Archive for the 'Occupational medicine' Category

ExperTox Opens New Lab

Have you ever wondered how a true forensic lab runs? If you are in the Houston area, we would like to invite you to visit us at our Open House on June 16, 2011. See more information at the link below.

Open House Invite

Our state of the art laboratory was designed by President Loretta Anderson and RGR Partnership, LTD and constructed by Tribble and Associates Contractors. The new lab space has over 3100 square feet with the option to utilize an additional 5000 square feet of off-site storage as needed.

The lab was designed with optimal work flow, employee convenience and with environmental sensitivity in mind.  There are separate departments for accessioning, specimen preparation, screening, EIA, ELISA, Heavy Metals ICP-MS, GC/MC, LC/MS, extraction hoods and analyzing (test data). In addition, there is a dedicated department for Certifying Scientist for reporting results.



Top Signs that Point to Prescription Drug Abuse

If you are worried about a friend or loved one abusing prescription drugs, you aren’t alone. The use and abuse of prescription drugs has amplified in the last 20 years.

According to the Center for Disease Control, narcotic prescription use rose 1,000 percent in the U.S. between 1990 and 2009. As well, nationally we experienced a 500 percent increase in the number of prescription narcotic-related deaths.

Psychiatrist and author, Stephen Seager, wrote an article on the dangers of abusing prescription health meds. In this article he states, in an effort to treat pain more effectively and with the advent of may newer forms of opiod (narcotic) pain relievers – Oxycontin, Lortab, Methadone, Percodan, Percocet, Tramadol, Fentanyl – millions of Americans now take these medications on a regular basis for a wide range of diagnoses. While generally meant for short-term use, opiate pain medications have slowly been used for longer periods and for many ailments previously untreated with narcotics. While some benefit has been noted, an unfortunate, tragic consequence ensued.

We find ourselves in the midst of what the U.S. government and many state health agencies have called an accelerating “epidemic of prescription drug misuse, addiction and overdose.” This new narcotic epidemic seems to be almost the exclusive province of middle-age and older people. The number of narcotic overdose cases peaks in the 34-54 age group, while the total number of people who overdose in their 60s, 70s and 80s has doubed in the past five years. Before you or some one you love becomes a statistic, be aware of the seven sure signs of narcotic addiction and impending problems.

• Has a trusted loved one or family member expressed concern about your prescription opiate use?

• Do you have more than one doctor who prescribes the same medication? Or multiple prescriptions from multiple providers?

• Do you have medications secretly hidden in more than one location around your home?

• Have you taken these medications on a regular basis for more than two weeks? Or a month?

• Do these medications help you to function? Have you returned to work? If not, why? What tasks do the medications help you to perform? If you cannot answer these questions and you continue taking opiates, this is a very dangerous sign.

• Take a step back and look at your life since you began taking opiate medications. Are things getting better or worse? Have bad things begun to happen? Lose your job? Wreck your car? Divorce? Arrest?

• Last, and most importantly, have you ever been admitted to a hospital, for any reason, due to prescription drug use?

Solutions to the national prescription opiate problem are elusive and multi-factorial. But two issues stand out. Doctors give these medications too liberally, for longer periods than are warranted and for pain issues that might better be treated by other modalities. But patients ask for these medications specifically and often insist upon them. More education on both parts seems to be in order.

If these medications are part of your life or the life of someone about whom you care, take a look at the issue of opiate use. Be honest. Talk with your family. Talk with your doctor. Ask if there aren’t other less dangerous medications that might also be effective. Ask if there are other treatment options — physical therapy, acupuncture, support groups — which might allow you to talk a lower dose of narcotic medications or perhaps wean off them entirely. And, equally importantly, discuss whether a formal drug detox and rehabilitation program might be needed.

Stephen Seager is a psychiatrist and author of “The God Gene: The Promise of Prometheus.” Please click here for more information.

Comprehensive K2 Legislation in TX

Read more about the new bill being brought to the Texas Senate this week. It is the most comprehensive bill in the country!

