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    <title>Transport Research International Documentation (TRID)</title>
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    <copyright>Copyright © 2026. National Academy of Sciences. All rights reserved.</copyright>
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    <managingEditor>tris-trb@nas.edu (Bill McLeod)</managingEditor>
    <webMaster>tris-trb@nas.edu (Bill McLeod)</webMaster>
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      <title>Transport Research International Documentation (TRID)</title>
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      <title>Prevalence Of Psychoactive Drugs in Injured Drivers Over 10 Years in Victoria, Australia</title>
      <link>https://trid.trb.org/View/2645535</link>
      <description><![CDATA[One thousand of the mandatory blood specimens taken from injured drivers attending a hospital over a decade were analyzed for a full range of legal and illegal drugs in an accredited forensic toxicology laboratory with confirmation by a validated LC-MS/MS procedure. Ethanol ( ≥0.05 gram/100mL), methamphetamine (≥0.01mg/L), THC (≥1ng/mL) were present in 13.6%, 12.7% and 11.5%, respectively with only minor variations over the decade. In contrast, the prevalence of ketamine, cocaine, fentanyl and new psychoactive substances (NPS) increased substantially over this period reaching 7.0%, 1.8%, 2.0% and 3.0% in the last 5 years of the study. A substantial proportion of drivers were also positive for opioids, antidepressants, and benzodiazepines, although some of these may have been given post-crash as part of their medical treatment. Overall, about 38% of drivers had a potentially impairing drug detected in their blood on presentation to hospital and at least one common illicit drug with or without ethanol were present in almost 23% of drivers. The presence of more than one common illicit drug (THC, methamphetamine, MDMA, cocaine, heroin), with or without ethanol, increased from 4.3% in the first 5 years to 5.8% in the last five years, which may reflect a higher crash risk for those drivers.]]></description>
      <pubDate>Thu, 15 Jan 2026 14:31:02 GMT</pubDate>
      <guid>https://trid.trb.org/View/2645535</guid>
    </item>
    <item>
      <title>The Alarming Surge of Driving Under the Influence-Related Motor Vehicle Crashes</title>
      <link>https://trid.trb.org/View/2611419</link>
      <description><![CDATA[The use of alcohol and illicit substances is increasing in the United States. However, it is not clear what proportion of motor vehicle crashes (MVCs) are related to driving under the influence (DUI) of alcohol or drugs. The aim of this study was to assess the prevalence and trends of positive drug and alcohol tests among drivers of MVCs admitted to trauma centers across the United States over the years. This is a retrospective analysis of the American College of Surgeons-Trauma Quality Improvement Program database over 4 years (2017-2020). Using International Classification of Diseases-10 diagnosis and E codes, the authors included patients presenting after an MVC as a driver of vehicles (cars, motorcycles, heavy transport vehicles, and three-wheeled motor vehicles). Trend analysis was performed for the rates of positive blood or urine toxicology results (alcohol, marijuana, cocaine, amphetamines, methamphetamines, and opiates) among these patients over the years. Over 4 years, from a total of 683,184 MVC drivers with trauma were identified (adolescents [10-19 yr]: 7.6%; young adults [20-64 yr]: 77.1%; older adults [>=65 yr]: 15.3%). The mean (standard deviation) age was 43 (19), and 69% were male. The median (interquartile range) Injury Severity Score was 9 (4-14). The median Glasgow Coma Scale score was 15, and 20% had a Glasgow Coma Scale score of less than 15 on presentation. Overall, 65.8% of the victims were car drivers, followed by motorcyclists (25%), heavy transport vehicle drivers (8.6%), and three-wheeled motor vehicle riders (0.5%). The drug or alcohol screening test was positive in 28.8% of drivers, with 36.3% of them testing positive for more than one substance. Overall, alcohol was the most common substance found (47.1%), followed by marijuana (41.6%), and amphetamines (16.3%). Among those with positive screen tests, 52.9% tested positive for drugs other than alcohol, around two-thirds (59.2%) of which tested positive for marijuana. Trend analysis indicated that the incidence of substance abuse-related MVCs increased significantly from 27% in 2017 to 32% in 2020 (P < 0.001), with the most notable rise in cannabis-abuse-related MVCs (2017:10.2%; 2020:14.6%, P < 0.001). Subanalysis of different age groups demonstrated the same trend toward increasing DUI-related MVCs, with the most prominent rise in the prevalence of marijuana-positive MVC drivers among adolescents. Despite policies in place for the prevention of DUI, the prevalence of drug- or alcohol-related MVCs has been increasing over the years, with over one-third of MVC drivers having a positive drug screen on admission in 2020. This surge was even more prominent among adolescents with positive marijuana screen. These findings provide essential epidemiological data as to the prevalence of DUI, which will further inform policymakers to prevent DUI-related MVCs.]]></description>
