[DHSS Logo] DELAWARE HEALTH & SOCIAL SERVICES Division of Public Health Laboratory LPAC Meeting Chemical Preparedness Update 14 November 2008 Tara Lydick, Analytical Chemist IV, Manager Special Projects Laboratory DPHL CT Procedures Training/Validation/Proficiency Referral lab status Methods, Training, & Exercises Current Chemical Preparedness Testing • LRN-C Qualified Level Two Laboratory • ICP/MS Methods: – Heavy & Trace metals in Urine – As, Se (DRC-ICP/MS) – Blood Metals – Blood Lead* Current Chemical Preparedness Testing • LRN-C Qualified Level Two Laboratory • GC/MS Methods: – Cyanide in Whole Blood – Volatile Organic Compounds in Blood Upcoming Chemical Preparedness Testing • Nerve Agent Metabolites in Urine by LC/MS/MS (OPNA) – LRN-C and vendor training complete – Instrumentation installed – Funding – materials – Validation – Qualifying proficiency test (PT): Feb 2009 Upcoming Chemical Preparedness Testing • Ricin & Abrin Biomarker in Urine by LC/MS/MS – Requires completion of OPNA method – LRN-C Training 2009 – Funding – materials – Validation – Qualification: 1 of 3 PTs in 2009 Delayed or Postponed Methods • Arsenic & Selenium Speciation in Urine by DRC-ICP/MS – Expandable: Cr, V – Instrumentation and Software installed – LRN-C Method Training delayed due to software – hardware interface issues • Sulfur Mustard Metabolites in Urine by GC/MS • Funding – not at present Future Chemical Preparedness Testing • Funding, funding, funding… – Nitrogen Mustards in urine – Adamsite (vomiting agent) – Riot/Tearing agents – Lewisite Metabolites – FDA Food methods – EPA Unknown chemical screens – Pesticides and HaloAcetic Acids – BIOMONITORING – ????? Equipment Updates • Installed Gilson SPE215 – Semi-automated solid phase extraction system – Multiple position system – 4 transfer probes – He, solvent driven – OPNA – Ricin & Abrin – Pesticides? – Other? Equipment Updates • Installing LabConco Multi-Hazard Glove box – Use for triaging specimens for BT analysis with AHRF protocol – Ventilation and electrical work needed – Training and protocols to be developed Equipment Updates • BT Large Volume Water Method – Filter and concentrate 40 L volume to less than 10 mL for PCR and TRF analysis – Ventilating Class II Biosafety Cabinet – BSC – vacuum – Small equipment purchases • Bacteriological Water Testing – Presence/Absence Total Coliforms, E. coli Collection, Packaging, & Shipping Update Clinical Shipping and Packaging Training (CSICPSD) • Preparation for LPX • Required training – Every 2 years to ship via air (referral to CDC) – Every 3 years to ship via ground (any local) – ANY individual involved in the process • Packers, shippers, handlers, or receivers • (DOT 49 CFR 172.700, IATA DGR 1.5) • Materials updated every 6 mo. to 1 yr. – Dependent on changes in DOT, IATA, and carrier regulations & requirements Clinical Chemical Exposure 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” • ALL UPDATED ON CDC website: http://www.bt.cdc.gov/labissues/ Environmental Shipping and Packaging (E-SCICPSD) • Collection of Environmental Specimens for analysis at DPHL or other referral laboratory • No national standard – yet • Required for all submitters of non-clinical specimens to DPHL – Exception: routine drinking water samples – Chain of Custody training is not exempt Transitioning of Training • Transitioning to Delaware State Fire School (DSFS) – All Specimen Identification, Collection, Packaging, Shipping, and Documentation Courses (SICPSD) – Proficiency Testing program (once started) – Hazardous Materials Instructors – January 2009 – as needed basis (2x/year) – Signup sheet for contact/interest • Not transitioning to DSFS – Sentinel Laboratory Training • BT Advanced Workshop – Exercises Outreach • LRN/APHL First Responder Workgroup – Developing consensus standards for collection, transport, training – Texas CT Meeting – December 2008 • LRN/APHL Proficiency Testing Workgroup – Developing PT program for first responders and partner laboratories – IAFC HazMat Conference May 2009 Other Internal Projects • Gas Room Emergency Training – DPHL SPL, E Chem., Section Safety Representatives – Acetylene (dissolved in acetone) – Bulk cryogenics and asphyxiants – Vaporized Hydrogen Peroxide – BPL • Select Agent and Toxin Certification Inspection – 4-5 Dec 2008 – lots of preparation – Changing standards • Laboratory Assessment – 10 Dec 2008 – Smyrna Opera House • Cross training – bacteriological water testing with chemists – Capacity – flood samples or water emergency 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