Abstract
Hair testing is a useful tool to investigate the prevalence of unsuspected chronic exposure to drugs of abuse in pediatric populations and it has been applied to three different cohorts of children from Barcelona, Spain along fifteen years to evaluate eventual changes in this exposure. Children were recruited from three independent studies performed at Hospital del Mar (Barcelona, Spain) and approved by the local Ethics Committee. Hair samples were collected from the first 187 children cohort (around 4 years of age) in 1998, from the second 90 children cohort (1.5–5 years of age) in 2008 and from the third 114 children cohort (5–14 years of age) in 2013. Hair samples were analysed for the presence of opiates, cocaine, amphetamines, and cannabis by validated methodologies using gas or liquid chromatography-mass spectrometry. Familiar sociodemographics and eventual consumption of drugs of abuse by parents, and caregivers were recorded. Hair samples from 24.6% children in 1998 were positive for any drug of abuse (23.0% cocaine), 25.5% in 2008 (23.3% cocaine), and 28.1% in 2013 (20.1% cocaine and 11.4% cannabis). In none of the cohorts, parental sociodemographics were associated with children exposure to drugs of abuse. The results of the three study cohorts demonstrated a significant prevalence of unsuspected pediatric exposure to drugs of abuse which mainly involved cocaine maintained along fifteen years in Barcelona, Spain. We recommend to be aware about unsuspected passive exposure to drugs of abuse in general population and to use general or selected hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions.
Highlights
IntroductionSince the second half of the 90s, two bi-yearly surveys concerning use of legal and illegal psychoactive drugs based on self-filled questionnaires have been carried out in setting: Hospital del Mar in Barcelona (Spain): the ETADES [1,2]survey on tobacco, alcohol and drugs of abuse consumption in the general population (14–65 years of age) and ESTUDES survey [3,4] concerning use of above reported substances in secondary school students.According to the data reported in the survey on general population, between 1999 and 2011 the consumption of drugs of abuse in the previous 12 months remained stable for the majority of the substances (alcohol: 74.6% vs. 76.6%; tobacco: 43.7% vs. 40.2%, MDMA: 0.8% vs. 0.7%, amphetamines: 0.7% vs. 0.6%, hallucinogens: 0.6% vs. 0.4% and heroin 0.1% vs. 0.1%), with a significant increase in cannabis and cocaine consumption (6.8% vs. 9.6% and 1.5% vs. 2.3%), respectively [1,2].These figures place Spain in the first place among the European countries concerning cocaine and cannabis consumption in the general population, exceeding even those reported from America [3].Concerns regarding the impact of these high levels of cannabis and cocaine use in Spain on passive exposure to these drugs in pediatric population prompted the investigation on the evolution in passive exposure in children of different ages from Barcelona Spain to show the usefulness of hair testing as a tool to disclose this exposure in order to raise the public awareness on this problem and to stimulate a political debate
The investigation was carried out on non-selected children from three independent studies conducted at different times in the same setting: Hospital del Mar in Barcelona (Spain)
Cocaine and benzoylecgonine were found in 23 hair samples (20.1%) with 6-MAM (0.42 ng/mg hair) and morphine (0.15 ng/mg hair), four samples positive for codeine and one sample positive for methadone (2.09 ng/mg hair) for a total of 28.1% children exposed to any drugs of abuse
Summary
Since the second half of the 90s, two bi-yearly surveys concerning use of legal and illegal psychoactive drugs based on self-filled questionnaires have been carried out in Spain: the ETADES [1,2]survey on tobacco, alcohol and drugs of abuse consumption in the general population (14–65 years of age) and ESTUDES survey [3,4] concerning use of above reported substances in secondary school students.According to the data reported in the survey on general population, between 1999 and 2011 the consumption of drugs of abuse in the previous 12 months remained stable for the majority of the substances (alcohol: 74.6% vs. 76.6%; tobacco: 43.7% vs. 40.2%, MDMA: 0.8% vs. 0.7%, amphetamines: 0.7% vs. 0.6%, hallucinogens: 0.6% vs. 0.4% and heroin 0.1% vs. 0.1%), with a significant increase in cannabis and cocaine consumption (6.8% vs. 9.6% and 1.5% vs. 2.3%), respectively [1,2].These figures place Spain in the first place among the European countries concerning cocaine and cannabis consumption in the general population, exceeding even those reported from America [3].Concerns regarding the impact of these high levels of cannabis and cocaine use in Spain on passive exposure to these drugs in pediatric population prompted the investigation on the evolution in passive exposure in children of different ages from Barcelona Spain to show the usefulness of hair testing as a tool to disclose this exposure in order to raise the public awareness on this problem and to stimulate a political debate. According to the data reported in the survey on general population, between 1999 and 2011 the consumption of drugs of abuse in the previous 12 months remained stable for the majority of the substances (alcohol: 74.6% vs 76.6%; tobacco: 43.7% vs 40.2%, MDMA: 0.8% vs 0.7%, amphetamines: 0.7% vs 0.6%, hallucinogens: 0.6% vs 0.4% and heroin 0.1% vs 0.1%), with a significant increase in cannabis and cocaine consumption (6.8% vs 9.6% and 1.5% vs 2.3%), respectively [1,2]. Hair testing results available from two investigations performed in 2009 and 2013 on two different cohorts of children [4,5] were compared with those obtained for the purpose of this study in hair samples collected in 1998 from a cohort of children of 4 years of age at that time
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