      <pubDate>Fri, 05 Dec 2025 17:12:09 GMT</pubDate>
      <guid>https://trid.trb.org/View/2611419</guid>
    </item>
    <item>
      <title>Elimination of EtG and EtS between two consecutive blood samples in apprehended drivers</title>
      <link>https://trid.trb.org/View/2619198</link>
      <description><![CDATA[Ethyl glucuronide (EtG) and ethyl sulphate (EtS) are non-oxidative metabolites of ethanol, valuable as biomarkers of alcohol consumption in forensic and clinical contexts. This study aims to calculate the elimination half-lives (t₁/₂) of EtG and EtS in apprehended drivers based on two consecutive blood samples, enhancing the reliability of forensic alcohol consumption assessments. Data was extracted from a database including apprehended drivers in Norway from 2019 to 2024. The study included suspected drunk drivers in which ethanol, EtG and EtS were detected in two consecutive blood samples, drawn at least 20 min apart. In cases where the blood alcohol concentration (BAC) was at or below 0.20 g/kg, in at least one sample, the t₁/₂ was estimated using both empirical and Bayesian statistical methods. In 670 cases, ethanol, EtG and EtS were detected in two consecutive samples. In 20 of these, the BAC was below 0.20 g/kg. In these 20 cases, the median time between blood samples was 0.46 h. The empirical calculations of t₁/₂ for cases with declining EtG and EtS concentrations yielded a median of 2.6 h for EtG and 2.4 h for EtS. A strong positive correlation was found between empirical t₁/₂ of EtG and EtS (rs=0.81, p < 0.001).The t₁/₂ values for EtG and EtS in apprehended drivers are comparable to those reported in experimental studies. The findings contribute to forensic alcohol assessments and legal expert reports. Additional research is needed to investigate EtG and EtS elimination kinetics in real-life impaired driving scenarios.]]></description>
      <pubDate>Fri, 05 Dec 2025 14:07:17 GMT</pubDate>
      <guid>https://trid.trb.org/View/2619198</guid>
    </item>
    <item>
      <title>Biomarkers for Noise-Induced Sleep Disruption</title>
      <link>https://trid.trb.org/View/2550834</link>
      <description><![CDATA[Noise experienced by the general population in proximity to airports and aviation flight routes can result in disrupted sleep. Sleep disruption and fragmentation may be mitigated by wearing earplugs or introducing broadband noise (e.g., pink noise) into the bedroom. However, these countermeasures are poorly investigated and understood. The Federal Aviation Administration (FAA) Center of Excellence for Alternative Jet Fuels and Environment (also known as the Aviation Sustainability Center or ASCENT) has supported the University of Pennsylvania in investigating earplugs and pink noise to mitigate sleep disruption from simulated aircraft noise, using approaches such as physiological and neurobehavioral performance monitoring. The FAA Civil Aerospace Medical Institute complemented these efforts by receipt of blood samples collected from human subjects exposed to the simulated aircraft noise and monitored by the University of Pennsylvania. Ribonucleic acid (RNA) was extracted from the blood followed by total RNA sequencing and differential gene expression analyses, which provided molecular insights about human responses to noise and the mitigations tested. Altogether 1,246 genes were differentially expressed in response to the experimental exposure condition (control without noise, pink noise at a level of 50 dBA, simulated aircraft noise, and simulated aircraft noise with a mitigation: pink noise at 40 dBA, pink noise at 50 dBA, or earplugs). There were 2,181 genes associated with awakenings during noise exposure.]]></description>
      <pubDate>Thu, 05 Jun 2025 11:59:53 GMT</pubDate>
      <guid>https://trid.trb.org/View/2550834</guid>
    </item>
    <item>
      <title>Uncovering the urgency for heightened drug testing</title>
      <link>https://trid.trb.org/View/2431544</link>
