Chemical Terrorism and Threat (CTAT ) Testing Capabilities

• Overview of CTAT Unit of The NC State Laboratory of Public Health (NCSLPH)

• Current Instrumentation• Current Analytes of Interest• Contact Information• How to Prepare and Ship Samples to the CTAT

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CTAT Unit NCSLPH• Unit consists of 4 chemists• Located in Raleigh, NC• Identify and quantitate levels of chemical agents and their

metabolites in blood and urine of patients exposed to chemical agents

• Lab personnel have been trained by and work closely with the CDC in methodology and instrumentation.

• Offer training workshops to hospitals and local health departments for collection, packaging and shipping of specimens.

• Future methods include: Carbamates, Sulfur mustard, Acrylonitriles, and Azides.

• Unknowns Analysis.

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Our Old LaboratoryLocation, Location, Location

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Our New Lab

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Current Instrumentation• GC/MS (4) Gas Chromatographs are equipped

with mass spectrophotometers for detection. Dual rail autosamplers, heated agitators, and cryo-traps are used for various testing.

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Current Instrumentation

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Current Instrumentation• ICP/MS (2) Used for elemental analysis,

equipped with robotic autosamplers and dynamic reaction cells.

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Current Instrumentation

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Current Instrumentation• LC/MS/MS (1) HPLC Tandem Mass Spec

equipped with degasser, autosampler, column oven and valve switching. Used for various urine tests.

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Current Instrumentation

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Current Instrumentation• Zephyr 96 well plate extractor (1) allows the

simultaneous preparation of 96 samples for high throughput.

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Current Instrumentation

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Analytes of Interest• Toxic Metals in Urine• Toxic Metals in Blood• Cyanide• Tetramine• Volatile Organic Compounds• HNPAA• Nerve Agents• Ricinine and Abrine• Metabolic Toxins• Unknowns Analysis

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Toxic Metals in Urine• Beryllium• Barium• Cadmium• Thallium

• Lead• Uranium• Arsenic

All of these metals are readily available and highly toxic.

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Toxic Metals in Blood• Lead• Mercury• Cadmium

All of these metals are readily available and highly toxic.

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Cyanide in Blood• Cyanide is present in everyone’s blood at

various levels• Cyanide is higher in the blood of smokers• Highly Toxic• Readily Available (1.7 Billion lbs annually

produced)• Has been used in the past (from ancient Egypt to

recent terrorist attacks/plans)• Accidental exposures, Suicides, Smoke

Inhalation04/21/23 16:33 not to be duplicated without express

written permission

Tetramine in Urine• Tetramethylenedisulfotetramine (TETS, Tetramine)• Tetramine is primarily used as a rat poison• Prohibited in the US and banned in China (1984)• Over 1000 deaths in China in the 1990’s and over

800 poisonings in 2002-2004• Still readily available in China• Considered the murder weapon of choice in rural

China

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Volatile Organic Compounds in Blood

• Volatile Organic Compounds (VOCs)• List of analytes as well as the ability to

identify additional volatile compounds• Readily available• Ease of use• High Toxicity

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HNPAA in Urine• Determines the exposure to

Tetranitromethane (TNM) by measuring 4-Hydroxy 3-Nitrophenylacetic Acid (HNPAA)

• TNM indicates exposure to explosives.• TNM is also highly toxic• Widely available

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Nerve Agent Metabolites in Urine• Determines the exposure to GB (Sarin), GF,

GD (Soman), VX, and Russian VX.• Extremely Toxic• Not readily available*• *Sarin was used in 1995 Tokyo subway

attacks and manufactured by the Aum Shinrikyo

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Abrine and Ricinine in Urine• Determines the exposure to Ricin and Abrin.• Extremely Toxic• Can be manufactured easily from plants

found in the United States• Ricin incident in Georgia in Nov 2011• Recent reports of plots to use Ricin

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Metabolic Toxins in Urine• Determines the exposure to Monochloroacetate

(MCA) and Monofluoroacetate (MFA)• MCA is a systemic poison where 10% body

coverage is lethal that is used as a chemical intermediate in various processes

• MFA is a tasteless water soluble rodenticide that must be ingested

• Extremely Toxic

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Unknowns Analysis• You have something and don’t know what it is• You send it to us• We try to figure it out

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Contacts for CTAT • William “Tex” Parks

CTAT Lab Coordinator

NCSLPH

4312 District Drive

Raleigh, NC 27607

(919)807-8771

(919)602-2481 (cell 24/7)

Bernard BarramedaAsst. CTAT Lab Coordinator

NCSLPH

4312 District Drive

Raleigh, NC 27607

(919)807-8774

(919)710-5104 (cell 24/7)

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Website

• http://slph.ncpublichealth.com/chemical-terrorism.asp

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When to Contact the CTAT

• ANYTIME YOU HAVE A QUESTION OR CONCERN• ABSOLUTELY ANYTIME YOU HAVE A QUESTION

OR CONCERN• ABSOLUTELY POSITIVELY ANYTIME YOU HAVE A

QUESTION OR CONCERN• Seriously, don’t wait to be sure you need us. It is

better to alert us of a situation that scales down than get behind on one that scales up.

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Specimen Collection•Collect from each patient

•Blood•3 purple top tubes (4 if collecting in 3mL ) and 1 green or gray top tube•Do not use gel tubes•Number the tubes in the order collected and mark a 1, 2, 3, or 4 on each

tube with indelible ink. Collect the green or gray top tube after collecting the purple top tubes.

•Urine•Collect at least 25–50 mL urine •Collect urine only (no blood) for children unless directed otherwise by CDC

•Note: send two empty blood tubes(purple and green or gray) for each lot of tubes used and 2 empty urine cups for each lot of urine

cups used.

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The Paperwork• Prepare a separate shipping manifest for urine and

blood samples since urine and blood samples cannot be shipped in the same container.

• Place a copy of the chain of custody form in the bag with the manifest, but keep the original chain of custody at your facility.

• Place all the paperwork in a plastic zippered bag on top of the specimens before closing the lid of the polystyrene foam insulated shipper.

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Where to Ship

Chemical Terrorism and Threat LabNCSLPH

4312 District DriveRaleigh, NC 27607

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Thank You for your attendance and attention.

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QUESTIONS

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