Wednesday saw the opening of the exhibition ‘Creative Health Nepal’ in Kathmandu. Creative Health Nepal reflects our interdisciplinary public health work, for the website click here!Our work on alcohol in Nepal’s society, which resulted in the paper ‘Participatory asset mapping and photovoice interviews to scope cultural and community resources to reduce alcohol harm in Chitwan, Nepal’ was represented in the exhibition.
Prof. Edwin van Teijlingen
Reference:
Dhital R, Yoeli H, Adhikari A, et al. Participatory asset mapping and photovoice interviews to scope cultural and community resources to reduce alcohol harm in Chitwan, Nepal. Perspectives in Public Health. 2024;144(5):312-323. doi:10.1177/17579139231180744
Your hair can say a lot about you. It doesn’t just give people clues about your personality or your taste in music. It can also record evidence of how much you drink, whether you smoke or take drugs, and perhaps even how stressed you are. My colleagues and I research how hair can be used to provide more accurate testing for these attributes. And a recent court case shows how far the technology has come.
In 2008, a mother who had been struggling with alcohol abuse was asked by a UK court judging a child custody case to abstain from drinking for one year. To assess whether she managed to do this, scientists used a hair analysis that can detect long-term drug or alcohol abuse (or abstinence) over a period of many months, from just one test. At HelpAddiction, we can discuss you the key stages of addiction treatment options and consider your preferences and requirements to find the best treatment plan for you.
This case turned out to be a landmark moment for toxicological hair analysis. The labs analysing the mother’s hair suggested that she may have been drinking during the time she was supposed to be abstinent. The case ended up in the High Court, where the scientific principles underlying hair testing and, crucially, the way the results are reported were thoroughly debated. The judge was critical of the interpretation of the hair analysis data and disagreed with the scientists, ruling that there was no evidence to support drinking during the defined time-period.
Fast forward to 2017 and hair analysis featured in the High Court again. Yet this time the reliability of hair testing was confirmed. A lot changed in the intervening years between these cases. Technology advanced but, importantly, so did our understanding of what hair analysis data actually means.
The traditional samples for drug and alcohol testing are blood and urine. These provide evidence for cases where we require an indication of exposure to drugs and alcohol in a very recent time frame. These samples have what is referred to as a “window of detection”. This is a timeframe over which that sample can demonstrate exposure to drugs or alcohol. The window of detection for blood is often measured in hours, and urine can show evidence over a few days, possibly a few weeks.
By contrast, hair can show a retrospective history of your drug or alcohol consumption (or abstinence) over many months. This level of information makes hair testing invaluable in a wide variety of legal scenarios. If you need to screen potential employees for a safety-critical role, you can use a hair test to check they are not regular drug users. What if you’re concerned your drink was spiked at a party, but too much time has passed for any drug to still be found in your blood or urine? The drugs can remain trapped in your hair, which gives you a longer window of detection and allows scientists to find traces of the drug long after the actual crime event.
My research group is investigating factors that affect the hair concentration of certain chemicals produced when the body processes alcohol (metabolites). This sort of work is important to give confidence to the results of hair testing when presented in court. We need the utmost confidence in the data, when a court judgment may have life-changing consequences.
We recently showed that hair sprays and waxes can greatly increase the level of alcohol metabolites found in hair, giving a false positive result in an alcohol test. In one of our experiments, a volunteer who was strictly teetotal tested negative for fatty acid ethyl esters (metabolites of alcohol) in head hair untreated with hair spray, but tested positive after application of hair spray. Not just a little positive either. The volunteer tested significantly over the threshold for chronic excessive alcohol consumption after using hair spray.
This may sound alarming for a test that is used in court, but now that scientists are aware of these limitations, procedures can be put in place to mitigate against them and guidance can be updated. Ethyl glucuronide (a different alcohol metabolite) is not affected by hair sprays and waxes and so is a better target to test when someone uses cosmetic products.
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Other ways of testing
Hair is not the only alternative to blood and urine testing. I’m currently investigating whether fingernails might be a better sample to test in cases where we need to prove abstinence from alcohol. It has been shown that fingernails may incorporate significantly more ethyl glucuronide (an alcohol metabolite) than hair samples. This means fingernails may be more sensitive than hair and could be better at distinguishing low levels of drinking and complete abstinence.
Toxicological hair analysis is not about catching criminals. It’s not about penalty or punishment. It’s about helping people. Results from hair testing can help support people struggling with addiction. In the future I hope we will also be using hair analysis as a diagnostic tool in healthcare.
The research I’m conducting at the moment is evaluating the potential for hair to be used as a diagnostic marker of chronic stress. Stress can lead to very serious healthcare issues. We are examining the stress hormone cortisol to see if we can identify people at risk from future healthcare issues from the concentration of this hormone in hair.
If successful, this work will take hair analysis into a new realm. I’d like to see a future where hair testing is used for a national screening programme for older adults who are most at risk from chronic stress. This could allow scientists to target interventions to lower stress at people who need them the most, which could significantly improve the health and well-being of older people in particular.
