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Analytical Chemistry Section
If you have been exposed to a poisonous chemical agent, IMMEDIATELY contact the Palmetto Poison Center at 1-800-222-1222.
The Level 1 and Level 3 laboratories in the Analytical Chemistry section are part of the Centers for Disease Control and Prevention (CDC) Laboratory Response Network for Chemical Threats (LRN-C).
Level 1 Laboratory
The Level 1 laboratory, one of only 10 in the USA, serves as a surge-capacity laboratory for the CDC to provide rapid and effective analysis of clinical specimens for chemical threat agents likely to be used in a terroristic event. These laboratory measurements will support the response to a public health emergency involving chemical threat agents by guiding emergency medical care and public health emergency management through the identification of the chemical threat agent(s) used and the determination of an individual's level of exposure. The Level 1 laboratory has the capacity to analyze for a wide spectrum of chemical classes and metabolites, e.g. metals, volatile organic compounds (VOCs) and nerve agent metabolites, to name a few. An analysis is done on human specimens, usually blood or urine, to detect exposure to toxic substances which are reported to local and/or regional healthcare providers and the CDC. The instrument platforms used for analysis include:
- Liquid chromatography (LC)
- Gas chromatography (GC)
- Inductively coupled plasma (ICP)
- Mass spectrometry (MS)
The Level 1 laboratory maintains readiness through continuous method optimization, stocking required surge materials and assuring staff competency through training and proficiency testing.
Level 3 Laboratory
The Level 3 laboratory participates in outreach to South Carolina (SC) public health emergency preparedness partners, e.g. hospitals and first responders, to educate in the capabilities of the Level 1 laboratory and/or train in procedures pertaining to safe and effective specimen collection, handling and shipping during and after a public health emergency involving chemical threat exposure(s). The Level 3 laboratory seeks to integrate the South Carolina LRN-C laboratories in the procedures and response exercises that are crucial to the overall emergency preparedness for the state. The training is usually held at the partner facility, or occasionally at the SC Public Health Laboratory (PHL). The topics covered may include:
- Background information on the Level 1 laboratory testing capacity
- Brief description of chemical threat agents
- Role of the CDC, Level 1 laboratory, and hospitals in a chemical terrorism/exposure event
- Clinical specimen collection, handling and shipping protocol
- Chain-of-custody protocol
A Chemical Exposure Response Kit is provided for each organization attending the training. The kits are customized for the training participants. Certificates are awarded upon completion of the training. For more information, or to set up a training session, please contact the laboratory via telephone at 1-803-896-0886 or e-mail the Analytical Chemistry supervisor or Chemistry Division Director listed below.
The chemical threat emergency response preparation in the Analytical Chemistry section is supported by the CDC Public Health Emergency Preparedness Cooperative Agreement.
Useful Information
Sample Collection, Packaging and Shipping Information for Health Professionals
- Flowchart: Chemical Terrorism Event Specimen Collection (pdf)
- DHEC 1327 NBS Test Request form (pdf)
- Chain-of-Custody Form (pdf)
- CDC Laboratory Information for Chemical Emergencies
Important Contacts
- Palmetto Poison Center 24/7 Emergency Number: 1-800-222-1222
- South Carolina Law Enforcement Division: 1-803-737-9000
- S.C. DHEC Reporting a Chemical Spill: 1-888-481-0125
Analytical Chemistry Section Contacts
- Elizabeth Bair, MS, Chemistry Division Director, 803-896-0991
- James LaPalme, Analytical Chemistry Supervisor, 803-896-3866
- Yuping Wang, Chemist III, 803-896-0953
- Gideon Paulovic, Program Coordinator, 803-896-1110
- Lawrence Creed, Program Coordinator: 803-896-0942
- SC DHEC Public Health Laboratory (24 hours): 803-896-0800
Overdose Biosurveillance Program
In 2019, the South Carolina Public Health Laboratory (SC PHL) received funding from the U.S. Centers for Disease Control and Prevention (CDC) Overdose Data to Action (OD2A) grant to develop an Overdose Biosurveillance Program (OBP). The purpose of the OBP is to test residual de-identified urine specimens for fentanyl and fentanyl analogs from suspected non-fatal drug overdoses. The laboratory started testing for fentanyl and twenty-one fentanyl analogs but quickly expanded to other opioids which have emerged as a public health threat. Given the rapidly evolving drug landscape and the evidence for intentional and unintentional usage of fentanyl combined with other drugs, CDC expanded the scope of OD2A funding to encompass other illicit compounds. The SC Public Health Laboratory has quickly expanded its scope to include additional drugs like Xylazine, Stimulants, and Benzodiazepines, which can be highly addictive and contribute to Naloxone resistance. The SC PHL has the capacity to increase its drug screening panel as new drugs emerge in South Carolina.
