Levels, distribution, sources and human exposure pathways of alkylphenol and alkylphenol ethoxylates in indoor dust in Turkiye.

Environmental phenolic chemicals, due to their widespread occurrence and potent estrogenic properties, pose a risk to human exposure. The phenolic organic contaminants alkylphenols (APs) and alkylphenol polyethoxylates (APEs) are used in various household applications, and they may enter to the environment during production and use, potentially appearing in indoor dust. However, little is known about the levels of environmental phenolics in indoor environments. In this study, five of these compounds namely octylphenol (OP), 4-Octylphenol Monoethoxylate (4-OPME), 4-tert-octylphenol (4-t-OP), 4-n-nonylphenol (4-n-NP) and nonylphenol diethoxylate (di-NPE) were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) in household dust samples (n = 148) collected from Ankara, the capital of Turkiye. OP and 4-OPME was not present in any of the analyzed samples. The median concentrations of the 148 settling dust samples were 35, 520, and 1910 ng g-1 dust for 4-t-OP, 4-n-NP, and di-NPE, respectively. An assessment of the human (children and adults) exposure pathway to APs and APEs, which are recognized as endocrine-disrupting chemicals found in residential dust, revealed that it was approximately 3 times higher for children than for adults at both moderate and heavy exposure levels. The association between chemical exposure, house characteristics, and family lifestyle was investigated using a multivariate logistic regression model. According to the results of this model, while the high concentrations measured for 4-t-OP were not found to be associated with any of the household parameters, high levels of 4-n-NP and di-NPE were associated with the frequency of house cleaning, repairs made during the previous year, residential type, the number of occupants, flooring materials, and the purchase of new household items within the past year. This study provides a basis for prioritizing toxicology and exposure studies for EDCs and mixtures and may offer new tools for exposure assessment in health studies.

Estimation of anti-diabetes drug metformin in Turkiye using wastewater-based epidemiology.

Metformin is the most commonly used drug for the treatment of type 2 diabetes (T2D), which is dramatically increasing due to factors such as increasing obesity, physical inactivity, and aging of the population. Metformin analysis was carried out in composite wastewater samples seasonally collected from wastewater treatment plants in 10 cities in 2019 and 2020 30 cities in 2021 in Turkiye. Metformin was measured in all wastewater samples, with an average concentration of 97.81 µg/l in 2019, 75.19 µg/l in 2020, and 69.13 µg/l in 2021. This study was utilized to predict metformin usage in different sociodemographic regions in Turkiye using a wastewater-based epidemiology (WBE) approach. As a result of the analysis, the average metformin consumption in Turkiye was estimated to be 22.2 ± 9.6 [1.9-63.8] g/d/1,000 persons (mean ± SD [range]). Furthermore, these estimates were compared with data for time, sociodemographic characteristics, and patient numbers. Assessing the correlation with estimates and the socioeconomic classes of the cities in question revealed that cities with high-income levels had the lowest metformin use rate. Finally, the study provides supporting data aiding the development of public health strategies for decreasing the overall load of T2D across Turkiye.

Method development, validation, and application for simultaneous determination of 56 new psychoactive substances in surface water by LC-MS/MS.

Despite preventive legislation, the popularity and consumption of new psychoactive substances (NPS) have been steadily increasing in recent years. This study provides a rapid and sensitive method for the quantitation and the detection of 56 NPS from surface water. Sample clean-up and pre-concentration were performed by solid-phase extraction (SPE) with Oasis HLB (6 cc/500 mg) cartridge. Following the chromatographic separation with Shim-pack FC-ODS column, the all substances were quantified by liquid chromatography-tandem mass spectrometry. The method was optimized and validated for all NPS. Despite the wide variety of physicochemical properties of the analytes, the recoveries for all compounds studied were in the range of 69-117%. The limit of quantitation (LOQ) ranging from 2.5 to 15 ng/L was reached for reliable and accurate quantification of analytes. The analytical method developed was successfully applied to the surface water samples. While synthetic cannabinoids were not detected, mephedrone from the synthetic cathinone group was detected under the LOQ. This novel method was expected to be a part of future environmental routine analyses as a satisfactory method.

