showed an influence of the water matrix, while the analysis of the blind solution was satisfactory. In addition, an ELISA in the enzyme tracer format was applied to analyze isoproturon, diuron, and atrazine in surface water samples, which had been set-up and spiked during a field trial (tank experiment) at the Maas River at Eijsden, The Netherlands. The immunoassay results were compared with those from an in-house on-line SPE LC/MS-MS used as reference. Although the immunochemical results were sometimes higher than those determined in the reference analysis, the general concentration trends in the samples were similar. The contribution of immunochemical methods to the implementation of the European Water Framework Directive is also discussed.

Increased instrument intelligence--can it reduce laboratory error?

Recent literature has focused on the reduction of laboratory errors and the potential impact on patient management. This study assessed the intelligent, automated preanalytical process-control abilities in newer generation analyzers as compared with older analyzers and the impact on error reduction. Three generations of immuno-chemistry analyzers were challenged with pooled human serum samples for a 3-week period. One of the three analyzers had an intelligent process of fluidics checks, including bubble detection. Bubbles can cause erroneous results due to incomplete sample aspiration. This variable was chosen because it is the most easily controlled sample defect that can be introduced. Traditionally, lab technicians have had to visually inspect each sample for the presence of bubbles. This is time consuming and introduces the possibility of human error. Instruments with bubble detection may be able to eliminate the human factor and reduce errors associated with the presence of bubbles. Specific samples were vortexed daily to introduce a visible quantity of bubbles, then immediately placed in the daily run. Errors were defined as a reported result greater than three standard deviations below the mean and associated with incomplete sample aspiration of the analyte of the individual analyzer Three standard deviations represented the target limits of proficiency testing. The results of the assays were examined for accuracy and precision. Efficiency, measured as process throughput, was also measured to associate a cost factor and potential impact of the error detection on the overall process. The analyzer performance stratified according to their level of internal process control The older analyzers without bubble detection reported 23 erred results. The newest analyzer with bubble detection reported one specimen incorrectly. The precision and accuracy of the nonvortexed specimens were excellent and acceptable for all three analyzers. No errors were found in the nonvortexed specimens. There were no significant differences in overall process time for any of the analyzers when tests were arranged in an optimal configuration. The analyzer with advanced fluidic intelligence demostrated the greatest ability to appropriately deal with an incomplete aspiration by not processing and reporting a result for the sample. This study suggests that preanalytical process-control capabilities could reduce errors. By association, it implies that similar intelligent process controls could favorably impact the error rate and, in the case of this instrument, do it without negatively impacting process throughput. Other improvements may be realized as a result of having an intelligent error-detection process including further reduction in misreported results, fewer repeats, less operator intervention, and less reagent waste.

From guaiac to immune fecal occult blood tests: the emergence of technology in colorectal cancer screening.

Colorectal cancer is the second leading cause of cancer deaths in the United States for both men and women. Colorectal cancer screening is an important means for reducing morbidity and mortality. The American Cancer Society recommends five different screening regimens for adults of average risk, age 50 years and older. The optimal effectiveness of a screening program is dependent on the accuracy of the screening test used. An accurate screening test would have high sensitivity (positive) when an adenomatous polyp or cancer is present and high specificity (negative) in their absence. In April 2002, the American Cancer Society Colorectal Cancer Advisory Group concluded that the immunochemical fecal occult blood test has some advantages that merit revision of their guideline statement for fecal occult blood testing, to include the immunochemical fecal occult blood test. The advantages cited were the possibility of improved sensitivity and specificity and the lack of required dietary restrictions, which make it a more patient-friendly test. Several types of immunochemical fecal occult blood tests are discussed in this article, including their advantages and disadvantages compared with those of the traditional guaiac fecal occult blood testing.

Environmental monitoring of pesticides by immunoanalytical techniques: validation, current status, and future perspectives.

Reliable monitoring technology is an essential component of effective regulation and risk management of environmental contaminants such as pesticides. Most environmental monitoring and analysis is currently conducted using instrumental techniques such as gas-liquid chromatography (GLC) and liquid chromatography (LC). Immunoanalysis provides powerful monitoring techniques that have emerged in the last 3 decades. This paper shows they can deliver rapid, accurate, and relatively inexpensive analysis with high throughput and that have the capability to be field oriented. The technique is versatile in application and can be formatted to suit different purposes such as quantitative analysis or simple "yes/no" tests that are field-portable. While there is a range of opinion on the merits of immunoassays as an analytical tool for pesticides, we suggest that this technology is best considered as complementary to GLC and LC, extending the range of capability for field monitoring. Supporting this view, an increasing number of successful applications of immunoassays to monitoring have been reported in recent years. We also report here the implications of recent developments in the field of immunodiagnostics and their application to monitoring of environmental contaminants. We emphasise that, together with adequate validation by instrumental techniques, immunoassays provide monitoring services yielding realistic and comprehensive data for risk management, allowing decisions on appropriate action by various authorities to be made.