MEDICAL TESTS, CONTAMINATION POTENTIAL DOMINATE TASK FORCE DISCUSSION

The roster of attendees at the county's methamphetamine task force
meetings continues to grow from month to month as workers in public
service agencies and organizations become more aware of the potential
for meth-related problems to arise as agency personnel provide their
regular services. Newcomers at last Friday's meeting included District
Attorney Jerry Wilson and representatives from Watauga Medical Center,
Avery County's Department of Social Services and the Parents and
Children Together (PACT) program.

The initial discussion centered on the most effective and least
traumatic way to decontaminate children found in homes where
methamphetamine has been produced, and what kinds of medical tests and
tests for determining the child's exposure should be performed.

Watauga Medical Center's procedures for handling persons coming from a
methamphetamine production environment call for decontamination before
those individuals enter the hospital's emergency room. While the
hospital staff is comfortable with decon procedures, members of the
task force raised questions about what medical tests should be
performed on the children, whether medical personnel need to collect
samples for subsequent use in legal proceedings and whether they need
to follow strict chain-of-evidence procedures.

Forensic toxicologist Dr. Andrew Mason pointed out that "there are no
quick and dirty tests to determine if kids have been exposed to the
by-products of production." He pointed out that if children are
exhibiting symptoms such as altered mental status or pulmonary
problems, then they obviously need immediate treatment for those
symptoms. However, he added, there are no tests that can be applied to
determine their degree of exposure, if any, to the various solvents
used in production and the gases that are created during the "cooking"
process.

Mason explained that hair and urine tests can provide limited
information about exposure to methamphetamine that could potentially
be useful for prosecuting methamphetamine cases. Mason said that a
hair test will show chronic (long-term) exposure, while a urine test
will show acute exposure. An individual "can be positive in hair and
negative in urine," Mason said, "and the converse also applies," so
both tests would be necessary from a law-enforcement perspective. What
those tests don't show, however, is dose and the number of exposures.

Wilson said that he would like for the hospitals to collect law
enforcement evidence at the time of medical examination and treatment,
and Mason offered to supply the procedures for collecting hair samples.

To address the medical questions regarding appropriate tests for
children who have been exposed to drug production, Chad Slagle,
treatment worker for DSS Child Protective Services, said that DSS will
"try to get all the pediatricians in the county together at the table"
to brainstorm ideas for an examination and treatment protocol.

The issue of second-hand contamination is a significant concern to
those at potential risk - home visitors and DSS personnel who respond
to calls for children's services. Task force members also had
questions about whether second-hand contamination is a problem with
toys, special equipment and personal vehicles used to transport
children who may be contaminated. According to Mason, there are no
clear or easy answers, in part because so much depends on the level of
contamination.

While the potential for spreading contamination to others via residue
on toys and other surfaces exists, he said, the potential risk
decreases by orders of magnitude. "The amount of material on a
surface, unless it has been grossly contaminated, will be relatively
small," Mason said, "and can be removed with washing." He suggested
using warm water and detergents rather than products such as Clorox to
clean potentially contaminated items.

Mason added, "This is not a virus. It does not multiply. The
concentration will not increase; it will decline."

Additional solutions, news and plans from the meeting included the
following:

A proposed solution for protecting home intervention workers from
primary contamination is to invest in inexpensive Tyvek coveralls,
protective "bunny suits" that the user can place in plastic bags for
disposal after the home visit.

The Northwestern Regional Housing Authority is planning to hold an
informational meeting for landlords participating in the housing
assistance program. The purpose of the meeting will be to educate
property owners in the products and apparatus used to produce
methamphetamine.

Slagle said he would continue working with Sheriff Mark Shook to
develop an information site listing all confirmed methamphetamine
production locations in the county. Prospective home renters and
buyers could check the site to determine if a property had been used
to manufacture the drug. The residual contamination in the house could
endanger the health of subsequent residents.

State epidemiologist Doug Campbell has announced that the state will
hold a meth lab summit later this year which will be the first step in
the development of state standards and protocols for addressing
methamphetamine contamination and cleanup.

DSS received an adjudication of abuse and neglect in its first
meth-related juvenile court case. Judge Bill Leavell reported that
expert testimony from Mason and a specially trained State Bureau of
Investigation expert was key in building the case. Slagle said, "This
is more like an episode of CSI than what we're used to." He pointed
out that establishing timelines, as well as the volumes and locations
of chemicals, was very important in the case to disprove the mother's
contention that the lab was set up during her absence from home one
morning.