Nicotine consumption rate through wastewater-based epidemiology: a systematic review, meta-analysis and probabilistic risk assessment.

Wastewater-based epidemiology (WBE), as a rapid tool, is used to measure and monitor illicit drug consumption in the population. This method is also used to bridge biomarkers of exposure, contaminants, and human health. Smoking cigarettes and tobacco use are everyday habits in nowadays community. This systematic review and meta-analysis aimed to calculate nicotine consumption globally. The related studies were retrieved within international databases including Scopus, Google Scholar, and Web of Science, up to February 2021. It included twenty-one articles containing 87 measurements covering 275.3 million people with total wastewater samples of 2250. Results showed that the highest and lowest nicotine consumption rate (mg/1000 inh./day) was in Portugal (5860) and Vietnam (1201), respectively. The global pooled nicotine consumption rate was 2476 mg/1000 inh./day (95% CI (2289-2663). Based on WBE results, the average daily cigarette smoked per smoker is 14 (95% CI: 10-18 cigarettes/inh./day), close to the value of 14.2 reported by the survey and interview studies. Risk assessment of the nicotine consumption rate through WBE was calculated by the margin of exposure (MOE) approach. In total, 82% of nicotine consumption measurements were located in the "risk" level (MOE < 100), and 18% of the MOE values were between 100-1000. The results reveal that nicotine consumption risks need immediate global and local action strategies. Finally, these findings are helpful for healthcare agencies and policy-makers to take action against tobacco use prevalence.

Optimization of biochip assay for illegal substances on drug abusers' whole blood: Randox Evidence vs LC-MS/MS.

Immunoassay tests are used in clinical and forensic toxicology laboratories to determine illicit drug use in biological samples. Therefore, this study aims to optimize the cutoff concentrations of DOA I Plus in the blood and compare the LC-MS/MS results. 680 authentic forensic whole blood specimens with Randox Evidence DOA I Plus array were screened for drug of abuse and confirmed by LC-MS/MS. Regarding the manufacturer recommended threshold values, 139 out of 680 authentic blood samples were positive for one or more analytes, while 541 were negative. Nearly all of the 139 positive blood samples confirmed by LC-MS/MS were true positive for one or more analytes, while 522 of the 541 negative blood samples were true negative. The overall sensitivity and the specificity were 87.8% and 99.6%, respectively. THC was considered in detail, and a receiver operator characteristic curve analysis was performed to determine the optimum cutoff for THC, as it accounts for 78% of all positive results according to the manufacturer's recommended thresholds. The optimal threshold value for THC was determined at a concentration of 23 ng/mL, while these values for other parameters were defined as recommended by the manufacturer.

Impact of COVID- 19 pandemic on antidepressants consumptions by wastewater analysis in Turkey.

The COVID-19 pandemic has been a major challenge worldwide, forcing countries to take restrictive measures beyond conventional methods in their fight against the spread of the disease. Followingly, many studies have been conducted on the effects of these measures on mental health. Wastewater-based epidemiology (WBE) was used in this study to monitor and estimate changes in antidepressant use under normal conditions (2019) and COVID-19 pandemic conditions (2020). Likewise, this study utilized wastewater-based epidemiology (WBE) to monitor and assess changing trends from the pre-pandemic period (2019) to COVID-19 pandemic conditions in antidepressant use (2020). Wastewater samples were collected from 11 cities in Turkey throughout six sampling periods covering the pre-pandemic and during-pandemic periods (June 2019-December 2020). Then, samples were analyzed via LC-MS/MS method. As a result, we observed that venlafaxine was the drug with the highest concentration (mean ± SD: 103.6 ± 112.1 mg/1000p/day). Moreover, city number 6 presented the highest venlafaxine use and the most dramatic increase during the pandemic period. Finally, this study revealed the potential of WBE to estimate the changing trends in mental health during the ongoing pandemic.

Determination of phosphatidyl ethanol (PEth) 16:0/18:1 in dried blood samples of drivers involved in traffic accidents: A pilot study.

