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Chemical Terrorism and Threat (CTAT ) Testing Capabilities

Chemical Terrorism and Threat (CTAT ) Testing Capabilities. Overview of CTAT Unit of The NC State Laboratory of Public Health (NCSLPH) Current Instrumentation Current Analytes of Interest Contact Information How to Prepare and Ship Samples to the CTAT. CTAT Unit NCSLPH.

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Chemical Terrorism and Threat (CTAT ) Testing Capabilities

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  1. Chemical Terrorism and Threat (CTAT ) Testing Capabilities • Overview of CTAT Unit of The NC State Laboratory of Public Health (NCSLPH) • Current Instrumentation • Current Analytes of Interest • Contact Information • How to Prepare and Ship Samples to the CTAT not to be duplicated without express written permission

  2. CTAT Unit NCSLPH • Unit consists of 4 chemists • Located in Raleigh, NC • Identify and quantitate levels of chemical agents and their metabolites in blood and urine of patients exposed to chemical agents • Lab personnel have been trained by and work closely with the CDC in methodology and instrumentation. • Offer training workshops to hospitals and local health departments for collection, packaging and shipping of specimens. • Future methods include: Carbamates, Sulfur mustard, Acrylonitriles, and Azides. • Unknowns Analysis. not to be duplicated without express written permission

  3. Our Old LaboratoryLocation, Location, Location not to be duplicated without express written permission

  4. Our New Lab not to be duplicated without express written permission

  5. Current Instrumentation • GC/MS (4) Gas Chromatographs are equipped with mass spectrophotometers for detection. Dual rail autosamplers, heated agitators, and cryo-traps are used for various testing. not to be duplicated without express written permission

  6. Current Instrumentation not to be duplicated without express written permission

  7. Current Instrumentation • ICP/MS (2) Used for elemental analysis, equipped with robotic autosamplers and dynamic reaction cells. not to be duplicated without express written permission

  8. Current Instrumentation not to be duplicated without express written permission

  9. Current Instrumentation • LC/MS/MS (1) HPLC Tandem Mass Spec equipped with degasser, autosampler, column oven and valve switching. Used for various urine tests. not to be duplicated without express written permission

  10. Current Instrumentation not to be duplicated without express written permission

  11. Current Instrumentation • Zephyr 96 well plate extractor (1) allows the simultaneous preparation of 96 samples for high throughput. not to be duplicated without express written permission

  12. Current Instrumentation not to be duplicated without express written permission

  13. Analytes of Interest • Toxic Metals in Urine • Toxic Metals in Blood • Cyanide • Tetramine • Volatile Organic Compounds • HNPAA • Nerve Agents • Ricinine and Abrine • Metabolic Toxins • Unknowns Analysis not to be duplicated without express written permission

  14. Toxic Metals in Urine • Beryllium • Barium • Cadmium • Thallium • Lead • Uranium • Arsenic All of these metals are readily available and highly toxic. not to be duplicated without express written permission

  15. Toxic Metals in Blood • Lead • Mercury • Cadmium All of these metals are readily available and highly toxic. not to be duplicated without express written permission

  16. Cyanide in Blood • Cyanide is present in everyone’s blood at various levels • Cyanide is higher in the blood of smokers • Highly Toxic • Readily Available (1.7 Billion lbs annually produced) • Has been used in the past (from ancient Egypt to recent terrorist attacks/plans) • Accidental exposures, Suicides, Smoke Inhalation not to be duplicated without express written permission

  17. Tetramine in Urine • Tetramethylenedisulfotetramine (TETS, Tetramine) • Tetramine is primarily used as a rat poison • Prohibited in the US and banned in China (1984) • Over 1000 deaths in China in the 1990’s and over 800 poisonings in 2002-2004 • Still readily available in China • Considered the murder weapon of choice in rural China not to be duplicated without express written permission

