Rapid determination of N-acetyl-4-aminophenol (paracetamol) in urine by tandem mass spectrometry coupled with on-line clean-up by two dimensional turbulent flow/reversed phase liquid chromatography.

N-Acetyl-4-aminophenol (NAAP) is the major urinary metabolite of aniline. The general population is known to be ubiquitously exposed to aniline through various sources. Furthermore, NAAP, known under the trade name paracetamol (resp. acetaminophen), is one of the most commonly used over-the-counter analgesics. Recent studies suggest anti-androgenic properties of NAAP. Although NAAP has been used as a pain reliever over decades and its role in aniline metabolism is well known there is a lack of internal exposure data both in environmental and occupational settings. To determine the internal NAAP exposure of the general population, workers exposed to aniline and users of paracetamol we developed a fast on-line HPLC-MS/MS method with isotope dilution quantification of NAAP after enzymatic hydrolysis of its conjugates in urine. We achieved minimal sample pretreatment through on-line extraction and enrichment of the analyte by turbulent flow chromatography on a Waters Oasis HLB phase followed by back-flush transfer onto the analytical column. The limit of quantification (LOQ) was 0.75 μg/L. In a pilot study, urine samples of 21 volunteers, not occupationally exposed to aniline, were analyzed for NAAP. NAAP was detected in all samples in a wide concentration range between 8.7 μg/L and 22100 μg/L (median 85.7 μg/L). The highest concentration was measured in a volunteer who took paracetamol one day ago. Half of the volunteers quoted to either never have taken paracetamol or at least not during several weeks before the study. Therefore, other routes of exposure than direct use of paracetamol, like aniline or paracetamol contaminated foodstuff, leading to the NAAP excretions have to be taken into account.