In routine forensic toxicology practices, blood alcohol concentration (BAC) levels are measured in traffic accidents that ended up in emergency departments. Nevertheless, since the elimination of ethanol from the blood is fast and the detection time is short, BAC cannot indicate the occurrence of chronic excessive alcohol consumption. Phosphatidylethanol (PEth) is a unique ethanol direct biomarker that occurs only in the presence of phospholipase D enzyme in erythrocyte membranes during alcohol intake, and it indicates alcohol intake. In this study, both whole blood and dried blood samples were collected from 50 patients who were admitted to Cukurova University Hospital Emergency Department due to a traffic accident. While studying BAC in whole blood samples, PEth 16:0/18:1 analysis was performed on dried blood samples by LC-MS/MS. According to the BAC (50 mg/dL) value, the legal limit in Turkey, the optimal threshold PEth 16:0/18:1 value was set as 160 ng/mL and over. This study determined that 15 people with above PEth 16:0/18:1 concentrations above 160 ng/mL were classified as excessive alcohol consumption. The data obtained in this study showed a positive correlation between BAC and PEth concentration when driving under the influence of ethanol.

Comparison of methods to develop fingerprints on papers impregnated with AB-PINACA and AB-FUBINACA.

Although there have been significant advances in fingerprinting techniques, studies on how these techniques affect other criminal evidence are limited. Synthetic cannabinoids (SC), which are illegal substances frequently encountered in crime scenes and are widely used worldwide, are available in various forms in the market (pill, powder, liquid, and herbal product). These synthetic cannabinoid substances have recently been introduced to places such as prisons and rehabilitation centers, primarily via an infused piece of paper. The first seizure of the paper-impregnated form of AB-PINACA and AB-FUBINACA in Turkey was observed in 2014. This study investigates the effects of fingerprint development methods on the concentrations of these SCs impregnated on paper. Therefore, eccrine and sebaceous fingerprints of volunteers were imprinted on the papers before and after they were impregnated with AB-PINACA and AB-FUBINACA. Six different fingerprint development methods were applied. Fingerprint development methods were later checked in 384 fingerprints. AB-PINACA and AB-FUBINACA infused on papers were extracted by the liquid-extraction method, and concentrations were analyzed via LC-MS/MS. After applying Thermanin, 1,2-indandione, iodine vapor, DFO, and 5-MTN fingerprint development methods, the concentration levels of AB-FUBINACA were 26.25, 19.60, 21.43, 17.76, and 17.77 ng/cm2 , while the concentration levels of AB-PINACA were 1.1, 0.98, 1.31, 1.28, and 1.22 ng/cm2 , respectively. Finally, although the best fingerprint visualization was obtained on papers that were applied the Ninhydrin method, the method failed to detect SCs on papers.

Polychlorinated biphenyls and organochlorine pesticides in breast milk samples and their correlation with dietary and reproductive factors in lactating mothers in Istanbul.

Persistent organic pollutants (POPs) continue to threaten the environment and human health. We have investigated levels of polychlorinated biphenyls (PCBs) and organochlorinated pesticides (OCPs) in breast milk samples. A questionnaire was also obtained from the study participants. A total of 48 healthy lactating mothers (mean age: 29.5±0.8 years) living in Istanbul volunteered to participate in this study. High-resolution analyses of several OCPs and PCB congeners were done by gas chromatography. The levels of seven major PCB congeners (28, 52, 101, 118, 138, 153, and 180) and eight OCPs (α-benzenehexachloride, ß-benzenehexachloride, δ-benzenehexachloride, hexachlorobenzene (HCB), and 2,4'-dichlorodiphenyldichloroethylene (2,4DDE), 4,4'-dichlorodiphenyldichloroethylene (4,4DDE), 2,4'-dichlorodiphenyltrichloroethane (2,4DDT), and 4,4'-dichlorodiphenyltrichloroethane (4,4DDT)) were determined. The analysis showed that the highest levels of PCBs were observed in PCB 52 (22.99±8.78 ng/g lipid), PCB 101 (12.22±7.8 ng/g lipid), PCB 28 (11.44±5.16 ng/g lipid), and PCB 153 (1.70±0.74 ng/g lipid). The highest OCPs detected were 4,4DDT (3.33±2.05 ng/g lipid) and 4,4DDE (0.86 ± 0.39 ng/g lipid), and the lowest was observed in HCB (0.016 ± 0.01 ng/g lipid). Our findings show that traces of PCBs and OCPs are still present in breast milk of lactating women living in Istanbul, and these pollutants decline in multipara women compared to primipara mothers. We also suggest that breast milk is a useful and representative biological tool for human biomonitoring of POPs.