The Overdose Biosurveillance Program involves partnerships with hospitals throughout the state who provide the SC PHL with de-identified residual urine specimens from suspected non-fatal overdoses. The de-identification protects and ensures the anonymity of those patients whose specimens have been submitted for analysis. The suspected non-fatal overdose urine specimens are analyzed using Ultra-High Performance Liquid Chromatography (UHPLC) coupled with Quadrupole Time-of-Flight Mass Spectrometer (LC-QTOF-MS), which has the ability to perform targeted and non-targeted analysis. The data produced has provided evidence for data-driven decision-making for DHEC programs working to combat the opioid and overdose epidemic in South Carolina.
The Analytical Chemistry Laboratory collaborates with the Bureau of Chronic Disease and Injury Prevention’s Division of Epidemiology, Analytics and Data Visualization team to provide and manage an interactive Overdose Biosurveillance dashboard. Coupling near real-time surveillance with data analytics can further drive resource allocation for prompt response and prevention, which saves lives and improves health outcomes for South Carolina citizens.
Newborn Screening (NBS)
In accordance with SC regulations, all infants born in the state are required by law to be screened for a panel of metabolic, hormone/enzyme, and genetic disorders. Parents may opt out only for religious objections. The disorders on the screening panel are based on the Secretary of U.S. Department of Health and Human Services Recommended Universal Screening Panel (RUSP). The SC NBS laboratory screens for most conditions on the RUSP; newly added conditions are in various stages of implementation. The NBS laboratory screens for the classes listed below:
- Amino Acid Disorders
- Organic Acid Disorders
- Fatty Acid Disorders
- Hormone and Enzyme Disorders
- Hemoglobinopathy Disorders
- T-cell Related Disorders
- Other Genetic Disorders
Refer to the SC NBS website for the list of specific conditions on the screening panel and related information sheets.
Preferably 24 - 48 hours after birth, a series of small drops of blood from the heel of an infant are placed on a filter paper card that contains the demographic information for the infant. The filter paper cards containing the blood spots are dried, then shipped to the NBS laboratory. The analysis for the screening panel is done on small samples of the dried blood spots (DBS). The instrument platforms used by the NBS laboratory include:
- Tandem Mass Spectrometry (MS/MS)
- Fluoroimmunoassay
- Enzymatic assay
- High Performance Liquid Chromatography (HPLC)
- Isoelectric Focusing
- Molecular assay
The laboratory sends the results of the analyses to the health care provider/facility that submitted the DBS filter paper card to the laboratory. The purpose of newborn screening is to identify infants at risk for a screened disorder. As with any laboratory test, both false positive and false negative results are possible. Thus, screening results are insufficient information upon which to base definitive diagnosis or treatment. Thus, when an abnormal screening result is obtained in the newborn screening laboratory, the Department of Health and Environmental Control (DHEC) Children's Services Division is notified. Children's Services personnel consult with clinical specialists and contact parents and infant healthcare providers. Families with infants with an abnormal screen are linked with or advised of the appropriate clinical follow-up for additional testing for possible diagnosis and treatment.
Useful Information
NewSTEP's website, a national newborn screening resource center
Newborn Screening Section Contacts
- Elizabeth Bair, MS, Chemistry Division Director, 803-896-0991
- Sandi Hall, Newborn Screening Supervisor, 803-896-0891
Children's Health & Perinatal Services Division Contacts
- Michelle L. Myer, DNP, RN, CPNP, APRN, Director, Division of Children's Health and Perinatal Services, 803-898-1580
- Tanya Spells, Newborn Screening, Metabolic Formula, and First Sound Program Director, 803-898-0619