Back to School and Immunizations

August is National Immunization Awareness month.  This is the perfect time to remind family, friends and co-workers about immunizations.  Parents are enrolling their children in school, young adults are preparing to enter college and employers are planning for this year’s flu season. 

Vaccines offer safe and effective protection from many infectious diseases.  Getting immunized is a life-long life protecting community effort, everyone from infants to the elderly need to keep current on their immunizations.   Immunization is one of the most significant public health achievements in the past century.  Several diseases such as small pox and polio have been eradicated due to vaccines.  There are still cases of measles, diphtheria, rubella (chicken pox), and pertussis  (whooping cough) in the  U.S. and adults and children still die from these and other vaccine preventable diseases.

Children attending school in Texas are required to have been vaccinated for 9 communicable diseases.  Children going into daycare have to be vaccinated for a total of 12 diseases.  Young adults entering college should check with the registrar’s office to find out what immunizations are required before enrollment.  Not all colleges and universities have immunization requirements but there are recommendations for students who will be living in dormitories.  Your state’s Department of Health website will have all the information you need for immunizations.

The state of Texas grants and acknowledges the rights of a parent to exempt their children from vaccination requirements for school, daycare and college for reasons of religious beliefs or medical reasons.  In 2003 the Texas legislature passed changes that expanded reasons a parent can claim an exemption.  This process is complicated and time consuming.  If you plan to have your child exempt from vaccination requirements don’t wait until the last minute.  Check with your state’s Department of Health to obtain the official forms and instructions to complete this process.

Now is also a good time to remind any senior citizens in your life to check with their health care providers in regard to flu and pneumonia vaccine.  Children and the elderly are most at risk for communicable diseases.

Health insurances will cover immunization costs.  If you are uninsured check with your city/county health department on where you can go to get reduced cost or free vaccinations.  In Texas you can call 211Texas toll free to get this information.  You can also call the Immunization Branch Customer Service number (800) 252-9152 if you have any questions or need more information about immunizations.

Lou Ann Enis, Registered Nurse and Occupational Health Supervisor

ExperTox interviewed on KHOU about K2 and Spice.

ExperTox was interviewed regarding testing of the synthetic cannabinoids.  Are you concerned about K2 or Spice? See interview below at

Energy Drinks – Are they really good for you?

How energetic do we really need to be?

The popularity of energy drinks has introduced a whole world of problems for those of us in Occupational Health and Safety.  When we have a client come to us for physicals, PFT’s and fit tests and they have an elevated blood pressure or irregular heart rate our first question no longer is, “Do you have a history of heart disease?”  Our first question now is, “Have you had an energy drink today?”

In general energy drinks are considered safe for most people.  When used in moderation they do what they advertise.  They give a boost in stamina and energy.  A good night sleep will do the same thing and you don’t need to drink it out of a can and ingest things that can potentially harm some people.

As it turns out most of the “energy” from these drinks come s from two main ingredients: Sugar and caffeine.  A typical energy drink contains up to 80 milligrams of caffeine (About the same as a cup of coffee).  The amount of sugar varies from brand to brand but in general there is more sugar than a 12 oz can of soda.

Other than caffeine levels, how do these energy drinks differ from sodas or sports drinks?  Soft drinks are mainly water, sugar and flavoring.  They don’t do anything for you; their main function is to taste good.  Sports drinks are designed to replenish fluids lost during activity.  They contain water, sugar, and electrolytes. Energy drink manufacturers have gone a step further and added additional items to help “boost” stamina and energy.