The risk estimation and assessment of heavy metal exposure by biomonitoring in the breast milk of mothers in the Cukurova Region, Turkey.

Toxic heavy metals released into the environment through various industrial processes have potential adverse effects on the environment and human health. In order to reveal these adverse health effects, it is vital to carry out toxicological studies by performing biomonitoring. This study aimed to assess the level of Cr, As, Cd, Hg, and Pb in the breast milk samples of mothers in the Cukurova region, Turkey, and its association with health risk to infants. Ten-milliliter postpartum milk samples were collected from 34 breast-feeding mothers in the first 2 months of their postpartum period and living in the Cukurova region, Adana. The measurement of target heavy metals levels was performed by using inductively coupled plasma mass spectroscopy (ICP-MS). The average breast milk levels of Cr, As, Cd, Hg, and Pb were 8.25, 1.64, 0.37, 2.60, and 12.12 µg/L, respectively. Evaluation of breast milk samples for these toxic heavy metals revealed the high exposure level for Cr and As. However, the mothers who participated in the study were not occupationally exposed to these metals. This study showed that Cr, As, Cd, Hg, and Pb cross the placenta and blood-brain barrier prenatally and accumulate in breast milk postnatally.

Association between occupational and environmental pesticide exposure in Cukurova region by hair and blood biomonitoring.

This study assesses association between occupational and environmental pesticide exposure on pesticide applicators directly exposed to pesticides and inhabitants of the Cukurova region by analyzing blood and hair samples. Hair and blood samples were collected from 132 volunteers, 66 of whom are pesticide applicators, and the rest are non-farmer residents, in 10 villages nearby the Ceyhan River between March and June in 2017. Samples were then analyzed via the liquid chromatography-tandem mass spectrometer. As the analysis result, a total number of 31 pesticides were detected in hair samples, whereas a total number of 15 pesticides were observed in blood samples. Twenty of the pesticides (64.5%) detected in the hair and 3 (20%) detected in the blood were significantly higher in the applicators than the non-farm residents. Also, 5 pesticides (16.1%) observed in the hair and 7 observed (46.6%) in the blood were banned pesticides. This study investigated the pesticide exposures on people living in the region via hair and blood samples. Our study revealed that, in addition to individuals who are occupationally exposed to pesticides, individuals from all parts of the society, especially those living in the agricultural region, have a certain level of pesticide exposure.

Determination of AB-FUBINACA and 5F-NPB-22 in rats exposed to "Bonsai" via inhalation and analysis of seized product.

Synthetic cannabinoids (SCs) are the most rapidly growing class of recreational designer drugs. Illicit drug manufacturers began to produce herbal smoking materials under a variety of brands names, e.g. "Spice, K2, Bonsai, Yucatan Fire". They were appeared on the European market in 2008. In this study, types of SCs in the herbal product sold as "Bonsai" in Turkey were determined and the identification of these substances in biological samples collected from rats depending on the inhalation of different amounts of plant material were aimed. To determine the SC species in the content of the plant product, analysis was performed via gas chromatography-mass spectrometry. Liquid-liquid extraction methods were utilized for blood and organ samples, while solid-phase extraction with ß-glucuronidase enzyme treatment was applied for urine sample preparation. The relationship between the amount of burned plant and the amount of SCs accumulated in the blood, urine and organ samples of rats exposed to the plant product by inhalation was examined by liquid chromatography-tandem mass spectrometry. AB-FUBINACA and 5F-NPB-22 were detected in the herbal product. A significant correlation was found between the amount of herbal product inhaled and the prevalence of SCs, especially in lung tissues while no SCs were detected in the blood and urine samples of rats. There is currently no study on biological samples of individuals exposed to herbal products containing SCs by inhalation. Regarding the findings obtained in this study, the overall increase in the amounts of herbal product inhaled was demonstrated to pose a potential risk to humans.

Determination of synthetic cannabinoids in randomly urine samples collected from probationers in Turkey.

