Chemical Identification and Confirmation of Contact Allergens.

Identification of the etiological chemical agent(s) associated with a case(s) of allergic contact dermatitis (ACD) is important for both patient management and public health surveillance. Traditional patch testing can identify chemical allergens to which the patient is allergic. Confirmation of allergen presence in the causative ACD-associated material is presently dependent on labeling information, which may not list the allergenic chemical on the product label or safety data sheet. Dermatologists have expressed concern over the lack of laboratory support for chemical allergen identification and possibly quantification from patients' ACD-associated products. The aim of this review was to provide the clinician a primer to better understand the analytical chemistry of contact allergen confirmation and unknown identification, including types of analyses, required instrumentation, identification levels of confidence decision tree, limitations, and costs.

Analytical methodology and assessment of potential second-hand exposure to fentanyl in the hospital surgical setting.

Second-hand exposure to aerosols containing fentanyl and other opiates during surgical procedures has been implicated as possibly contributing to maintenance of addiction among medical professionals, specifically anesthesiologists. This article outlines a pilot study that was conducted to verify a reported finding fentanyl in the air of operating suites. Environmental fentanyl air sampling and analysis methods were developed and evaluated for this study. Multiple sampling media and extraction solvents were evaluated for trace fentanyl air sampling. Non-specific binding losses were reduced by using silanized binder-free glass fiber sampling media with subsequent methanol extraction. Filtration air samples were then collected in surgical suites during the entire operation time from two cardiovascular surgical procedures. Both surgical procedures were conducted at the same hospital but on different days. Samples were extracted and analyzed by high-performance liquid chromatography/tandem mass spectrometry using a capillary high-performance liquid chromatography coupled to a quadrupole time-of-flight mass spectrometer. The total air volume collected per surgery was 290 to 300 L at a rate of 1 LPM giving an limit of quantification for fentanyl of 57 pg/m(3) air (17 pg/filter). No fentanyl was detected in the air during cardiovascular surgical operations from either surgical suite.