      <description><![CDATA[Drivers involved in traffic crashes are typically tested less for drugs than for alcohol. Estimates of the prevalence of various drug types present in traffic crashes are therefore based on incomplete data. To address this issue, a study involving the comprehensive reanalysis of blood samples collected from drivers hospitalised post traffic crashes was conducted in 2021. The toxicological results demonstrated that 47% of blood samples contained at least one drug of interest, and combinations of up to five drugs of interest were found in 18% of the samples. These results suggest that drug use among drivers involved in traffic crashes is prevalent, and this use consists of many drug types. Additionally, drugs of interest were detected in 39% of the blood samples that had previously only been tested for alcohol. This finding indicates that analysis for drugs other than alcohol could be relevant for all drivers involved in severe traffic crashes.]]></description>
      <pubDate>Tue, 17 Sep 2024 14:49:44 GMT</pubDate>
      <guid>https://trid.trb.org/View/2431544</guid>
    </item>
    <item>
      <title>The relationship between clinical impairment and blood drug concentration: Comparison between the most prevalent traffic relevant drug groups</title>
      <link>https://trid.trb.org/View/2418294</link>
      <description><![CDATA[The aim of the present study was to investigate the relationship between blood concentrations of four different drug classes; ethanol, benzodiazepines, amphetamines and tetrahydrocannabinol (THC) and driver impairment as assessed by a clinical test of impairment (CTI). Data was retrieved from a national database on CTI assessments and accompanying blood drug concentrations from apprehended drivers. All drug concentrations in blood were quantified using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS), and compared to the results of the CTI which were categorized as either “not impaired”, “mildly impaired”, “moderately impaired”, or “considerably impaired.” A total number of 15 514 individual mono drug-cases collected over 9 years was included. 89 % were men and the median age was 34 years. In addition, 3 684 individual cases with similar age and gender distribution where no drugs were detected, were included as a reference group. For ethanol and benzodiazepines the percentage of clinically impaired cases increased markedly from lower to higher concentration windows, from 60 % to 97 % for ethanol and from 38 % to 76 % for benzodiazepines. The corresponding increase for amphetamines and THC was modest, from 43 % to 58 % for amphetamines and from 41 % to 55 % for THC. The correlation between drug concentration and degree of impairment was high for ethanol (Spearman´s rho=0.548, p<0.001) and relatively high for benzodiazepines (Spearman´s rho=0.377, p<0.001), but low for amphetamines (Spearman´s rho=0.078, p<0.001) and THC (Spearman´s rho=0.100, p<0.001).The percentage of impaired drivers increased with increasing blood drug concentration for all four drug classes, most pronounced for ethanol and benzodiazepines and much less for amphetamines and THC. The median blood drug concentration increased with increasing magnitude of impairment for ethanol and benzodiazepines, while this was much less pronounced for amphetamines and THC. The ranges of drug concentrations, however, were wide for all four drug classes in all impairment categories as assessed by individual clinical examination.]]></description>
      <pubDate>Mon, 26 Aug 2024 14:44:26 GMT</pubDate>
      <guid>https://trid.trb.org/View/2418294</guid>
    </item>
    <item>
      <title>Postmortem Blood Genomics Biorepository</title>
      <link>https://trid.trb.org/View/2413999</link>
      <description><![CDATA[The Federal Aviation Administration Civil Aerospace Medical Institute Bioaeronautical Sciences Research Laboratory (BSRL) collects, processes, and analyzes forensic fluid and tissue samples from fatal civil aviation accidents in the United States. The BSRL issues standardized forensic sample collection kits (ToxBoxes) for medical examiners and coroners to collect and ship the samples needed for toxicological analysis. The BSRL Forensic Sciences section receives and assays incoming forensic samples to determine if the pilot consumed or was exposed to known drugs or toxic substances. This information is collected on behalf of the National Transportation Safety Board to assist in accident investigation. The BSRL Functional Genomics Research team previously examined gene expression patterns in such forensic samples. However, ToxBox forensic samples were not routinely preserved in a manner that prevented the degradation of those patterns during collection and storage. This report details establishment of protocols and selection of tubes to supplement ToxBox collections with preservation of blood for functional genomics analyses. To preserve ribonucleic acid (RNA) and deoxyribonucleic acid (DNA) in forensic samples and establish a biorepository of samples suitable for future gene expression analyses, a supplemental whole blood research specimen collection kit is now included in ToxBoxes. These kits have been distributed in ToxBoxes since August 2022.]]></description>