  18. Volatile Organic Compounds in Blood • Volatile Organic Compounds (VOCs) • List of analytes as well as the ability to identify additional volatile compounds • Readily available • Ease of use • High Toxicity not to be duplicated without express written permission

  19. HNPAA in Urine • Determines the exposure to Tetranitromethane (TNM) by measuring 4-Hydroxy 3-Nitrophenylacetic Acid (HNPAA) • TNM indicates exposure to explosives. • TNM is also highly toxic • Widely available not to be duplicated without express written permission

  20. Nerve Agent Metabolites in Urine • Determines the exposure to GB (Sarin), GF, GD (Soman), VX, and Russian VX. • Extremely Toxic • Not readily available* • *Sarin was used in 1995 Tokyo subway attacks and manufactured by the Aum Shinrikyo not to be duplicated without express written permission

  21. Abrine and Ricinine in Urine • Determines the exposure to Ricin and Abrin. • Extremely Toxic • Can be manufactured easily from plants found in the United States • Ricin incident in Georgia in Nov 2011 • Recent reports of plots to use Ricin not to be duplicated without express written permission

  22. Metabolic Toxins in Urine • Determines the exposure to Monochloroacetate (MCA) and Monofluoroacetate (MFA) • MCA is a systemic poison where 10% body coverage is lethal that is used as a chemical intermediate in various processes • MFA is a tasteless water soluble rodenticide that must be ingested • Extremely Toxic not to be duplicated without express written permission

  23. Unknowns Analysis • You have something and don’t know what it is • You send it to us • We try to figure it out not to be duplicated without express written permission

  24. Contacts for CTAT • William “Tex” Parks • CTAT Lab Coordinator • NCSLPH • 4312 District Drive • Raleigh, NC 27607 • (919)807-8771 • (919)602-2481 (cell 24/7) • Bernard Barrameda • Asst. CTAT Lab Coordinator • NCSLPH • 4312 District Drive • Raleigh, NC 27607 • (919)807-8774 • (919)710-5104 (cell 24/7) not to be duplicated without express written permission

  25. Website • http://slph.ncpublichealth.com/chemical-terrorism.asp not to be duplicated without express written permission

  26. When to Contact the CTAT • ANYTIME YOU HAVE A QUESTION OR CONCERN • ABSOLUTELY ANYTIME YOU HAVE A QUESTION OR CONCERN • ABSOLUTELY POSITIVELY ANYTIME YOU HAVE A QUESTION OR CONCERN • Seriously, don’t wait to be sure you need us. It is better to alert us of a situation that scales down than get behind on one that scales up. not to be duplicated without express written permission

  27. Specimen Collection • Collect from each patient • Blood • 3 purple top tubes (4 if collecting in 3mL ) and 1 green or gray top tube • Do not use gel tubes • Number the tubes in the order collected and mark a 1, 2, 3, or 4 on each tube with indelible ink. Collect the green or gray top tube after collecting the purple top tubes. • Urine • Collect at least 25–50 mL urine • Collect urine only (no blood) for children unless directed otherwise by CDC • Note: send two empty blood tubes(purple and green or gray) for each lot of tubes used and 2 empty urine cups for each lot of urine cups used. not to be duplicated without express written permission

  28. The Paperwork • Prepare a separate shipping manifest for urine and blood samples since urine and blood samples cannot be shipped in the same container. • Place a copy of the chain of custody form in the bag with the manifest, but keeptheoriginalchainofcustodyatyourfacility. • Place all the paperwork in a plastic zippered bag on top of the specimens before closing the lid of the polystyrene foam insulated shipper. not to be duplicated without express written permission

  29. Where to Ship • Chemical Terrorism and Threat Lab • NCSLPH • 4312 District Drive • Raleigh, NC 27607 not to be duplicated without express written permission

  30. Thank You for your attendance and attention. not to be duplicated without express written permission

  31. QUESTIONS not to be duplicated without express written permission

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