Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-30T23:29:18.823Z Has data issue: false hasContentIssue false

Analysis of Chemical Simulants in Urine: A Useful Tool for Assessing Emergency Decontamination Efficacy in Human Volunteer Studies

Published online by Cambridge University Press:  30 June 2020

Thomas James*
Affiliation:
Centre for Radiation, Chemicals and Environmental Hazards (CRCE), Public Health England, Chilton, United Kingdom
Samuel Collins
Affiliation:
Centre for Radiation, Chemicals and Environmental Hazards (CRCE), Public Health England, Chilton, United Kingdom
Richard Amlôt
Affiliation:
Emergency Response Department Science & Technology, Public Health England, Porton Down, Salisbury, Wiltshire, United Kingdom
Tim Marczylo
Affiliation:
Centre for Radiation, Chemicals and Environmental Hazards (CRCE), Public Health England, Chilton, United Kingdom
*
Correspondence: Thomas James, MSc, Centre for Radiation, Chemicals, and Environmental Hazards (CRCE), Public Health England, Chilton, OX11 0RQUnited Kingdom, E-mail: [email protected]

Abstract

Introduction:

To date, all human studies of mass-casualty decontamination for chemical incidents have relied on the collection and analysis of external samples, including skin and hair, to determine decontamination efficacy. The removal of a simulant contaminant from the surface of the body with the assumption that this translates to reduced systemic exposure and reduced risk of secondary contamination has been the main outcome measure of these studies. Some studies have investigated systemic exposure through urinary levels of simulant metabolites. The data obtained in these studies were confounded by high background concentrations from dietary sources. The unmetabolized simulants have never been analyzed in urine for the purposes of decontamination efficacy assessment.

Study Objective:

Urinary simulant analysis could obviate the need to collect skin or hair samples during decontamination trials and provide a better estimate of both decontamination efficacy and systemic exposure. The study objective therefore was to determine whether gross skin contamination as part of a decontamination study would yield urine levels of simulants sufficient to evaluate systemic availability free from dietary confounders.

Methods:

In this study, a gas chromatography-tandem mass spectrometry method was developed for the analysis of two chemical simulants, methyl salicylate (MeS) and benzyl salicylate (BeS), in urine. An extraction and sample clean-up method was validated, enabling quantitation of these simulants in urine. The method was then applied to urine collected over a 24-hour period following simulant application to the skin of volunteers.

Results:

Both MeS and BeS were present in all urine samples and were significantly increased in all post-application samples. The MeS levels peaked one hour after skin application. The remaining urinary levels were variable, possibly due to additional MeS exposures such as inhalation. In contrast, the urinary excretion pattern for BeS was more typical for urinary excretion curves, increasing clearly above baseline from four hours post-dose and peaking between 12.5 and 21 hours, a pattern consistent with dermal absorption and rapid excretion.

Conclusion:

The authors propose BeS is a useful simulant for use in decontamination studies and that its measurement in urine can be used to model systemic exposures following skin application and therefore likely health consequences.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amlôt, R, Carter, H, Riddle, L, Larner, J, Chilcott, RP. Volunteer trials of a novel improvised dry decontamination protocol for use during mass casualty incidents as part of the UK’S Initial Operational Response (IOR). PLoS One. 2017;12(6):e0179309.CrossRefGoogle Scholar
Chilcott, RP, Larner, J, Durrant, A, et al. Evaluation of US federal guidelines (Primary Response Incident Scene Management [PRISM]) for mass decontamination of casualties during the initial operational response to a chemical incident. Ann Emerg Med. 2019;73(6):671–84.CrossRefGoogle ScholarPubMed
Chilcott, RP, Mitchell, H, Matar, H. Optimization of non-ambulant mass casualty decontamination protocols as part of an initial or specialist operational response to chemical incidents. Prehosp Emerg Care. 2019:23(1):3243.CrossRefGoogle ScholarPubMed
Larner, J, Durrant, A, Hughes, P, et al. Efficacy of different hair and skin decontamination strategies with identification of associated hazards to first responders. Prehosp Emerg Care. 2020;24(3):355368.CrossRefGoogle ScholarPubMed
James, T, Wyke, S, Marczylo, T, et al. Chemical warfare agent simulants for human volunteer trials of emergency decontamination: a systematic review. J Appl Toxicol. 2018;38(1):113–21.CrossRefGoogle ScholarPubMed
Amlôt, R, Larner, J, Matar, H, et al. Comparative analysis of showering protocols for mass-casualty decontamination. Prehosp Disaster Med. 2010;25(5):435439.CrossRefGoogle ScholarPubMed
Bartelt-Hunt, SL, Knappe, DRU, Barlaz, MA. A review of chemical warfare agent simulants for the study of environmental behavior. Crit Rev Environ Sci Technolgy. 2008;38(2):112136.Google Scholar
James, T, Collins, S, Amlôt, R, Marczylo, T. GC-MS/MS quantification of benzyl salicylate on skin and hair: a novel chemical simulant for human decontamination studies. J Chromatogr B Analyt Technol Biomed Life Sci. 2019;1129:121818.CrossRefGoogle ScholarPubMed
Mongillo, JA, Paul, J. Determination of aspirin and its major metabolites in human urine by gas chromatography-mass spectrometry, II. Microchem J. 1997;55(3):296307.CrossRefGoogle Scholar
James, T, Collins, S, Amlôt, R, Marczylo, T. Optimization and validation of a GC-MS/MS method for the analysis of methyl salicylate in hair and skin samples for use in human-volunteer decontamination studies. J Chromatogr B Analyt Technol Biomed Life Sci. 2019;1109:8489.CrossRefGoogle Scholar
US Department of Health and Human Services Center for Drug Evaluation and Research (CDER), Center for Veterinary Medicine (CVM), editor. Bioanalytical Method Validation Guidance for Industry. Silver Spring, Maryland USA: Food and Drug Administration; 2018.Google Scholar
Baxter, GJ, Lawrence, JR, Graham, AB, Wiles, D, Paterson, JR. Identification and determination of salicylic acid and salicyluric acid in urine of people not taking salicylate drugs. Ann Clin Biochem. 2002;39(1):5055.CrossRefGoogle Scholar
Supplementary material: File

James et al. supplementary material

James et al. supplementary material

Download James et al. supplementary material(File)
File 13.5 KB