Agricultural and horticultural pesticides fatal poisoning; the Jordanian experience 1999-2002.

A prospective autopsy study addressing fatal poisoning with agricultural and horticultural pesticides was undertaken in Jordan over a 4 year period. A total number of 140 deaths occurred during 1999-2002. The mean fatality rate was 0.68 case per 100,000 population and the age range was 2-55 years; mean 28.3 years with male to female ratio 1.03. The largest number of cases occurred in those 20-29 years (n=69, 49.3%) followed by the age group 30-39 years (n=34, 24.3%) and 40-49 years (n=17, 12.1%). Less than 3.0% of the total fatal poisoning was noticed in both children younger than 9 years of age and those in the age group 50-59 years, with no fatal poisoning in adults at the age 60 years and above. At least 64.3% of all pesticide fatalities were due to suicide with male: female ratio (1.37:1). Accidental and homicide poisoning resulted in 24.3% and 7.9% of the total fatalities, respectively; however, only five cases 3.6% of fatal poisoning were due to unknown pesticides. The main pesticide used was carbamates with 110 cases 78.6% followed by organophosphorus 23 cases 16.4%. The study showed that the present legislation on pesticides availability in Jordan failed to reduce the number of fatal pesticides poisoning since the number of fatal pesticides poisoning was increased from 25.3 to 35 cases per year over a 20 years period. Enforcement of a new legislation addressing the availability of agricultural and horticultural pesticides for self-harm, especially carbamates and organophosphorus, is the most important strategy in the long term to prevent fatal pesticides poisoning in Jordan.

Determination of tramadol in hair using solid phase extraction and GC-MS.

Tramadol is a centrally acting synthetic analgesic with mu-opioid receptor agonist activity, it is a widely prescribed analgesic used in the treatment of moderate to severe pain and as an alternative to opiates. Tramadol causes less respiratory depression than morphine at recommended doses. Its efficacy and low incidence of side effects lead to its unnecessary prescribing in patients with mild pain. Tramadol was classified as a "controlled drug" long after its approval for use in Jordan. Analysis of drugs of abuse in hair has been used in routine forensic toxicology as an alternative to blood in studying addiction history of drug abusers. A method for the determination of tramadol in hair using solid phase extraction and gas chromatography-mass spectrometry (GC-MS) is presented, the method offers excellent precision (3.5-9.8%, (M)=6.77%), accuracy (6.9-12%, M=9.4%) and limit of detection 0.5 ng/mg. The recovery was in the range of 87-94.3% with an average of 90.75%. The calibration curve was linear over the concentration range 0.5-5.0 ng/mg hair with correlation coefficient of 0.998. The developed method was tested on 11 hair samples taken from patients using tramadol as prescribed by their physician along with other different drugs in treating chronic illnesses. Tramadol was detected in all hair samples at a concentration of 0.176-16.3 ng/mg with mean concentration of 4.41 ng/mg. The developed method has the potential of being applied in forensic drug hair testing. In Jordan, hair drug testing started to draw the attention of legal authorities which stimulated forensic toxicologists in recent years to develop methods of analysis of drugs known or have the potential to be abused.

Investigating the presence of a common drug of abuse (benzhexol) in hair; the Jordanian experience.

The analysis of hair is now accepted as a recognised alternative method for the determination of drug misuse. It has several advantages over the biological fluids; blood and urine, including collection of information regarding long-term drug use and determination of compliance with treatment programmes. In Jordan, the abuse of Artane (benzhexol hydrochloride) has been recognised as the most commonly abused drug among Jordanian youths. Hair samples were collected from nine patients (Male 25-55 years, M=39.11, SD=10.53, CV=26.93%). Samples were analysed for the presence of benzhexol and the toxicological analysis revealed the presence of benzhexol in all samples and its concentration ranged from 0.104 to 7.81 ng/mg hair. Solid phase extraction and GC-MS on selective ion storage (SIS) were used for extraction and detection of the drug with papaverine as external standard. The mass detector was operated at selective ion storage (SIS) to monitor the m/z of 98 and 218 for benzhexol and m/z 339 and 324 for the papaverine. The retention times of benzhexol and papaverine were 6.77 and 12.48 min, respectively. The method was linear in the range of 0.5 to 40 ng/mg hair, with a mean coefficient of determination (R2=0.9982). The limit of detection was 0.04 ng/mg. The intra- and inter-day variations were 3.85% and 3.35%. Recovery was found to be above 90%.