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
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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.
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Our Old Laboratory
Location, Location, Location
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Our New Lab
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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.
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Current Instrumentation
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Current Instrumentation
• ICP/MS (2) Used for elemental analysis,
equipped with robotic autosamplers and
dynamic reaction cells.
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Current Instrumentation
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Current Instrumentation
• LC/MS/MS (1) HPLC Tandem Mass Spec
equipped with degasser, autosampler, column
oven and valve switching. Used for various
urine tests.
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Current Instrumentation
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Current Instrumentation
• Zephyr 96 well plate extractor (1) allows the
simultaneous preparation of 96 samples for
high throughput.
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Current Instrumentation
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Analytes of Interest
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Toxic Metals in Urine
Toxic Metals in Blood
Cyanide
Tetramine
Volatile Organic Compounds
HNPAA
Nerve Agents
Ricinine and Abrine
Metabolic Toxins
Unknowns Analysis
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Toxic Metals in Urine
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Beryllium
Barium
Cadmium
Thallium
• Lead
• Uranium
• Arsenic
All of these metals are readily available and highly toxic.
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Toxic Metals in Blood
• Lead
• Mercury
• Cadmium
All of these metals are readily available and highly toxic.
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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
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Tetramine in Urine
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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
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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
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HNPAA in Urine
• Determines the exposure to
Tetranitromethane (TNM) by measuring 4Hydroxy 3-Nitrophenylacetic Acid (HNPAA)
• TNM indicates exposure to explosives.
• TNM is also highly toxic
• Widely available
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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
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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
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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
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Unknowns Analysis
• You have something and don’t know what it is
• You send it to us
• We try to figure it out
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Contacts for CTAT
• William “Tex” Parks
Bernard Barrameda
 CTAT Lab Coordinator
Asst. CTAT Lab Coordinator
 NCSLPH
NCSLPH
 4312 District Drive
4312 District Drive
Raleigh, NC 27607
 Raleigh, NC 27607
(919)807-8774
 (919)807-8771
(919)710-5104 (cell 24/7)
 (919)602-2481 (cell 24/7)
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Website
• http://slph.ncpublichealth.com/chemical-terrorism.asp
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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.
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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.
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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 keep the original chain of
custody at your facility.
• 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
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written permission
Where to Ship
Chemical Terrorism and Threat Lab
NCSLPH
4312 District Drive
Raleigh, NC 27607
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Thank You for your attendance and
attention.
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QUESTIONS
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