Biol. Pharm. Bull. 29(1) 7—13 (2006)

festival in Wakayama prefecture, Japan, was laced with an arsenic compound. In the following month, a case was reported in Niigata prefecture in which sodium azide was added to a pot of tea. Subsequently, there was a series of cases involving the poisoning of tea or fruit juice across Japan, which caused health problems in many citizens and were fatal to others. The Japanese Ministry of Health, Labor and Welfare reacted to those events with great urgency, supplying the 73 Resuscitation and Emergency Centers nationwide with equipment for analyzing the substances responsible for poisonings. To establish a standard approach for the effective use of the distributed equipment, the Japanese Society for Clinical Toxicology (JSCT) suggested: 1) drawing up lists of substances that cause toxicosis and had resulted in deaths, toxic substances for which physicians most frequently request analysis, and toxic substances for which specific treatment methods already exist; and 2) identifying 15 toxic substances or groups of toxic substances that should be subjected to qualitative analysis at the centers where the analyzers had been distributed, e.g., methanol, benzodiazepam compounds, triand tetracyclic antidepressants, organophosphorus pesticides, carbamate pesticides, glufosinates (herbicides), paraquat, arsenic compounds, cyanides, methamphetamines, salicylic acid, acetaminophen, theophylline, barbiturates, and bromvalerylurea. In addition, the JSCT suggested that it was necessary to perform quantitative analysis on methanol, glufosinates, arsenic compounds, salicylic acid, acetaminophen, theophylline, and barbiturates, for which the concentrations in biological samples can be used to determine the most effective treatment method, and paraquat, for which the concentration in samples can predicted the likelihood of patient survival. Analytical methods that are valuable in the clinical setting must not only be accurate and highly specific, they must also be rapid, making it possible for quick decisions to be made on the best possible treatment method. In particular, for toxic substances that require quantitative analysis to be performed after qualitative analysis, it is convenient to be able to carry out quantitative analyses simultaneously with screening for multiple substances. However, it is difficult to analyze all of the substances listed above with their differing chemical properties at the same time. As the literature shows, of the above toxicosis-inducing substances that must be subjected to both qualitative and quantitative analyses, methanol, glufosinates, and paraquat, are suitable for rapid methods of qualitative and quantitative analyses. Moreover, specimens containing arsenic compounds can rapidly be analyzed qualitatively and quantitatively using the energy-dispersion X-ray fluorescence analyzers distributed by the Ministry of Health, Labor and Welfare to the Resuscitation and Emergency Centers; this is also a useful method of analysis in the diagnosis of acute poisoning and determining effective treatment January 2006 7 Biol. Pharm. Bull. 29(1) 7—13 (2006)