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Source: Laura C. Fulginiti, PhD, 2022-23 AAFS President
The Academy Apercus is a monthly feature that celebrates 75 years of forensic science by spotlighting the history and anticipating the future of each section of the Academy. Beginning with the Jurisprudence Section and progressing through each section in the order of acknowledgement by the Academy, a senior member will join with a junior member to memorialize salient events, highlight members, and provide insight into why the Academy remains the premier forensic science organization in the world. This month features the Toxicology Section.
Toxicology Section at 75 Years
Source: Michael A. Peat, PhD, AAFS Past President and Toxicology Section Fellow, with input from Graham R. Jones, PhD, AAFS Past President and Toxicology Section Retired Fellow
As I was President of AAFS during its 50th Anniversary in 1998, it is an honor to author this Apercus and to be assisted in doing so by Graham Jones, President of AAFS from 2002 to 2003. Madeleine Swortwood will follow us in describing her path to forensic toxicology and the Academy.
First let us define the scope of forensic toxicology. Unlike some Academy Sections, there are several forensic toxicology organizations representing the discipline, and there is tremendous overlap between them in their aims and their membership. We are going to list the forensic toxicology organizations in no order of priority or contribution, as the toxicologists involved have all participated in the growth of the discipline and its impact. These are the major organizations:
- The Toxicology Section of AAFS
- The Society of Forensic Toxicologists (SOFT)
- The International Association of Forensic Toxicologists (TIAFT)
- The American Board of Forensic Toxicology (ABFT)
There are other organizations that have contributed to the discipline, especially to clinical toxicology, such as the American Association of Clinical Chemistry and the College of American Pathology. As we said, there is considerable cross-membership. For example, Graham and I have been members of all these organizations during our careers.
So let us remind you of where we were in 1998. The toxicology community assisted the forensic pathologist in determining the cause of death. The toxicology community members worked in crime labs on Driving Under the Influence of alcohol (DUI) and Driving Under the Influence of Drugs (DUID). They perform all these duties today; however, there are many more areas in which they are involved, for example, workplace drug testing, sexual assault cases, and drug testing to support many areas of criminal and civil litigation. Back in 1998, the analytical procedures used were not as sophisticated as they are today. Gas Chromatography/Mass Spectrometry (GC/MS) was becoming common partly because of the requirement in workplace testing programs to confirm the presence of drugs and metabolites by GC/MS. Today, we have access to a plethora of procedures, for example, Liquid Chromatography/Mass Spectrometry (LC/MS), Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS), Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS), quadrupole Time-Of-Flight (qTOF), and Direct Insertion Probe (DIP)MSMS. These technologies are all available and their use is increasing for both screening samples and confirming and quantifying the concentrations of drug and metabolites in a variety of specimens. The revolution in the use of MS technology has been partnered by an evolution of the immunoassays available to the labs, allowing more sensitive cut-offs and their use in a more widespread set of specimens.
As technology has advanced, we can now detect drugs and metabolites in a variety of specimens, not just urine, blood, and autopsy specimens. Today, we can test oral fluid, hair, sweat, fingernails, ear wax, and other alternative specimens. It is amazing what we can do today! However, we would argue that the ability to detect drugs has far outpaced our ability to interpret the analytical findings—a challenge for the next 25 years!
Members of the AAFS Toxicology Section, SOFT, and TIAFT have all contributed to the changes in the scope of forensic toxicology. The fact that the discipline advanced so far, so quickly reflects the dedication of all. However, this rapid growth has not come without its challenges, especially in the early days in the use of Standard Operating Procedures (SOP), quality control and quality assurance protocols, and the definition of a positive result. Today, due to several accreditation programs, for example, the Substance Abuse and Mental Health Services Administration (SAMHSA) ones for workplace drug testing labs in the United States, similar ones in Europe and other areas of the world, and the College of American Pathologists programs for clinical laboratories, we have come a long way. There have been transfers of programs and ideas between these organizations. Again, the Toxicology Section of AAFS has taken a leading role in these endeavors.
Let’s start this journey with the establishment of a SOFT/AAFS Joint Forensic Laboratory Guidelines Committee in 1988 and end it with the establishment of the Academy Standards Board (ASB), a standards setting board accredited by the American National Standards Institute (ANSI).