      <pubDate>Thu, 15 Aug 2024 09:28:20 GMT</pubDate>
      <guid>https://trid.trb.org/View/2413999</guid>
    </item>
    <item>
      <title>Delays in blood collection and drug toxicology results among crash-involved drivers arrested for impaired driving</title>
      <link>https://trid.trb.org/View/2387222</link>
      <description><![CDATA[The concentration of drugs in a driver’s system can change between an impaired driving arrest or crash and the collection of a biological specimen for drug testing. Accordingly, delays in specimen collection can result in the loss of critical information that has the potential to affect impaired driving prosecution. The objectives of the study were: (1) to identify factors that influence the time between impaired-driving violations and specimen collections (time-to-collection) among crash-involved drivers, and (2) to consider how such delays affect measured concentrations of drugs, particularly with respect to common drug per se limits. Study data included blood toxicology results and crash-related information from 8,923 drivers who were involved in crashes and arrested for impaired driving in Wisconsin between 2019 and 2021. Analyses examined how crash timing and severity influenced time-to-collection and the effects of delays in specimen collection on blood alcohol concentrations (BACs) and blood delta-9-tetrahydrocannabinol (THC) concentrations. The mean time-to-collection for the entire sample was 1.80 h. Crash severity had a significant effect on time-to-collection with crashes involving a fatality having the longest duration (M = 2.35 h) followed by injury crashes (M = 2.06 h) and noninjury crashes (M = 1.69 h). Time of day also affected time-to-collection; late night and early morning hours were associated with shorter durations. Both BAC (r = −0.11) and blood THC concentrations (r = −0.16) were significantly negatively correlated with time-to-collection. Crash severity and the time of day at which a crash occurs can result in delays in the collection of blood specimens after impaired driving arrests. Because drugs often continue to be metabolized and eliminated between arrest and biological specimen collection, measured concentrations may not represent the concentrations of drugs that were present at the time of driving. This has the potential to affect drug-impaired driving prosecution, particularly in jurisdictions whose laws specify per se impairment thresholds.]]></description>
      <pubDate>Wed, 26 Jun 2024 14:16:48 GMT</pubDate>
      <guid>https://trid.trb.org/View/2387222</guid>
    </item>
    <item>
      <title>Ketamine in DUID cases in the greater Cologne area.</title>
      <link>https://trid.trb.org/View/2301845</link>
      <description><![CDATA[Ketamine is primarily used as an anesthetic or for analgesics in medical treatment, but due to its dissociative and hallucinogenic effects, abuse has increased in the past years leading to several drug impaired driving cases. Eight DUID (driving under the influence of drugs) cases involving ketamine from two institutes of legal medicine over a period from January 2021 to January 2023 were evaluated. The cases were compared with regard to psychomotor impairments, adverse effects on driving performance and co-consumption of drugs. Analyses of ketamine were carried out by high performance liquid chromatography with diode array detection (HPLC-DAD). Other drugs of abuse were either detected via LC-MS/MS and/or gas chromatography with (tandem) mass spectrometry (GC-MS(/MS)). Ketamine plasma concentrations in a range of approx. 100 – 1200ng/mL (mean: 510ng/mL, median: 370ng/mL) were detected. Co-consumption of at least one substance was ascertained in all cases. Besides driving impairments, recorded psychomotor impairments of the drivers comprised e.g. dilated pupils, missing or delayed pupil reactions, a slurred or decelerated speech, delayed reaction, lack of concentration, vertigo, or agitation. The observed peculiarities were in-line with literature data. However, the assessment and differentiation of ketamine-induced impairments was aggravated due to co-consumption of other drugs of abuse or pharmaceuticals in the herein investigated cases. Nevertheless, in two cases impairments can be attributed mainly to ketamine consumption since the co-consumed substances were below therapeutic range. The presented case series provides additional data on psychomotor impairments observed in ketamine-related DUID cases. Limiting factors are co-consumption of substances, unknown habituation to drugs and the limited case number. Nevertheless, the results of this study are comparable with existing literature data. Since the abuse of ketamine has increased in the past years, these data will support forensic casework.]]></description>
