Quality testing in toxicology

Abstract

Maintaining up-to-date toxicology External Quality Assurance (EQA) programs can prove challenging given the new and synthetic drugs which constantly arise. Toxicology labs need to invest in the latest technology not only to keep pace with new and variant drugs, but also with changes to artificial urines and adulterants designed to mask illegal drugs. The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) currently provides 3 toxicology programs designed to supplement quality toxicology testing for a range of applications (from large state of the art laboratories to onsite workplace testing). These programs also need to keep pace with updates and emerging trends (which can vary on state/regional basis) and the input of an expert committee is an essential component. Ethical issues can arise when contentious programs are explored, e.g., an EQA for pill testing. Sourcing otherwise illegal drugs and their variants is difficult. Interesting data can sometimes emerge when samples are re-used in surveys 1-2 years apart and ‘new’ drugs are reported. Challenging labs with artificial urines and adulterants has also proved to be useful. Demonstrating ‘fitness for purpose’ is another function of quality testing and some onsite screening devices still have room for improvement, particularly for oral fluid testing.