APHL 2022 POSTER ABSTRACTS
Environmental Health with 12 new compounds identified by the DEA in the past two years . To increase surveillance regarding these issues and better detect emerging synthetic opioids in clinical matrices , a high-resolution mass spectrometry method , validated using ANSI / ASB Standard 036 , has been developed that can identify over 250 novel and synthetic opioids . This method is easily expandable to include new novel drugs for future and retrospective analysis , with the mass spectral library publicly available for use by any lab .
Method : The development of a mass spectral library and effective opioid detection are accomplished using a high-performance liquid chromatography-high resolution mass spectrometry ( HPLC-HRMS ) method . Analytes in clinical matrices ( urine , plasma and whole blood ) are extracted and screened against the existing in-house library for tentative identification . For increased confidence , identifications are confirmed through comparison to a reference standard . The lower limit of detection , carryover , interference , extraction efficiency and matrix effects of select analytes are validated . The curated in-house library created using the Traceable Opioid Material Kit ® ( TOM Kit ®) product line can be easily transferred between instruments and laboratories , and the library files are available for download free-of-charge from the TOM Kits ® website .
Results and Conclusions : This method has the capability to detect over 250 novel and synthetic compounds within a 16-minute time of analysis . Its validation processes have reflected high confidence in detection capability , as it has been used in four external proficiency tests with a 100 % success rate . It expedites the detection and identification of synthetic opioids in clinical matrices over existing targeted analytical methodology , with the ability to increase its analytical capabilities through addition of new analytes . To date , over 100 new compounds have been added since initial method creation in early 2020 . This method enables comprehensive synthetic opioid detection and supports public health activities related to surveillance , health studies and emergency response .
( Traceable Opioid Material and TOM Kits are registered marks of the US Department of Health and Human Services )
Presenter : Anisha Saddy , Centers for Disease Control and Prevention , shv8 @ cdc . gov
Detection of Opioids in Public Health Studies by High Performance Liquid Chromatography Coupled with Tandem Mass Spectrometry
A Tuachi , R Shaner-Forster , E Hamelin and M Carter , Centers for Disease Control and Prevention
Substance abuse is an ongoing threat to public health domestically and internationally . There is accumulating evidence about the harmful effects of opioids abuse ; however , studying long-term health effects of abuse is complicated . This is due , in part , to the lack of available longitudinal data , discrepancies in the ability to study abuse consistently , and a lack of information about the best way to characterize and measure long-term opioids abuse . We developed a high-sensitivity laboratory detection method to support the opioids public health emergency . This method identifies 26 fentanyl analogs and related synthetic opioids in human whole blood using high performance liquid chromatography coupled with tandem mass spectrometry ( HPLC-MS / MS ). The integration of dried blood spots ( DBS ) allows for a simple sample collection protocol with high extraction efficiencies . The Opioid Certified Reference Material Kit ( Opioid CRM Kit ) from the Traceable Opioid Material ® Kits ( TOM Kits ®) product line supplies this method with 22 emerging synthetic opioids and their paired isotopically-labeled internal standards ( carbon-13 ; nitrogen-15 ) free-of-charge . This method was validated following SWGTOX guidelines and boasts sensitive detection limits ranging between 0.25 and 0.50 ng / mL for all analytes . With measurable long-term stability , low matrix effects and high reproducibility , this method is invaluable in our laboratory ’ s ability to support the opioids public health emergency and provide laboratory testing in stakeholder health and surveillance studies .
Presenter : Abraham Tuachi , Centers for Disease Control and Prevention , qtr4 @ cdc . gov
Strengthening Regional Environmental Health Systems Partnering to Improve Water Pathogen Surveillance and Public Health Communication
K Schieble , L Beversdorf , B Pfotenhauer , J Plevak and S Bhattacharyya , City of Milwaukee Health Department
Introduction : The water-related exposure of microbial pathogens is a significant determinant of human health . The disease burden from water-associated communicable diseases is influenced by water use , chemical pollution , pathogens and other disease vectors . The Milwaukee Health Department Laboratory ( MHDL ) hosted a meeting with 50 system partners in Southeastern Wisconsin to share information and evaluate knowledge gaps regarding drinking , waste and recreational water pathogen surveillance . The goal of this multi-sector partnering approach was to educate environmental health system ( EHS ) stakeholders on current surveillance efforts to continuously improve public health essential services .
Method : A planning committee comprised of representatives from drinking and wastewater utilities , public health laboratories , academia , local businesses and community organizations was tasked with refining the objectives , identifying subject matter experts as presenters and establishing evaluation criteria for the meeting . The water pathogen surveillance presentations included laboratory technology use and innovations , regulations and processes regarding pathogen surveillance and how these data are shared with local stakeholders and amongst regional partners . The breakout groups , which consisted of drinking water , recreational water and wastewater , evaluated system performance using the Association of Public Health Laboratories ( APHL ) Laboratory System Improvement Program ( L-SIP ) essential public health services : Monitor Health Status , Mobilize Community Partnerships and Assure a Competent Workforce .
Results : In general , observations were consistent between the drinking water , recreational water and wastewater groups : 1 ) a major strength is community partnering and opportunity for collaborations in the areas of water pathogen surveillance , crosssector partnerships and fellowship opportunities ; 2 ) improving public education and outreach , including robust and sustainable public data sharing , would help establish trust in the community ; and 3 ) statewide community of EH practice system improvement would benefit from having a system “ champion ” to guide and coordinate regional efforts .
Conclusion : A participant evaluation was performed , recommendations were made and a final report was issued back to