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Forensic Toxicology Section 1 1. 2. 3. 4. 5. 6. 7. 8. 5/24/2017 Objectives Explain how alcohol is absorbed into the bloodstream, transported throughout the body, and finally eliminated by oxidation and excretion. Name the important parts of the human circulatory system. Describe the process by which alcohol is excreted in the breath via the alveoli. Describe the design of the Breathalyzer. Explain the significance of a chemical equation. Explain the concept of infrared and fuel-cell breath-testing devices. Demonstrate some common field sobriety tests. List common laboratory procedures for measuring alcohol’s concentration in the blood. Created by C. Ippolito Feb 2008 1 Role of Forensic Toxicology Uncontrolled use of drugs has increased world wide importance of the field Toxicologist detect and identify drugs and poisons in body fluids, tissues, and organs – test lead exposure in children – urine analysis for drug treatment programs – urine analysis of prospective employees 5/24/2017 Created by C. Ippolito Feb 2008 2 Toxicology of Alcohol Ethyl alcohol – most abused drug responsible for 40% of traffic deaths 17,500 fatalities per year hospitalizations from injuries 2 million per year Metabolism chemical reactions in an organism Alcohol Metabolism absorption – how it gets into systems distribution – how it moves through body elimination – how it is removed from body 5/24/2017 Created by C. Ippolito Feb 2008 3 Alcohol Metabolism Absorption slowly enters bloodstream in stomach in small intestines Factors affecting adsorption: time taken to consume amount consumed alcohol content of beverage quantity and type of food in stomach 5/24/2017 Created by C. Ippolito Feb 2008 4 Alcohol Metabolism (con’t) Distribution equally distributed into watery parts of (2/3) body Elimination (0.015% per weight/volume per hour) Oxidation in liver (95-98%) alcohol dehydrogenase – alcohol acetaldehyde acetic acid – acetic acid carbon dioxide and water Excretion lungs (breath) kidneys (urine) sweat glands (perspiration) 5/24/2017 Created by C. Ippolito Feb 2008 5 Blood Alcohol Concentration How much alcohol impairs brain function [blood alcohol] directly proportional [brain alcohol] maximum [blood alcohol] may not be reached for 2-3 hours after consumption usually 20-30 minutes after final drink absorption is completed 5/24/2017 Created by C. Ippolito Feb 2008 6 Alcohol Ingestion and Distribution Closed Circulatory System heart (pump) arteries - carry blood away from heart capillaries - exchange blood with tissue veins - returns blood from tissues to heart 5/24/2017 Created by C. Ippolito Feb 2008 7 Alcohol Aeration Lungs alveoli oxygen and carbon dioxide exchange Henry’s Law volatile in liquid reached equilibrium with air at a fixed ratio that is constant at a given temperature at 34°C ratio is 2100 to 1 so that 1 mL of blood has the same [alcohol] as 2100 mL of breath basis of breathalyzer tests 5/24/2017 Created by C. Ippolito Feb 2008 8 Alcohol Recirculation and Adsorption arterial blood sends alcohol to tissues [alcohol] in arteries > [alcohol] in veins up to 41% higher 30 mins after last drink does not equalize until adsorption stage is completed 5/24/2017 Created by C. Ippolito Feb 2008 9 Breath Testing for Alcohol Measures [alcohol] in pulmonary artery by measuring [alcohol] in alveolar breath during absorptive phase will be higher than [alcohol] in veins Breathalyzer developed 1954 by R. Borkenstein of Indiana State Police Infrared Light Absorption Devices Fuel Cell Detectors 5/24/2017 Created by C. Ippolito Feb 2008 10 Breathalyzer Test 52.5 mL collected passed through potassium dichromate reacts with alcohol forming acetic acid silver nitrate acts as catalyst 2 to 3 ratio for every 2 units of potassium dichromate used 3 units of alcohol was present 5/24/2017 Created by C. Ippolito Feb 2008 11 Infrared Light Adsorption Devices microprocessor controlled self calibrating breath collected IR light passed through chamber filter selects IR wavelength alcohol absorbed