Abstract
Population-based newborn screening (NBS) using blood collected and dried on filter paper was developed in the 1960s and remains the international standard for NBS programs. Glue, used in the manufacture of dried blood collection cards, may present a source of contamination and is often considered as a possible cause of anomalous results in routine screening. Our study evaluates this potential contamination on NBS analyses. EBF#1003 glue was blotted onto dried blood collection cards made of Whatman grade 903 filter paper (Whatman#903) and adult whole blood was pipetted onto the dried glue blots. In addition, blank glue blots (i.e., no blood) and dried blood spots (DBSs) in the absence of glue were prepared. The DBSs and blank samples were run in duplicate as routine samples for NBS. DBS absorption time and diameter, the effect of glue on measurements (concentrations and variation) were assessed. DBS absorption time and shape were equivalent for DBSs prepared in the absence and presence of undiluted glue. DBS diameter increased when prepared in the presence of glue. When EBF#1003 was diluted prior to use, DBS absorption time increased, and DBSs were non-uniform. Glue, diluted or not, did not produce measurements above the established Limit of Detection (LOD) for all assays used in the current Dutch screening programme. For all analytes with concentrations in the quantifiable range, contamination with glue had no effect on measurement variation, as it appeared equivalent to variation in untreated DBSs. Our data show that, in the unlikely event of contamination of Whatman#903 with EBF#1003, there is no effect on the measured concentration of analytes.
Highlights
The Dutch neonatal screening (NBS) programme, started in 1974, currently screens for 19 diseases: conducted in five laboratories, it is available to all babies born in The Netherlands and uses the filter paper card often referred to as a “Guthrie Card”
As with all methods of blood collection, there is associated imprecision and variability with the use of filter papers, for example, the variable distribution of analytes in the dried blood spot (DBS), blood absorption time, contamination, and the filter paper matrix, which can all have an influence on the recovery of analytes [1,2]
A verification study has been conducted in our laboratory to assess the effect this change would have on newborn screening (NBS) analysis; the results illustrate that the two filter papers are essentially equivalent, an observation which concurs with a previous study comparing PerkinElmer#226 and Whatman#903 [4]
Summary
The Dutch neonatal screening (NBS) programme, started in 1974, currently screens for 19 diseases: conducted in five laboratories, it is available to all babies born in The Netherlands and uses the filter paper card often referred to as a “Guthrie Card”. As with all methods of blood collection, there is associated imprecision and variability with the use of filter papers, for example, the variable distribution of analytes in the dried blood spot (DBS) (the “chromatography effect”), blood absorption time, contamination, and the filter paper matrix, which can all have an influence on the recovery of analytes [1,2]. For this reason, approved standards for the manufacture of filter paper for NBS purposes are available [3]. We present the effect of glue on the measurements of analytes employed in Dutch newborn heel prick screening, tested as glue on filter paper and in combination with DBSs, evaluating multiple assays and multiple analytes
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