Here are some of the ingredients you may find in popular energy drinks and what they do in the body:

  • Caffeine-Both a stimulant and a diuretic. As a diuretic caffeine stimulates your kidneys to remove extra fluid from your body.  If you consume energy drinks while sweating these effects can be extremely dangerous because you can become severely dehydrated quickly.  Energy drinks should be avoided in situations such as work or strenuous activities where dehydration could be an issue.
  • Ephedrine-A stimulant that works on the central nervous system.  It is common in weight-loss products and decongestants.  There are many concerns about its effect on the heart.
  • Taurine-A natural amino acid produced by the body that helps regulate heart beat and muscle contractions.  It is now produced synthetically. Studies have now linked it to a variety of illnesses from high blood pressure to strokes and other types of heart disease.
  • Ginseng-A root believed by some to have many medicinal qualities including reducing stress and boosting energy levels.
  • B-Vitamins-A group of vitamins that can convert sugar to energy and improve muscle tone.  Eating a well balanced diet can do the same thing safely.
  • Guarana Seed-A central nervous system stimulant that comes from a small shrub native to Venezuela and Brazil.
  • Carnitine-An amino acid that plays a role in fatty acid metabolism.
  • Creatine-An organic acid that helps supply energy for muscle contractions.  Some experts feel that this creates a feeling of alertness in people.  In reality it makes most people feel tense and unable to stay still.
  • Inositol-A member of the vitamin-B complex (not a vitamin itself, because the body can synthesize it) that helps relay messages within cells in the body.
  • Ginkgo biloba-Made from the seeds of the ginkgo biloba tree, thought to enhance memory.

Energy drinks come in variety of formulas.  An occasional energy drink may be safe for most people.  Most of them contain the same amount of caffeine as a cup of coffee and the same amount of sugar as a soda.  But some contain very high levels of caffeine, sugar and other herbal stimulants that can have a variety of serious effects.  They may cause markedly faster heart rates, elevated blood pressure, irritability, nervousness, insomnia and increased blood sugar levels. 

By itself large amounts of caffeine can increase your blood pressure and impair blood flow to the heart.  It can also trigger abnormal heart rhythms, which in some people can be life threatening.  It is very important to educate yourself about what goes into your body and how it can affect you.  It is important to read the labels on these drinks.  If you any conditions such as heart disease, high blood pressure, or diabetes avoid them.  At the very least check with your physician to make sure they are safe for you.

The problems caused by energy drinks becomes very real when we cannot  complete pre-employment testing on  one of our clients because their blood pressure or heart rate are so elevated that it would not be safe to do a pulmonary function test.  There are times that we have to turn a client away to return the next day due to the effect of these drinks.  This can cause costly delays for employers who may be waiting for that individual to complete testing prior to starting a job.

Lou Ann Enis, Registered Nurse and Occupational Health Supervisor

Breath Alcohol Analysis

Everyday we hear and read about drivers involved in accidents who are charged with DUI or DWI.  The media will discuss a suspect’s breath alcohol level and the legal limit for alcohol.  A driver might be found to have an alcohol level of 0.15 and the legal limit is 0.08.  You probably hear or read the media discuss a “Breathalyzer” being used to test the suspected driver’s alcohol level but are not sure how breath can determine a blood alcohol level or how much someone has had to drink.

Interesting Historical Note:

The terms “Breathalyser” and” Breathalyzer” have become synonymous with all breath alcohol testing equipment.  Both names are trademarked and originated from an instrument invented by Dr. R.F. Borkenstein who worked for the Indiana State Police. It was invented in 1954 and the technology behind it is still used today. This fact is for those of you who aspire to appear on” Jeopardy” or” Who Wants to be a Millionaire”.

Back to business…How do you get a blood alcohol level from breath you ask?

Alcohol that a person drinks will always appear in their breath.  This is because alcohol is absorbed from the mouth, throat, stomach and intestines into the blood stream.  Alcohol is not digested like food or chemically changed in the blood when it is absorbed.  When blood passes through the lungs some of the ingested alcohol travels across the membranes of the lungs air sacs or alveoli and moves into the air.  This process is one of alcohol’s main properties of evaporating from a volatile solution.

So…the alcohol concentration from lung air is directly related to the alcohol concentration in the blood.  It can be detected by a breath alcohol testing device. 

What are the best ways to test blood alcohol concentration levels (BAC)?