Synthetic cannabinoids are a significant public health and safety problem that complicates drug tests with their ever-changing structures in our country and worldwide. The fact that most synthetic cannabinoids cannot be detected in biological samples by routine drug of abuse screening tests also causes an increase in the use of these substances in return. In this study, 500 urine samples of randomly selected probationers, analyzed with an enzymatic immunoassay test at Ege University Institute of Drug Addiction, Toxicology and Pharmaceutical Sciences (BATI) and tested negative, were then selected for retrospective analysis. Synthetic cannabinoids and their metabolites were quantitatively scanned in the collected urine samples via the liquid-liquid extraction method with the LC-MS/MS. Of the 500 studied urine samples, 108 (21.6%) were positive for 20 synthetic cannabinoids and their metabolites. The two most detected synthetic cannabinoids were 5F-NPB-22 (58%) and (S)-AB-FUBINACA (36%), and their mean concentrations were 72.94 ±â€¯47.51 ng/mL and 5.84 ±â€¯14.7 ng/mL, respectively. These results were also compared with national statistics from the general population. It resulted that immunoassay screening tests used in this study were insufficient, and urine samples should be studied in clinical and forensic cases with a validated chromatographic method.

Fabrication of novel magnetic CuS/Fe3O4/GO nanocomposite for organic pollutant degradation under visible light irradiation.

The magnetic nanocomposites composed of copper sulphide, iron oxide, and graphene oxide (CuS/Fe3O4/GO) were synthesized through a facile sol-gel combined with hydrothermal techniques for photodegradation of methylene blue (MB) as a model organic pollutant. The as-prepared samples were characterized by powder X-ray diffraction (XRD), vibrating sample magnetometer (VSM), differential reflectance spectroscopy (DRS), Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscopy (FESEM), and energy dispersive X-ray analysis (EDX) and results confirmed successful synthesis of magnetic nanocomposite. Presence of Fe3O4 and GO in nanocomposite induced a synergistic effect in CuS performance as CS88F6G6 (i.e. 88% CuS, 6% Fe3O4, and 6% GO). The photocatalytic degradation efficiency of MB reached up to 90.3% after exposure to visible light irradiation for 80 min. The composite nanosheets are photostable, reusable, and magnetically recoverable, revealing potential application in removal of organic pollutants.

New Psychoactive Substance 5-MeO-MiPT In vivo Acute Toxicity and Hystotoxicological Study.

BACKGROUND: The hallucinogenic tryptamine analog 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT) causes social problems worldwide. There are several studies on the metabolism; however, not more studies were found in the literature on acute toxicity. AIMS: To report the acute toxicity of 5-MeO-MiPT in mice, followed by quantitative toxicological analysis of blood and organs, hystotoxicological and immunohistochemical analysis of tissues and cells. STUDY DESIGN: Animal experiment Methods: In vivo experiments were performed using CD1 adult female mice (n=26). Animals were caged in 4 groups randomly. First group was a control (n=3). Second group was vehicle control (n=3) and injected 150 µL of blank solution (50% dimethyl sulfoxide in saline /0.9% of NaCl). While for acute toxicity experiments, 5-MeO-MiPT was added to a blank solution in order to obtain a dose of 0.27 mg/kg in 150 µL injection (n=10) and the last group were injected 2.7 mg/kg 5-MeO-MiPT in a 150 µL injection (n=10). Quantitative toxicological analysis, hystotoxicological and immunohistochemical analysis were performed. RESULTS: In the toxicological analysis, 5-MeO-MiPT was found negative in biological samples which were control, vehicle control, and 0.27 mg/kg dose mice groups. 5-MeO-MiPT was found 2.7-13.4 ng/mL in blood, 11-29 ng/g in kidney, 15.2-108.3 ng/g in liver, and 1.5-40.6 ng/g in the brain in 2,7 mg/kg injected group. In a low dose of the 5-MeO-MiPT liver section, compared with normal tissues, the difference in staining was statistically significant (p<0.0001). In high-dose of 5-MeO-MiPT, H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p<0.05). In high-dose of 5-MeO-MiPT, intense Caspase-3 immunoreactivity was observed and the increase in the number of Caspase-3 positive cells compared to the control was statistically significant (p<0.05). In brain section, the statistics of the results obtained from the H-score showed that the increase in the number of Caspase-3 positive cells was significant compared to the control (p=0.0183). In vehicle control liver section, there were few Caspase-8 positive cells characterized by a light brown appearance (p=0.0117). In the high-dose 5-MeO-MiPT group, the numbers of positive cells at low and high doses of 5-MeO-MiPT group were statistically significant compared to the control (p<0.05). In the high-dose 5-MeO-MiPT group, Caspase-8 immunoreactivity was detected in the glomerular structures. Compared to control, the increase in Caspase-8 immunoreactivity was found to be statistically significant (p<0.05). CONCLUSION: Low-dose 5-MeO-MiPT did not cause any serious histopathological effects on the liver, kidney, and brain. High doses induce apoptotic cell death through caspase activity.

Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology.

Wastewater-based epidemiology (WBE) is an ever-increasing discipline that enables researchers to track near-real-time data concerning the recreational use of illicit drugs. Community illicit drug use was estimated in eleven Turkish cities, using eighteen wastewater treatment plants, representing the metropolitan cities and rural areas with different socio-demographic characteristics. In this study, 24-h composite influent wastewater samples were collected for 1 week per season between March 2019 and December 2019. Heroin, amphetamine, methamphetamine, ecstasy, cocaine, and marijuana were covered as illicit drugs in this study. Solid-phase extraction, LC-MS/MS separation, identification, and quantification were used as the analytical methods. Overall results indicate that both cocaine and MDMA usage increased in all cities on weekends. More specifically, it was observed that the average amount of cocaine use regarding 11 cities was 14.7 mg/1000 person/day, while figures for other substances are as follows: 9.5 for amphetamine, 34.5 for methamphetamine, 38.4 for MDMA, 42.2 for heroin, and lastly 5412 mg/1000p/day for marijuana. This study holds the position of being the most comprehensive one conducted, considering spatial and temporal datasets on illicit drug consumption obtained via WBE in Turkey.

Estimation of alcohol and nicotine consumption in 11 cities of Turkey using wastewater-based epidemiology.

Alcohol and tobacco are the most frequently consumed substances in the world. Both are significantly associated with the increasing number of different diseases. Thus, monitoring nicotine and alcohol use is vital for public health planning and intervention strategies. This study aimed to calculate estimates of alcohol and nicotine use in 11 cities of Turkey using wastewater-based epidemiology. In 2019, daily composite wastewater samples from 18 wastewater treatment plants were collected for a week per season. The 24-h composite samples were collected via auto-samplers. Sample preparation for wastewater samples collected was done using liquid-liquid extraction and solid-phase extraction. Nicotine and ethyl sulfate (EtS) were analyzed using validated liquid chromatography-tandem mass spectrometry method. The estimated average nicotine consumption was 2.84 mg/p/day, and the average alcohol consumption was 3.46 ± 1.83 ml/p/day. The highest nicotine consumption was observed in Kayseri city; the highest alcohol consumption was calculated for Mersin city. In this study, the cigarette and alcohol consumption estimate obtained by wastewater-based epidemiology (WBE) was found to be higher than the Turkey Tobacco and Alcohol Market Regulatory Authority report. To our knowledge, this study is the most comprehensive one so far applied using WBE for 11 cities in Turkey and evaluates alcohol and nicotine use together.

Estimating alcohol consumption by using wastewater-based epidemiology in Adana Province, Turkey.