- Establishment of the National Institute on Drug Abuse (NIDA) (later SAMHSA) Guidelines (1988)
- Commence development of the SOFT/AAFS Toxicology Laboratory Guidelines (1989)
- Publication of the SOFT/AAFS Forensic Toxicology Laboratory Guidelines and Sell-Evaluation Checklist (1991)
- Development of the ABFT Toxicology Laboratory Accreditation Program (1996)
- Establishment of the Scientific Working Group for Toxicology (SWGTOX) Toxicology Standards Development Committee (2010)
- Establishment of the ASB (2015)
You will note that I included the ABFT in the list of organizations. When it was established in 1975, its primary purpose was to certify forensic toxicologists and it has done this for many years. Today, toxicologists can obtain certification as a Fellow, Diplomate, or Analyst (www.abft.org). As noted above in the discussion on accreditation, ABFT has also been active in those programs. Without question, its activities have contributed to the recognition of forensic toxicology as a profession and as a career choice.
You will note, I am sure, that I have not specifically recognized any of those who have contributed. That is not because some have not done more than others, they have. However, the progress forensic toxicology has made over 25 years has been a team effort and one we should all be proud of. We should all thank each other for our contributions and look forward to the next 25 years.
In ending, I think we would all agree that the last 25 years have been ones of tremendous progress in forensic toxicology. We can test for compounds that we never imagined would exist—the designer fentanyls and novel psychoactive substances being two examples—in specimens we would not imagine testing, for example, fingernails, hair, and ear wax. However, apart from reporting that a drug is present in those specimens, we cannot say much more. Of course, breath and blood alcohol are exceptions to this, as there is copious data on impairment of driving by alcohol. The challenge for the next 25 years is to solve the conundrum. Good luck to everyone.
My Journey in Forensic Toxicology
Madeleine J. Swortwood, PhD, Toxicology Section Chair
I first joined the AAFS Toxicology Section in 2011 as a Student Affiliate when I was working on my PhD. A few short years later, I am now the Chair of the Toxicology Section. My first exposure to forensic science was job-shadowing with a homicide detective while I was in high school. He gained his expertise in forensics from years of law enforcement. However, he told me of a new program that would allow me to get a degree in forensic science. Initially, I concentrated on biology so I could be a DNA analyst. I got frustrated that I could never get my own profile to amplify and switched my focus to the chemistry side of things. Little did I know back then that being a poor shedder would have been advantageous. I completed some research projects with fingerprints and counterfeit drugs only to find my true passion in forensic toxicology.
In the past decade, the Academy has afforded me many opportunities to contribute to the toxicology field and to the Toxicology Section. I have been an author and co-author on posters, presentations, and Journal of Forensic Sciences (JFS) manuscripts. I have served as a moderator, workshop presenter, and committee member. I have stepped into leadership roles in the Section and now contribute to JFS as a member of the Editorial Board. My professional service has also reached into other Academy-related areas such as the ASB and the Forensic Science Education Programs Accreditation Commission (FEPAC) as a Graduate Program Director for an accredited Master’s program.
One of my favorite aspects of my career over the past decade is the chance to mentor younger forensic scientists. I myself am a first-generation college student and a woman in science (and still technically a “young” forensic scientist). I try to foster the progress of other young scientists, first-gen students, minorities, and women as they navigate forensics. I was fortunate to have the support of many excellent mentors over the years and want to continue this important support network to cultivate the next generation of forensic toxicologists within the Academy.
It has been so exciting to watch technology advance in the field—the shift from GC/ to LC/MS, the increasing use of High Resolution Mass Spectrometry (HRMS), and the emergence of alternative matrices. Analytically, I look forward to seeing improvements in laboratory efficiency, a shift from immunoassay-based to MS-based screening, improved extraction techniques, and simplified data-processing—all in an effort to improve data interpretation for toxicology. Professionally, I look forward to hearing the thoughts and ideas of young scientists so we can propel the field forward and create an inclusive, welcoming field for science to thrive. Personally, I look forward to the day that I am introducing some of my students for prestigious young investigator awards and seeing them step into leadership roles within the Academy. AAFS offers such excellent opportunities and I am excited to see where our section and our field go in the coming years.