[Toxicological analysis at the beginning of the third millennium: promising new applications and future implications]

Enormous progress has been made in clinical toxicology over the last two decades, notably in the detection of pollutants. Chromatographic techniques have now replaced colorimetric reactions, which were non specific and poorly sensitive. Mass spectrometry has largely supplanted immunological methods, and is now coupled to gas phase (GC-MS or GC-MS/MS), liquid phase (LC-MS or LC-MS/MS) or induced coupled plasma spectrometry (ICP-MS). Few substances responsible for clinical syndromes now escape detection, be they medicinal drugs, plant products, pesticides, drugs of abuse, drugs used for criminal purposes, metals, metalloids, or poisons. Forensic medicine has benefited from these advances, notably in the fields of post-mortem toxicology, driving under the influence of drugs of abuse, and drug-facilitated crime. Rapid advances are being made in occupational and environmental monitoring of new substances with poorly documented toxicity. The French National Health and Environment Program, launched on 9 August 2004, specifically takes this problem into account. The author presents recent personal laboratory results illustrating the potential of these new techniques.