title: Rapid identification of pesticides in human oral fluid for emergency management by thermal desorption electrospray ionization/mass spectrometry.
abstract: Self-poisoning with pesticides accounts for approximately one-third of all suicides worldwide. To expedite rescue in the emergency department, it is essential to develop a point-of-care analytical method for rapid identification of ingested pesticides. In this study, five of the most common pesticides ingested by self-poisoning patients in Taiwan were analyzed from oral fluid samples. Pesticide-oral fluid mixtures were applied on a cotton swab and then transferred into methanol. A metallic probe was used to sample the methanol solution for subsequent thermal desorption-electrospray ionization mass spectrometry analysis. Altogether, pesticide sampling, transfer, desorption, ionization, and detection took less than 1 min. The reproducibility of this method (n = 6) was shown in the observed low-relative standard deviation (<7%) in the detection of pesticide in oral fluid. The detection limits of the pesticides in oral fluid obtained from four human subjects by thermal desorption-electrospray ionization mass spectrometry were between 1-10 ppb with relative standard deviation 10.7%. Moreover, in this study, linear responses of five pesticides in oral fluid with concentrations between 1 ppb-1 ppm (R2 between 0.9938 and 0.9988) were observed. As the whole analytical process is extremely short, this technique allows for early non-invasive point-of-care identification of pesticides in the oral fluid of self-poisoning patients in the emergency room, providing important toxicological information for decision-making during critical resuscitation.
authors.affiliation: Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan.
authors.forename: Hung
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan.
authors.forename: Peng-Yu
authors.initials: PY
authors.lastname: Chen
authors.affiliation: Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan.
authors.forename: Shiang-Jiun
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan.|Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jentaie
authors.initials: J
authors.lastname: Shiea
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Shyi-Jang
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Bai-Hsiun
authors.initials: BH
authors.lastname: Chen
mesh_terms: D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010575:Pesticides / Q000032:analysis* / Q000506:poisoning*; D012463:Saliva / Q000737:chemistry*; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods*; D013405:Suicide
chemical_list: D010575:Pesticides
keywords: emergency room; mass spectrometry; oral fluid; pesticide; point-of-care identification