      <pubDate>Fri, 05 Apr 2024 09:03:15 GMT</pubDate>
      <guid>https://trid.trb.org/View/2301845</guid>
    </item>
    <item>
      <title>Utility of Capillary Blood for Gene Expression Studies [supporting dataset]</title>
      <link>https://trid.trb.org/View/2353860</link>
      <description><![CDATA[Blood collection method selection is critical when analyzing blood gene expression. Multiple blood collection methods and sites exist, each with advantages and disadvantages. For human blood gene expression analyses, blood is commonly collected by venipuncture at the antecubital fossa (interior elbow) using a range of vacutainer tubes. Several vacutainer tube types contain RNA-preserving additives, all adequately preserving blood RNA. Most human subjects accept venipuncture, which collects sufficient high-quality blood and RNA suitable for gene expression analysis by RNA sequencing (RNA-Seq). Venipuncture has drawbacks; it requires trained personnel, carries a risk of injury, is time-consuming, and is often unsuitable for in-the-field, at-home, or self-collection. Capillary blood collection by fingerstick is common and widely practiced but not often used for RNA-Seq analysis due to low and variable blood quantity, a lack of blood RNA preservation options, low RNA yields, and variable RNA quality. This study used total RNA-Seq to compare two different fingerstick blood collection, preservation, and RNA extraction methods with a commonly used venipuncture blood collection and RNA extraction method. The authors demonstrate that fingerstick blood collection produces RNA suitable for RNA-Seq, that each fingerstick method produces results more similar to one another than venipuncture-derived blood RNA, and that each fingerstick blood collection method can distinguish between experimental groups (male and female subjects). While the venipuncture method examined here is generally preferable to the fingerstick blood collection methods, particularly in well-controlled and resourced environments, capillary blood is suitable and useful for gene expression analysis.  The total size of the zip file is 19.2 MB. An .sh file is a script that can be run with the Bash Unix shell. It contains instructions written in the Bash command language. Users can execute the commands an SH file contains by calling the file in a Bash shell. (from https://fileinfo.com/extension/sh). The .xlsx and .xls file types are Microsoft Excel files, which can be opened with Excel, and other free available spreadsheet software, such as OpenRefine. The .csv, Comma Separated Value, file is a simple format that is designed for a database table and supported by many applications. The .csv file is often used for moving tabular data between two different computer programs, due to its open format. The most common software used to open .csv files are Microsoft Excel and RecordEditor, (for more information on .csv files and software, please visit https://www.file-extensions.org/csv-file-extension). The .rmd file extension is associated with the RStudio, an integrated development tool for Windows, macOS (OS X) and Linux operating systems, which allows users to create apps with R programming language. The .rmd file stores R markdown data (for more information on .rmd files and software, please visit https://www.file-extensions.org/rmd-file-extension-r-markdown-data).]]></description>
      <pubDate>Mon, 25 Mar 2024 17:12:49 GMT</pubDate>
      <guid>https://trid.trb.org/View/2353860</guid>
    </item>
    <item>
      <title>Utility of Capillary Blood for Gene Expression Studies</title>
      <link>https://trid.trb.org/View/2352881</link>
      <description><![CDATA[Blood collection method selection is critical when analyzing blood gene expression. Multiple blood collection methods and sites exist, each with advantages and disadvantages. For human blood gene expression analyses, blood is commonly collected by venipuncture at the antecubital fossa (interior elbow) using a range of vacutainer tubes. Several vacutainer tube types contain RNA-preserving additives, all adequately preserving blood RNA. Most human subjects accept venipuncture, which collects sufficient high-quality blood and RNA suitable for gene expression analysis by RNA sequencing (RNA-Seq). Venipuncture has drawbacks; it requires trained personnel, carries a risk of injury, is time-consuming, and is often unsuitable for in-the-field, at-home, or self-collection. Capillary blood collection by fingerstick is common and widely practiced