APHL 2022 POSTER ABSTRACTS
ENVIRONMENTAL HEALTH
Assessing the Feasibility and Acceptability of using Residual Newborn Dried Blood Spots ( DBS ) for Prenatal Opioid Exposure Surveillance
N Ancona 1 , J Liebreich 1 , J Nassif 1 , S Singh 1 , J Ojodu 1 , S Kim 2 , K Miele 2 , E Tran 4 , V Goodson 3 ; 1 Association of Public Health Laboratories , 2 Centers for Disease Control & Prevention , 3 Council of State and Territorial Epidemiologists , 4 Eagle Global Scientific LLC
Rationale : This project sought to inform the Council of State and Territorial Epidemiologists ( CSTE ) and Centers for Disease Control and Prevention National Center for Birth Defects and Developmental Disabilities ( CDC NCBDDD ) about efforts to enhance laboratory surveillance of prenatal opioid exposures . Using newborn DBS to determine the prevalence of late-pregnancy opioid exposures can provide data on to estimate prevalence , guide resource allocation and service delivery to families affected by opioid use , and support public health interventions .
Objective : To explore the feasibility and acceptability of using anonymized , residual newborn DBS as a specimen type for assessing late in utero exposure to opioids and / or their metabolites .
Methods : The Association of Public Health Laboratories ( APHL ), in collaboration with CSTE and CDC NCBDDD , conducted an assessment and key informant interviews with state public health laboratory newborn screening programs . An assessment with 10 questions was sent to 53 programs . Key informant interviews were conducted with four programs to learn more about possibly using residual newborn DBS for surveillance of late prenatal opioid exposure , terms for specimen and data sharing , and interest in participating in a pilot project .
Results : Overall , 22 ( 42 %) programs completed the assessment . Four programs that indicated possible interest in participating in a pilot project were interviewed and reported a range of available hole punch ( 0 – 58,000 ) and DBS card ( 0 – 62,000 ) specimens . Three key informants stated that their specimens were likely collected from hospitals providing care for an elevated number of newborns prenatally exposed to substances . All four key informants already had existing systems or working relationships for opioid biosurveillance . Barriers to participating in a pilot project included extended timelines to revise formal processes ( e . g ., Institutional Review Board , consent forms , collecting new specimens versus using residual specimens ) and to gain support from leadership ( e . g , health department , newborn screening programs , genetics advisory committee ). Two had a strong interest in piloting residual DBS . Two programs expressed concerns about the potential to reduce public trust in newborn screening programs and to discourage participation in newborn screening programs in general . Most key informants noted that performing testing on site would be preferred to shipment of specimens , as this would be more efficient and likely more acceptable to individuals consenting and policy . All key informants expressed concerns about rising numbers in prenatal opioid use and most were enthusiastic about the benefits of using a novel method to perform prenatal opioid exposure surveillance .
Conclusions : Collection of a separate newborn blood spot may be feasible and acceptable for the purposes of prenatal opioid surveillance .
Presenter : Nicholas Ancona , Association of Public Health Laboratories , nicholas . ancona @ aphl . org
Overcoming Per-and Polyfluorinated Alkyl Substances Sample Preparation Challenges in Drinking Water
M Ebitson , Biotage
Per- and Polyfluorinated Alkyl Substances ( PFAS ) have been an interest for the last few years and will continue to be as new analytes are being explored . They are highly resistant to degradation , which allows them to persist in the environment and accumulate in many matrices , including our drinking water sources . Exposure to these compounds has been found to negatively impact human health , which motivated the US EPA to add these analytes to newly developed methods to be monitored in drinking water . When working with selected per- and polyfluorinated alkyl substances in drinking water , one faces several challenges , such as how to minimize background contamination , eliminating unknown sources of interferences and failing results of compounds based on the methodology quality control . These analytes are becoming one of the fastest growing classes being monitored today , and the methodology has been evolving to larger lists to be monitored as we learn more about these analytes . The methodology we will discuss will be based on EPA 537.1 guidelines and will highlight a turnkey solution for extracting and quantifying analytes from drinking water for 18 per-and polyfluorinated alkyl substances . This work demonstrates a method compliant streamlined workflow for PFAS compounds from extraction , concentration to analysis . Drinking water volumes were demonstrated with 250 mL and processed using a 6 mL cartridge-based extraction platform . The cartridge of choice with this methodology was a 6 mL 500 mg unmodified polystyrene-divinylbenzene copolymer . This media choice provides excellent retention for the extraction of a range of polar analytes from aqueous samples using a non-polar retention mechanism . This cartridge was an excellent choice which demonstrated low system background well below the EPA 537.1 methodology recommendation limits of 1 / 3 the method reporting limit ( MRL ). The extraction platform provided consistent flows and , when coupled with an ISOLUTE ® 101 PS-DVB 6 mL 500 mg PS-DVB cartridge , demonstrated an excellent initial demonstration of accuracy and precision turnkey solution . The results of the analytes were within 15 % of their normal values and had a relative standard deviation ( RSD ) under 11 % for each analyte . The recovery data will be presented , along with tips for troubleshooting interferences that are commonly experienced in the lab and for complying with blank contamination issues , as well as areas to focus on to improve and yield consistent recoveries and concentration optimization , and what to avoid .
Presenter : Paul Cannon , Biotage , paul . cannon @ biotage . com
Detection of Synthetic Opioids using High Resolution Mass Spectrometry
A Saddy , L Krajewski , K Swanson , R Shaner-Forster , E Hamelin , R Johnson , W Bragg and M Carter , Centers for Disease Control and Prevention
Introduction : In 2020 , opioid usage in the United States was involved in nearly 69,000 overdose deaths , 80 % of which involved synthetic opioids . Novel synthetic opioids are reported frequently ,
Environmental Health