Increased alcohol consumption, especially among young people, is a major concern in Turkey as it is around the world due to negative effects on public health and safety. Regarding this, it is pivotal to monitor and therefore control alcohol use in public. In this case, wastewater-based epidemiology (WBE), which is the in-depth analysis of wastewater and a relatively new method, can deliver complementary information concerning the abuse of different substances. The proven potential of the WBE approach offers new promises in the process of monitoring alcohol use, namely the monitoring of the levels of ethyl sulfate (EtS) as a urinary biomarker of alcohol consumption, and it is a powerful mean to estimate alcohol use at the community level. In this study, raw 24-h composite wastewater samples were collected from Seyhan and Yüregir wastewater treatment plants (WWTPs) in Adana Province for one week per season (October 2016-August 2017). The fast and validated analytical method was performed by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) and therefore applied to the analysis of ethyl sulfate (EtS). Obtained concentration values were back-calculated, and regional and temporal social usage rates were determined. Higher values were calculated for both WWTPs on Sunday. Alcohol consumption in the region served by Seyhan WWTP was higher than Yüregir WWTP. The results showed that the levels of alcohol consumption during given periods in Adana ranged from 659.8 to 8998.7 mL/day/1000 per person with an average value of 4983.9 and 3924.2 mL/day/1000 inhabitant in Seyhan WWTP and Yüregir WWTP, respectively. This study shows that weekly and annual trends in alcohol consumption can be detected quickly from wastewater analysis.

Assessment of recent alcohol consumption by detecting ethyl glucuronide and ethyl sulphate level among traffic accident patients.

Objective: This study aims to explain whether EtG and EtS, which are two non-oxidative ethanol metabolites secreted by the liver and used as markers of alcohol intake related to an incident, were also present in whole blood samples of patients with traffic accident injuries.Methods: EtG and EtS concentrations in all of the whole blood samples were sent to the Forensic Medicine Department of Cukurova University for testing Blood Alcohol Concentrations (BAC) via validated liquid chromatography-tandem mass spectrometer method.Results: The scope of the study covers 200 patients that were admitted to medical services within 12 h following the incident. Of all patients 16.5% were found to be BAC positive, while 35.5 and 23.5 were positive for EtG and EtS, respectively. All samples with a positive BAC result were also positive for EtG and EtS.Conclusion: Detection of EtG and EtS, minor metabolites along with ethanol in the blood can serve as an objective tool to provide further analysis regarding alcohol-related traffic accidents at emergency services.

A global systematic review and meta-analysis on illicit drug consumption rate through wastewater-based epidemiology.

Wastewater-based epidemiology (WBE) is a complementary, well-established comprehensive, cost-effective, and rapid technique for monitoring of illicit drugs used in a general population. This systematic review and meta-analysis is the first to estimate the rank and consumption rate of illicit drugs through WBE studies. In the current study, the related investigations regarding the illicit drug consumption rate based on WBE were searched among the international databases including Scopus, PubMed, Science direct, Google scholar, and local database, Magiran from 2012 up to May 2019. The illicit drug consumption rate with 95% confidence intervals was pooled between studies by using random effect model. The heterogeneity was determined using I2 statistics. Also, subgroup analyses were conducted to examine the possible effects of year and location of studies on observed heterogeneity. Meta-analysis of 37 articles indicates that the overall rank order of illicit drugs according to their pooled consumption rate can be summarized as tetrahydrocannabinol or cannabis (7417.9 mg/day/1000 people) > cocaine (655.7 mg/day/1000 people) > morphine (384.9 mg/day/1000 people) > methamphetamine (296.2 mg/day/1000 people) > codeine (222.7 mg/day/1000 people) > methadone (200.2 mg/day/1000 people) > 3,4-methylenedioxymethamphetamine (126.3 mg/day/1000 people) > amphetamine (118.2 mg/day/1000 people) > 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (33.7 mg/day/1000 people). The pooled level rate was 190.16 mg/day/1000 people for benzoylecgonine (main urinary cocaine metabolite), 137.9 mg/day/1000 people for 11-nor-9-carboxy-delta9-tetrahydrocannabinol (main metabolite of cannabis), and 33.7 mg/day/1000 people for 2-ethylidene-1,5-dimethyl-3, 3-diphenylpyrrolidine (main metabolite of methadone). The I2 values for all selected drugs were 100% (P value < 0.001). The results of year subgroup indicated that the changes of heterogeneity for all selected drugs were nearly negligible. The heterogeneity within studies based on continents subgroup just decreased in America for drugs like 11-nor-9-carboxy-delta9-tetrahydrocannabinol (I2 = 24.4%) and benzoylecgonine (I2 = 94.1%). The outcome of this meta-analysis can be used for finding the illicit drugs with global serious problem in view of consumption rate (i.e., cannabis and cocaine) and helping authorities to combat them.