Is there an interest for hair analysis in non-intentional pediatric cannabis intoxication?
Body Weight
Cannabis
/ poisoning
Child Protective Services
Child Welfare
Child, Preschool
Coma
/ chemically induced
Dronabinol
/ analogs & derivatives
Emergency Service, Hospital
Environmental Exposure
/ adverse effects
Female
Hair
/ chemistry
Hair Analysis
Humans
Infant
Male
Pilot Projects
Prospective Studies
Cannabis
Hair testing
Hashish
Intoxication
Pediatric
Journal
Forensic science international
ISSN: 1872-6283
Titre abrégé: Forensic Sci Int
Pays: Ireland
ID NLM: 7902034
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
27
01
2020
revised:
16
06
2020
accepted:
17
06
2020
pubmed:
6
7
2020
medline:
10
2
2021
entrez:
5
7
2020
Statut:
ppublish
Résumé
The incorporation of drugs in the hair of young children differs from that of adults and the metabolism of cannabis cannot be the same. Our primary objective was to analyze the distribution of the different cannabinoids in children's hair samples. The secondary objective was to correlate the intensity of toxic environmental exposure to cannabinoid metabolite levels. This was a prospective, single-center, observational pilot study of a pediatric cohort. Included subjects were all children less than 6 years of age admitted to a tertiary pediatric emergency unit for proven cannabis intoxication during the reference period. A hair strand was sampled within 12h of emergency admission. Forty-one pediatric patients were consecutively enrolled. Hair analysis showed that 34 children were positive for Δ9-THC (range 0.06-284.4ng/mg); 41 % of them were also positive for THC-COOH (range 0.26-2.76pg/mg). Depending on the Δ9-THC concentration (>1ng/mg), 39 % of the children could be considered exposed to an intensely toxic environment. The rate of THC-COOH detection steadily increased from 2015 to 2018 (18 %, 40 %, 50 %, 58 % for each consecutive year). Children intensely exposed weighed less on admission (p=0.02), had more comatose presentations (p=0.02), and more previous social issues (75 % versus 12 %, OR 22.0, p=0.0002). Hair testing in this context indirectly shows the intensity of children's toxic environmental exposure by the cannabinoid metabolite threshold. This was very helpful during the collegial examination of the toddlers' environment and led to a full investigation and to appropriate decisions concerning social measures.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
The incorporation of drugs in the hair of young children differs from that of adults and the metabolism of cannabis cannot be the same. Our primary objective was to analyze the distribution of the different cannabinoids in children's hair samples. The secondary objective was to correlate the intensity of toxic environmental exposure to cannabinoid metabolite levels.
METHODS
METHODS
This was a prospective, single-center, observational pilot study of a pediatric cohort. Included subjects were all children less than 6 years of age admitted to a tertiary pediatric emergency unit for proven cannabis intoxication during the reference period. A hair strand was sampled within 12h of emergency admission.
RESULTS
RESULTS
Forty-one pediatric patients were consecutively enrolled. Hair analysis showed that 34 children were positive for Δ9-THC (range 0.06-284.4ng/mg); 41 % of them were also positive for THC-COOH (range 0.26-2.76pg/mg). Depending on the Δ9-THC concentration (>1ng/mg), 39 % of the children could be considered exposed to an intensely toxic environment. The rate of THC-COOH detection steadily increased from 2015 to 2018 (18 %, 40 %, 50 %, 58 % for each consecutive year). Children intensely exposed weighed less on admission (p=0.02), had more comatose presentations (p=0.02), and more previous social issues (75 % versus 12 %, OR 22.0, p=0.0002).
CONCLUSION
CONCLUSIONS
Hair testing in this context indirectly shows the intensity of children's toxic environmental exposure by the cannabinoid metabolite threshold. This was very helpful during the collegial examination of the toddlers' environment and led to a full investigation and to appropriate decisions concerning social measures.
Identifiants
pubmed: 32622274
pii: S0379-0738(20)30239-5
doi: 10.1016/j.forsciint.2020.110377
pii:
doi:
Substances chimiques
11-nor-delta(9)-tetrahydrocannabinol-9-carboxylic acid
4TPC9E4A32
Dronabinol
7J8897W37S
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
110377Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors have no conflicts of interests to disclose.