Delaware Health and Social Services Division of Public Health Laboratory DPHL Chemical Terrorism Update 15 November 2007 DPHL CT Procedures Training/Validation/Proficiency Referral lab status Methods, Training, & Exercises Current CT Testing LRN-C Qualified Level Two Laboratory Heavy & Trace metals in Urine (ICP/MS) Nutritional & toxicological interest Be, Co, Mo, Cd, Sb, Cs, Ba, W, Pt, Tl, Pb, U As, Se (DRC-ICP/MS) Blood Metals Pb, Cd, Hg Blood Pb screening in children Cyanide in Whole Blood (GC/MS) Upcoming CT Testing: InOrganic Arsenic & Selenium SPECIATION in Urine by DRC-ICP/MS Expandable: Matrices, Metals, Speciation Speciation equipment at DPHL Utilizes HPLC front end for chromatographic separation CDC Method Training delayed 2Q08 Future: Vanadium, Chromium, & Thallium by DRC-ICP/MS Gallium - integrated circuits & microprocessors Upcoming CT Testing: Organic Nerve Agent Metabolites in Urine by LC/MS/MS Sarin, Soman, Cyclohexylsarin, VX, Tabun Training 27-29 November 2007 Validation and proficiency test anticipated February 2008 Volatile Organic Compounds in Blood by GC/MS: Initial training complete Water pipes delayed validation – aim is March 2008 Future CT Testing : LC/MS/MS Ricin (Ricinine biomarker) in urine Pesticides and HaloAcetic Acids Nitrogen Mustards in urine Adamsite (vomiting agent) Riot/Tearing agents Lewisite Metabolites FDA Food methods EPA Unknown chemical screens BIOMONITORING ????? Collection, Packaging, & Shipping Update Carriers…or Who Will Take This? USPS no longer accepts Class 6.2 Category A materials regardless of volume or mass DHL and FedEx DO accept Class 6.2 Category A materials (under standard volume/mass limits) UPS does NOT accept Class 6.2 Category A materials UPS DOES accept Class 6.2 Category B materials To learn more, come to one of the Collection, Shipping, Packaging and Documentation Courses! Forms…or Paperwork, Paperwork, Paperwork All shipments require an itemized list of contents between the secondary and outer packages Mass/Volume, number of primary containers, a brief description Technical Name is not required on the exterior of the box Technical Name is required on the Shipper’s Declaration of Dangerous Goods Dry Ice below 200 kg: With a Category B material does NOT require a Shipper’s Declaration of Dangerous Goods With a Category A material DOES require a Shipper’s Declaration of Dangerous Goods CT Clinical Samples Collection follow “Chemical Terrorism Event Specimen Collection” Specimens must have two layers of evidentiary seal May be individually sealed with evidence tape Must be initialed, time, and dated Freeze urine samples Chill (do not freeze) blood samples Shipping & Packaging: “Chemical Terrorism Event Shipping Instructions – Blood” “Chemical Terrorism Event Shipping Instructions – Urine” DPHL Specimen Paperwork Paperwork to accompany samples: DPHL Chain of Custody 1 per patient / environmental specimen category DPHL Request for Preparedness Testing must be completed PRIOR to any Testing Include Field Screening report ANY additional information is useful! 1 per batch of samples (clinical vs. environmental) Routine specimens – use LIMS form (or entry!) Shipping Manifest: 1 per box shipped Environmental or Clinical Version Polling Question: Do you have capability to quarantine personnel potentially exposed to a BT or CT agent? Your own staff? First responder staff? DPHL staff? How many? For how long? What materials/agents/syndromes? Polling Question: Do you have a Continuity of Operations Plan in place for service disruptions? Increased sample/patient load? Outbreak? Pandemic? Utility disruption? Civil disruption? For how long? How many staff affected? Training What are your staff or facility training needs? ODP Courses: Excellent, Free Program, for more information: http://www.ojp.usdoj.gov http://www.state.de.us/dema/default.shtml Call Dwayne Day at DEMA: (302) 659-2214 http://fema.gov