but not often used for RNA-Seq analysis due to low and variable blood quantity, a lack of blood RNA preservation options, low RNA yields, and variable RNA quality. This study used total RNA-Seq to compare two different fingerstick blood collection, preservation, and RNA extraction methods with a commonly used venipuncture blood collection and RNA extraction method. The authors demonstrate that fingerstick blood collection produces RNA suitable for RNA-Seq, that each fingerstick method produces results more similar to one another than venipuncture-derived blood RNA, and that each fingerstick blood collection method can distinguish between experimental groups (male and female subjects). While the venipuncture method examined here is generally preferable to the fingerstick blood collection methods, particularly in well-controlled and resourced environments, capillary blood is suitable and useful for gene expression analysis.]]></description>
      <pubDate>Thu, 21 Mar 2024 13:24:06 GMT</pubDate>
      <guid>https://trid.trb.org/View/2352881</guid>
    </item>
    <item>
      <title>Utility of Capillary Blood for Gene Expression Studies: Data Management Plan</title>
      <link>https://trid.trb.org/View/2352882</link>
      <description><![CDATA[This document is the data management plan for the project: Utility of Capillary Blood for Gene Expression Studies. Project description: Blood RNA is typically derived from blood tubes collected using standard venous phlebotomy practices. Venipuncture provides ample material for RNA extraction, but presents challenges when considering the time, labor, and acceptability among study participants. This study examines the utility of capillary blood collected through standard fingerstick practices as a replacement for venous blood as a source for blood RNA for RNA sequencing. Volunteer subjects will provide venous and fingerstick blood, and RNA from each sample will be extracted from each sample. Extracted RNA will be sequenced, and sequence data from each collection method will be compared to assess what differences exist between sample collection methods. If capillary blood RNA is determined to be a reliable source of gene expression data with equivalence to venous blood RNA, the methods developed in this study may be applied to future blood sample collections intended for RNA sequencing.]]></description>
      <pubDate>Thu, 21 Mar 2024 13:24:06 GMT</pubDate>
      <guid>https://trid.trb.org/View/2352882</guid>
    </item>
    <item>
      <title>Do crashed drivers need more drug testing? A retrospective analysis of blood samples from hospitalised post-crash drivers in New Zealand</title>
      <link>https://trid.trb.org/View/2304642</link>
      <description><![CDATA[Driving under the influence of alcohol and other drugs is a prominent safety concern in New Zealand and across the world. While alcohol testing is routinely performed for drivers involved in hospitalization crashes, testing for other drugs is often not undertaken. The present study refers to 530 traffic crashes that occurred from October 2019 to January 2020 on New Zealand roads. The blood samples from 550 drivers who were injured in a crash and were admitted to a hospital (66% of all drivers involved in these crashes), previously tested for drugs and/or alcohol, were retested for a wider range of drugs. Alcohol above the applicable limit was found to be present in 38% of hospitalized drivers, while other drugs of interest were found in 47% of hospitalized drivers. Binary logistic regression was used to predict the presence of drugs of interest for a crashed driver using previous offence data. A driver having at least one prior drink and drug driving offence is 61% more likely to be positive for a drug of interest when involved in a crash. Similarly, a driver having at least one prior non-traffic drug offence is 4.7 times more likely to be positive for at least a drug of interest when involved in a crash. While the presence of a drug or drugs cannot be presumed to have played a role in the occurrence of the crash, this study has provided a unique and comprehensive picture of the presence of various drugs present in New Zealand drivers’ blood. It is recommended to consider standardizing drug testing on all blood specimens taken in relation to a serious injury or fatal crash. This procedure is not only of interest for information purposes but may importantly inform appropriate charging decisions.]]></description>
      <pubDate>Wed, 27 Dec 2023 17:08:12 GMT</pubDate>
      <guid>https://trid.trb.org/View/2304642</guid>
    </item>
    <item>
      <title>Driving under the influence of cannabis: A 5-year retrospective Italian study</title>
      <link>https://trid.trb.org/View/2286734</link>
