Pediatric Emergency Department, Children's Hospital, CHU Toulouse, France; UMR 1027, Inserm, Paul Sabatier University, UPS, Toulouse, France.
Pediatric Intensive Care Unit, Children's Hospital, CHU Toulouse, France.
Forensic Sci Int. 2020 Aug;313:110377. doi: 10.1016/j.forsciint.2020.110377. Epub 2020 Jun 19.
The incorporation of drugs in the hair of young children differs from that of adults and the metabolism of cannabis cannot be the same. Our primary objective was to analyze the distribution of the different cannabinoids in children's hair samples. The secondary objective was to correlate the intensity of toxic environmental exposure to cannabinoid metabolite levels.
This was a prospective, single-center, observational pilot study of a pediatric cohort. Included subjects were all children less than 6 years of age admitted to a tertiary pediatric emergency unit for proven cannabis intoxication during the reference period. A hair strand was sampled within 12h of emergency admission.
Forty-one pediatric patients were consecutively enrolled. Hair analysis showed that 34 children were positive for Δ9-THC (range 0.06-284.4ng/mg); 41 % of them were also positive for THC-COOH (range 0.26-2.76pg/mg). Depending on the Δ9-THC concentration (>1ng/mg), 39 % of the children could be considered exposed to an intensely toxic environment. The rate of THC-COOH detection steadily increased from 2015 to 2018 (18 %, 40 %, 50 %, 58 % for each consecutive year). Children intensely exposed weighed less on admission (p=0.02), had more comatose presentations (p=0.02), and more previous social issues (75 % versus 12 %, OR 22.0, p=0.0002).
Hair testing in this context indirectly shows the intensity of children's toxic environmental exposure by the cannabinoid metabolite threshold. This was very helpful during the collegial examination of the toddlers' environment and led to a full investigation and to appropriate decisions concerning social measures.
婴幼儿体内药物的分布与成人不同，大麻的代谢也可能不同。我们的主要目的是分析儿童头发样本中不同大麻素的分布。次要目的是将有毒环境暴露的强度与大麻素代谢物水平相关联。
这是一项前瞻性、单中心、观察性儿科队列研究。在参考期内，所有因确诊大麻中毒而被收入三级儿科急诊的 6 岁以下儿童均纳入研究。在急诊入院后 12 小时内采集头发样本。
连续纳入 41 例儿科患者。毛发分析显示，34 例儿童的 Δ9-THC 呈阳性（范围 0.06-284.4ng/mg）；其中 41%的儿童也呈 THC-COOH 阳性（范围 0.26-2.76pg/mg）。根据 Δ9-THC 浓度（>1ng/mg），39%的儿童可被认为处于高度有毒环境中。2015 年至 2018 年，THC-COOH 的检出率稳步上升（每年分别为 18%、40%、50%、58%）。高度暴露的儿童入院时体重较轻（p=0.02），昏迷表现更为严重（p=0.02），且有更多的既往社会问题（75%对 12%，OR 22.0，p=0.0002）。
在这种情况下，通过大麻素代谢物阈值，头发检测可间接反映儿童有毒环境暴露的强度。在对幼儿环境进行同行审议时，这非常有帮助，并促使对社会措施进行全面调查和适当决策。
