Details of a thallium poisoning case revealed by single hair analysis using laser ablation inductively coupled plasma mass spectrometry.

Heavy metals pose significant morbidity and mortality threats to humans in connection with both acute and chronic exposure. The often-delayed manifestations of some toxic effects and the wide-spectrum of symptoms caused by heavy metal poisoning may perplex the clinical diagnosis and, when involved in crimes, complicate the forensic investigation. To investigate the original intoxication process of a thallium poisoning case, which occurred in China more than two decades ago, laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) was used to analyze several hairs of the victim from before, during and after the poisoning period. Ablation line scans of the entire length of a ∼7cm hair revealed ∼4months of repeated exposure to thallium with increased doses and frequency toward the end, while scan of a ∼0.7cm hair revealed ∼2weeks of constant ingestions of large doses of thallium accompanied by elevated amount of lead. The endogenous origin of thallium was confirmed by the preservation of the same longitudinal distribution profile in the inner part of hair, but the source of lead could not be unambiguously determined due to the intrinsic limitation of hair analysis to distinguish ingested lead from exogenous contaminants. The overall thallium distribution profiles in the analyzed hairs suggested both chronic and acute thallium exposures that correlated well with the sequential presentation of a plethora of symptoms experienced by the victim. Aligning the time-resolved thallium peaks with symptoms also provided clues on possible routes of exposure at different poisoning stages. This work demonstrated the capability of using single hair LA-ICP-MS analysis to reconstitute a prolonged and complicated heavy metal poisoning case, and highlighted the necessity of assessing multiple elements in the medico-legal investigation of suspicious heavy metal poisonings.