Mantinieks Dylan, Parsons Sarah, Schumann Jennifer, Drummer Olaf H, Crump Kerryn, Baber Yeliena, Archer Melanie, Gerostamoulos Dimitri
Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
Forensic Sci Med Pathol. 2024 Dec;20(4):1261-1267. doi: 10.1007/s12024-024-00778-8. Epub 2024 Jan 19.
This study investigated methylamphetamine (MA) exposures in the deaths of children (≤ 12 years old) reported to the Coroner in the state of Victoria, Australia, between 2011 and 2020. Demographics, autopsy findings including the cause of death, self-reported prenatal or caregiver drug use, child protection services information, and toxicological findings were summarized by descriptive statistics. Validated methods of liquid chromatography-tandem mass spectrometry were used in the analysis of drugs. There were 50 child deaths with MA detected in blood, urine, and/or hair with 64% (n = 32) identified in 2018-2020. Most children were 1-365 days old (66%, n = 33) and the cause of death was unascertained in 62% (n = 31) of cases. MA was toxicologically confirmed in hair (94%, n = 47) significantly more than blood (18%, n = 9). Prenatal or caregiver drug use was self-reported in 44% (n = 22) and 42% (n = 21) of cases, respectively. Moreover, only 54% (n = 27) of deceased children were a child protection client at their time of death. These findings suggest the number of deceased children exposed to MA has increased over the past 10 years, which is consistent with the greater supply of crystal MA in the Australian community. Hair analysis provided additional means to identify cases that were unknown to child protection services and may have implications for other children in the same drug exposure environment.
本研究调查了2011年至2020年间向澳大利亚维多利亚州验尸官报告的12岁及以下儿童死亡案例中的甲基苯丙胺（MA）暴露情况。通过描述性统计对人口统计学信息、尸检结果（包括死因）、自我报告的产前或照料者药物使用情况、儿童保护服务信息以及毒理学结果进行了总结。在药物分析中使用了经过验证的液相色谱 - 串联质谱法。在血液、尿液和/或毛发中检测到MA的儿童死亡案例有50例，其中64%（n = 32）是在2018 - 2020年发现的。大多数儿童年龄在1 - 365天（66%，n = 33），62%（n = 31）的案例死因未明确。毛发中MA毒理学确认的比例（94%，n = 47）显著高于血液（18%，n = 9）。分别有44%（n = 22）和42%（n = 21）的案例自我报告了产前或照料者药物使用情况。此外，只有54%（n = 27）的死亡儿童在死亡时是儿童保护服务的对象。这些发现表明，在过去10年中，暴露于MA的死亡儿童数量有所增加，这与澳大利亚社区中冰毒供应增加相一致。毛发分析为识别儿童保护服务未知的案例提供了额外手段，并且可能对处于相同药物暴露环境中的其他儿童产生影响。