The Festival of Learning event grew out of Donna’s PhD research. Donna’s PhD is jointly supervised by Dr. Greta Westwood of Portsmouth Hospitals NHS Trust & the University of Southampton and FHSS academics Dr. Liz Norton and Prof. Edwin van Teijlingen.
Reference:
Wixted, D., Hundley, V., Norton, L., van Teijlingen, E., Westwood, G. (2016) Drinking in pregnancy: poor guidelines or lack of evidence? MIDIRS Midwifery Digest26(4): 462-65.
Faculty of Health & Social Sciences’ Liz Norton and Edwin van Teijlingen affiliated with the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) argued in favour of the motion. Donna Wixted, Joint Bournemouth University (BU)-Portsmouth Hospitals NHS Trust, doctoral student and Greta Westwood of Portsmouth Hospitals NHS Trust & the University of Southampton argued strongly against the motion. The exciting debate was chaired by Prof. Vanora Hundley from the Faculty of Health & Social Sciences.
We are preparing a lively debate on the motion: “Advising pregnant women to avoid drinking alcohol during pregnancy is symptom of the Nanny State and another step towards the medicalisation of childbirth”. The venue for this event is the Executive Business School on 89, Holdenhurst Road. Members of the public, staff and students are invited to come along on Tuesday 28th June 13.30-14.30!
The UK Government state there is no known safe level for drinking alcohol in pregnancy. Therefore, it recently changed the official recommendation to pregnant women avoid drinking any alcohol as a precaution. In doing so the UK follows countries like Canada, where a similar recommendation has been in place for over a decade. At the same time one can ask whether such approach undermines a woman’s right to make an informed choice regarding the health of her unborn child. Some would argue that is represents yet another step towards the medicalisation of childbirth.
Faculty of Health & Social Sciences’ staff Liz Norton and Edwin van Teijlingen affiliated with the Centre for Midwifery, Maternal & Perinatal Health and will argue in favour of the motion. Donna Wixted, Joint Bournemouth University (BU)-Portsmouth Hospitals NHS Trust, doctoral student and Greta Westwood of Portsmouth Hospitals NHS Trust & the University of Southampton will argue against the motion.
The audience will be asked to vote for or against the motion, both before and after the debate, to see if the debate has helped anybody in making up their mind. Our debate will be chaired by Prof. Vanora Hundley from the Faculty of Health & Social Sciences. In previous Festival of Learning events she has been involved in various debates around childbirth, such as The media is responsible for creating fear in childbirth and the year before that on Caesarean Section on demand under the title Intervention in childbirth: What’s wrong with letting women choose?
The debate is part of BU’s annual Festival of Learning which this year for the first time has satellite events in China and Malaysia.
If you are interested to come along please book your free ticket here! The Executive Business School is easy to find on 89, Holdenhurst Road near Bournemouth Railway Station.
Donna Wixted, Liz Norton, Greta Westwood, Vanora Hundley & Edwin van Teijlingen
National Institute on Alcohol Abuse and Alcoholism – Economic Research on Incentives for Efficient use of Preventive Services: This R01 funding opportunity announcement solicits applications for economic research on the role of incentive arrangements in promoting efficient use of preventive services and interventions, specifically considering both costs and health outcomes. NIH intends to commit approximately $1.6 million in fiscal year 2012 to fund approximately four awards. Application budgets are not limited, but need to reflect actual needs of the proposed project for the maximum project period of five years. Deadline 15.11.11
Healthy Ageing: Funding is available for innovative policies to support healthy, active and dignified ageing and raise the effectiveness and efficiency of spending on social, health and long-term care services and benefits. Deadline 26.09.11
ESF-LiU Travel Grants for Conference on Images & Visualisation – Imaging Technology, Truth and Trust: The conference, to be held from 17 to 21 September 2012 in Scandic Linköping Vast, Sweden, will bring together experts from across the natural and social science with curators, artists, producers and users of images based on advanced visual engineering, in order to explore challenges at the interface between science and visual art. Grants are available to cover conference fees and possible part travel costs for students and early stage researchers. Deadline 06.06.12
Culture Programme: The Culture Programme has been established to enhance the cultural area shared by Europeans, which is based on a common cultural heritage, through the development of cooperation activities among cultural operators from eligible countries, with a view to encouraging the emergence of European citizenship. The Programme is aimed at three specific objectives: promotion of the trans-national mobility of people working in the cultural sector; support for the trans-national circulation of cultural and artistic works and products; and promotion of inter-cultural dialogue. The Programme has a flexible, interdisciplinary approach and is focused on the needs expressed by cultural operators during the public consultations leading up to its design. Deadlines are: 15.09.11, 05.10.11, 16.11.11, 03.02.12, 03.05.12
These fund any aspect of biomedical or psychosocial research into beer or alcohol. Grants are worth €50,000 per annum over one to two years and the deadline is 10th April 2012.
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