Vrednotenje izidov hitrih presejalnih testov za določanje psihoaktivnih snovi v urinu v laboratoriju Holmed v obdobju 2016-2018

• Main Author: Rozman, Tjaša
• Other Authors: Sollner Dolenc, Marija
• Format: Master Thesis
• Language: Slovenian
• Published: 2020
• Subjects: psihoaktivne snovi; EMCDDA; hitri presejalni testi; določanje psihoaktivnih snovi na delovnem mestu; psychoactive substances; rapid screening tests; determination of psychoactive substances at the workplace; sami
• Online Access: https://repozitorij.uni-lj.si/IzpisGradiva.php?id=115139; https://repozitorij.uni-lj.si/Dokument.php?id=127735&dn=

Naraščajoča uporaba in enostavna dostopnost psihoaktivnih snovi predstavljata velik javnozdravstveni in širši družbeni problem. Občasna uporaba psihoaktivnih snovi običajno vodi v tvegano uporabo in nastanek zasvojenosti ter pojav motenj, ki jih uporabniki sami ne opazijo. Čeprav psihoaktivne snovi uporabljajo v času, ko niso na delovnem mestu, se njihovo delovanje lahko občuti med delovnim časom. Vse več je delodajalcev, ki se zavedajo negativnih posledic uporabe psihoaktivnih snovi in se zato odločajo za preverjanje svojih zaposlenih. Za pogostejše preverjanje preiskovancev, pri katerih obstaja sum za uporabo psihoaktivnih snovi, pa se odločajo tudi zdravniki specialisti medicine dela, prometa in športa v sklopu preventivnih zdravstvenih pregledov. V magistrski nalogi predstavljamo retrospektivni pregled podatkov in statistični pregled vzorcev, ki so bili analizirani s hitrimi presejalnimi testi v laboratoriju Holmed z namenom ugotoviti prisotnost ali odsotnost psihoaktivnih snovi in njihovih metabolitov v urinu. Pregledali smo 1.452 primerov testiranj na psihoaktivne snovi preiskovancev, ki so v obdobju med majem 2016 in marcem 2018 prišli na zdravstveni pregled v Zasebno zdravstveno ambulanto medicine dela, prometa in športa Holmed, d. o. o. 160 preiskovancev je bilo na testiranju pozitivnih na vsaj eno od preverjenih psihoaktivnih snovi. V informacijskem sistemu ISOZ21 smo zbrali podatke o preiskovancih na podlagi podane anamneze, osebnega zdravstvena kartona in ugotovitev o zdravstvenem stanju s strani strokovnih delavcev. V laboratorijskem informacijskem sistemu L@b-IS pa smo pregledali podatke o prisotnosti psihoaktivnih snovi v vzorcu, rezultate analiziranega urina in hematoloških preiskav. Rezultati so pokazali, da je najpogosteje uporabljena psihoaktivna snov med preiskovanci tetrahidrokanabinol, razširjena predvsem med moškimi preiskovanci. Uživanje psihoaktivnih snovi prevladuje med preiskovanci v starostnem razponu med 20 in 35 let, z izjemo uporabe amfetamina, ki ga uporabljajo predvsem preiskovanci v starostnih skupinah nad 35 let. Psihoaktivne snovi uživajo predvsem preiskovanci z osnovnošolsko ali srednješolsko izobrazbo. Največ uporabnikov psihoaktivnih snovi je zaposlenih v proizvodnji, sledijo jim monterji, delavci na višini, varilci, vozniki tovornih vozil, viličaristi in komunalni delavci. Poleg najpogosteje uporabljenega tetrahidrokanabinola pogosteje uporabljajo še benzodiazepine in kokain. Preiskovanci sočasno uporabljajo več različnih psihoaktivnih snovi. Posebno pozornost je treba posvetiti tistim, pri katerih se sočasno z uporabo psihoaktivnih snovi pojavljajo simptomi psihičnih motenj. Ugotovili smo statistično pomembno pozitivno povezavo med uživanjem alkohola in povišano koncentracijo hemoglobina v krvi. Preiskovanci, ki so imeli pozitiven test na tetrahidrokanabinol, so imeli statistično povišano število levkocitov v krvi. Growing use and easy access to psychoactive substances represent a large public health and wider social problem. Occasional use of psychoactive substances usually leads to risky use, addiction and disorders, which go unnoticed by users. Although psychoactive substances are being used outside the working hours, their effects can be felt during working hours. An increased number of employers are aware of negative consequences of the use of psychoactive substances and are therefore deciding to check on their employees. Physicians, specialised in occupational, traffic and sports medicine, are also deciding for more frequent checking of subjects, who are suspected of psychoactive substance use, during preventive health checks. In this research thesis, we present a retrospective review of data and a statistical review of samples, which have been analysed with rapid screening tests in the laboratory Holmed to determine the presence or absence of psychoactive substances and their metabolites in urine. We examined 1.452 drug tests of subjects, who were subjected to a health check at the Private health clinic for occupational, traffic and sports medicine Holmed, Ltd. between May 2016 and March 2018. During the checks, 160 subjects tested positive for at least one of the checked psychoactive substances. In the information system ISOZ21, we collected data on the subjects based on the provided anamnesis, personal medical record and findings about their state of health, determined by professional workers. In the laboratory information system L@b-IS, we reviewed the data on the presence of psychoactive substances in the sample, the results of the urine tests and haematology. The results showed that the most commonly used psychoactive substance among the subjects is tetrahydrocannabinol, spread mainly among male subject. The consumption of psychoactive substances prevails in subjects, aged 20-25 years, while the use of amphetamine prevails among subjects over 35 years. Psychoactive substances are being used particularly by subjects with primary or high school education. Most users of psychoactive substances work in production, followed by fitters, workmen working at height, welders, lorry drivers, forklift operators and public workers. In addition to the most commonly used tetrahydrocannabinol, they also often use benzodiazepines and cocaine. The subject simultaneously use more different psychoactive substances. Special attention needs to be paid to those, who simultaneously to the use of psychoactive substances experience symptoms of psychotic disorders. We identified a statistically important correlation between the use of alcohol and high haemoglobin levels. Subjects, who tested positive for tetrahydrocannabinol in urine, had statistically significant increased number of leukocytes.