Blood was the original medium used to test BAC’s.   A blood test offers the ability to accurately test the same sample several times, if the sample is properly maintained.  On the down side, blood tests are invasive and analysis time is longer.  The collection process requires trained medical personnel and the analysis requires precise procedures performed by trained lab technicians.  The results are not immediately available.  The test is also expensive.

Breath Alcohol Testing is very accurate, noninvasive, inexpensive and can be performed anywhere.  There is extensive training required and procedures to be followed but you do not have to have medical personnel to perform the test.  It can also be performed anywhere.  That is why it used by law enforcement, medical and safety personnel, and educators to name a few.

Urine testing may also be performed to test BAC.  It is the least desirable of all the methods.  It must be collected in a lab or medical facility and analysis be done by trained lab technicians in much the same manner as the blood test.  It is also expensive and not as accurate as blood or breath.

At ExperTox, we can collect and perform all 3 types of alcohol tests.  In our Occupational Health department we offer DOT and Non-Dot alcohol and drug testing.  We also perform court ordered and tests for the private sector.  We normally do breath alcohol tests unless another type is specified by the client.

There are four types of breath alcohol tests:

  • Screening – A device is used to test a subject to see if BAC is above limits set by employers or state laws.
  • Evidential – A test is done to collect evidence of BAC to be used in court or industry such as post accident cases, reasonable suspicion of use on the job or in traffic violations, and follow-up testing  for previous positive tests.
  • Interlock – Tests are designated for permanent connection to an electrical system of a vehicle; its purpose is to prevent or deter its operation by persons with alcohol in their system.
  • Self Test- Used by people to check their own BAC before working or driving. These have a high degree of accuracy and reproducibility but are not admissible in court.

There are three major types of breath alcohol testing devices, and there based on different principles:

  • Alcosensor – Detects a chemical reaction of alcohol in a fuel cell
  • Breathalyzer – Uses a chemical reaction involving alcohol that produces a color change
  • Intoxilyzer – Detects alcohol by infrared spectroscopy

We use Alcosensor at ExperTox for breath alcohol testing.  They are extremely accurate, dependable, easy to use and portable.  Intoxilyzer instruments are mainly used for research and by law enforcement. They are desk top devices and are stationary.  Breathalyzers are also not used for field work and are more difficult to use and maintain.  Operators of any breath alcohol testing device must be trained in use and calibration of the device.  Scrupulous records must be maintained.

What are your best bets?

If you insist on drinking and driving, just know you can’t hold your breath long enough to avoid the consequences.  Cover-ups such as gum or mints will not do the trick.  Your best option is a designated driver or taxi.

Friday afternoons may seem like a time to celebrate, but a beer or two at lunch could get you into real trouble, either by having an accident that might injure yourself or others or by getting caught as a safety violation.  Just expect when you blow, your employer will know…. the truth.

Lou Ann Enis, Registered Nurse and Occupational Health Supervisor

One Source…Numerous Options…Differences That Matter!

ExperTox® is a recognized forensic toxicology laboratory, combining advanced technology and science with a human heart.

We use our scientific expertise to provide our customers answers to their substance abuse, use and exposure questions.

We focus our personal character on supporting, caring for and understanding what our clients are going through as they contemplate and proceed through the testing process.

Our Tweets

  • Groundbreaking News, Expertox can now differentiate between amphetamine and methamphetamine on drug screens. Go Expertox 2 years ago
  • Use is acceptable, abuse sometimes requires assistance. Detect. treat, recover. Expertox 2 years ago
  • Alcohol abuse is one of the leading causes of relationship problems, risk and safety situations, absenteeism and personal injury. 2 years ago
  • RT @PoisonInfo: Kids love to mimic what they see adults do. Avoid taking medications in front of children and keep them locked away. https:… 3 years ago
  • RT @PoisonInfo: Adult's purses/bags look like a treasure chest to kids, but can be full of hazards. Keep them high off the ground. https://… 3 years ago

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