detector measures alcohol present 5/24/2017 Created by C. Ippolito Feb 2008 12 Fuel Cell Device microprocessor controlled self calibrating platinum electrodes separated by porous acid or base containing membrane alcohol acetic acid + free electrons current formed is proportional to alcohol in breathe 5/24/2017 Created by C. Ippolito Feb 2008 13 Consideration in Breath Testing need alveolar breathe (1.1 – 1.6 L) slope detector insures this avoid “mouth alcohol” regurgitation, mouth wash, etc observe 15 to 20 minutes before test take duplicate samples 5/24/2017 Created by C. Ippolito Feb 2008 14 Field Sobriety Testing psychophysical tests degree of impairment whether evidential test justified Alco-Sensor FST Horizontal-gaze Nystagmus involuntary jerk moving eye Walk and Turn heel to toe walk for nine steps turn and heel to toe walk back One-Leg Stand stand on one foot and count out loud 5/24/2017 Created by C. Ippolito Feb 2008 15 Forensic Toxicology Section 2 1. 2. 3. 4. 5. 6. 7. 5/24/2017 Objectives Describe the precautions to be taken to properly preserve blood for analysis for its alcohol content. What is the presumptive impairment level for blood alcohol in your state? Explain the significance of the implied consent law and the Schmerber v. California case to traffic enforcement. Define acid and base. Develop an appreciation for the role of the toxicologist in the criminal justice system. Describe some of the techniques that forensic toxicologists use for isolating and identifying drugs and poisons. Discuss the significance of finding a drug in human tissues and organs. Created by C. Ippolito Feb 2008 16 Analysis of Blood for Alcohol gas chromatography alcohol has definite peak peak size can be compared to knowns alcohol dehydrogenase NAD reaction converts NAD to NADH measurable by spectrophotometer 5/24/2017 Created by C. Ippolito Feb 2008 17 Collection and Preservation of Blood blood drawn by qualified person use nonalcoholic disinfectant Zepiran or Betadine sealed in airtight container anticoagulant (EDTA potassium oxalate) preservative (sodium fluoride) refrigerate postmortem bacteria produce ethanol prefer vitreous humor or urine to limit this effect 5/24/2017 Created by C. Ippolito Feb 2008 18 Alcohol and the Law AMA and NSC establish uniform / reasonable blood alcohol levels Blood-Alcohol Laws AMA NSC 0.15% w/v under influence 1992 DOT recommends lower 0.08% w/v under influence – 2003 states not lose fed funds Commercial Drivers 0.04% w/v under influence 5/24/2017 Created by C. Ippolito Feb 2008 19 Constitutional Issues Fifth Amendment protects from self-incrimination NSTA implied-consent law refusing test leads to loss of license Schmerber vs. California blood take w/o consent after accident led to conviction Supreme Court – 5th Amendment prohibits testimonial self incrimination – does not apply to furnishing physical evidence – 4th Amendment (unreasonable search) » emergency situation warranted taking » taken in accepted manner without unreasonable force 5/24/2017 Created by C. Ippolito Feb 2008 20 Role of Toxicologist w/o clue needs extensive “screening” using small amounts micrograms if not nanograms body actively alters substances i.e. heroin is immediately metabolized to morphine which can combine with carbs in body and not end up in urine samples 5/24/2017 Created by C. Ippolito Feb 2008 21 Toxicological Techniques Acid/Base control pH affects drug removal Acid – barbiturates and aspirin Basic – phencyclidine, methadone, amphetamine, cocaine Screening Tests TLC, GC, Immunoassay (monoclonal antibodies) Confirmation Tests GC followed by MS Hair Analysis used for measuring long term abuse 5/24/2017 Created by C. Ippolito Feb 2008 22 Other techniques Reinsch Test screens for heavy metals treat body fluid with HCl – copper strip in fluid darkens heavy metal present – followed with more detailed inorganic analysis CO poisoning spectrophotometer reagent followed by GC find percent saturation – 35-40 percent is fatal – 8-10 percent seen in chain smokers 5/24/2017 Created by C. Ippolito Feb 2008 23