      <description><![CDATA[Cannabis consumption is associated with driving impairment and increased crash risk, endangering road safety. Toxicological analyses play a fundamental role in detecting a recent consumption of psychoactive substances. The aim of this study was to examine the concentration of cannabinoids in blood samples of driving-under-the-influence (DUI) offenders in order to investigate whether delayed sample collection affects the toxicological assessment of the offenders. An observational retrospective study was performed using anonymized toxicological data referring to cannabis-related DUI offenders involved in road traffic accidents (RTA) or apprehended by the police from 1 January 2017–31 December 2021 archived at Legal Medicine and Toxicology Department of the University Hospital of Padova, Italy. In a total sample of 318 drivers, 143 blood samples tested positive for tetrahydrocannabinol (THC) and metabolites 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC) and 11-nor-Δ9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH), and 173 blood samples were positive for THC-COOH with THC negative. In the first group, the mean concentrations of THC and THC-COOH were 4.05 ng/mL and 28.29 ng/mL, respectively. In THC-negative cases, the mean THC-COOH concentration was 7.3 ng/mL. The time elapsed between the event and sample collection varied from 15 min to 7 h (mean 2 h 29 min). The average estimated time elapsed after consumption of cannabinoids was 3 h 7 min (Model I) and 2 h 36 min (Model II). The present research discussed the main difficulties in the toxicological evaluation of drivers under the influence of Cannabis. Issues related to the time between RTA and sample collection, the laws and legal limits in force in various Countries were presented.]]></description>
      <pubDate>Tue, 28 Nov 2023 10:39:02 GMT</pubDate>
      <guid>https://trid.trb.org/View/2286734</guid>
    </item>
    <item>
      <title>A Two-Sample Approach to Retrograde Extrapolation of Blood THC Concentrations – Is It Feasible?</title>
      <link>https://trid.trb.org/View/2256588</link>
      <description><![CDATA[Retrograde extrapolation of drug concentrations in blood can be relevant in cases of drug-impaired driving and is regularly used in forensic toxicology in Norway. Δ9-tetrahydrocannabinol (THC) has complex, multi-compartmental pharmacokinetics, which makes retrograde extrapolation of blood THC concentrations problematic. In the present study, the authors evaluated an approach to retrograde extrapolation in which momentary rates of decrease of THC were estimated from two consecutive blood samples in apprehended drivers. Data were collected from apprehended drivers in Norway 2000–2020. The authors included 548 cases in which THC was detected in two consecutive blood samples collected ≥20minutes apart. THC concentrations were measured by GC-MS and UHPLC-MS/MS. In each case, THC concentrations and the time between the two sampling points (Δt) were used to estimate the rate constant k. The relationship between THC concentration and k was modelled by linear regression. The median Δt was 31min (interquartile range, IQR = 9). The median blood THC concentration was 2.4μg/L (IQR = 3.4) at the first sampling point and 2.3μg/L (IQR =3.1) at the second. The concentration decreased in 62% and increased in 38% of all cases. However, considering measurement uncertainty, the changes were not statistically significant in 87% of cases. The mean of k was 0.12 h-1, corresponding to an apparent t1/2 of 6.0hours. The t1/2 predicted from linear regression of k against THC concentration ranged from 0.93 to 13hours for the highest and lowest concentrations observed (36 and 0.63μg/L, respectively). The time from driving to blood collection had a median of 1.7hours (IQR = 1.5), and did not correlate with k. The apparent t1/2 of THC calculated from the mean of k was 6.0hours, which is shorter than the terminal elimination t1/2 suggested in previous population studies. This indicates that blood samples were often taken during the late distribution phase of THC. Because Δt was short relative to the rates of decrease expected in the late distribution and elimination phases, the underlying true concentration changes related to in vivo pharmacokinetics were small and masked by the relatively larger “false”changes introduced by random analytical and pre-analytical error. Therefore, individual values of k calculated from only two blood samples taken a short time apart are unreliable, and a two-sample approach to retrograde extrapolation of THC cannot be recommended.]]></description>
      <pubDate>Wed, 15 Nov 2023 09:19:57 GMT</pubDate>
      <guid>https://trid.trb.org/View/2256588</guid>
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