Cannabis detection in hair typically relies on Δ9-tetrahydrocannabinol (THC), but interpretation is limited by its lipophilicity, external contamination, and washout. The metabolite 11-nor-9-carboxy-THC (THC-COOH) is considered a more specific biomarker, though often present at much lower concentrations than THC. Cases with THC-COOH detected without THC present an interpretative challenge. This study investigated the prevalence, segmental distribution, and significance of hair samples positive for THC-COOH in the absence of THC in a forensic cohort monitored for driving license regranting. Hair (n = 639), blood (n = 198), and urine (n = 221) were collected. Hair was segmented (0-3 cm proximal, 3-6 cm distal) and analyzed using validated UPLC-MS/MS for THC, CBN, CBD, and THC-COOH. Cutoffs were THC ≥ 50 pg/mg and THC-COOH ≥ 0.2 pg/mg. Self-reported use was recorded and compared to biological results using phi (φ) coefficients. Of 639 hair samples, 276 were negative, 207 positive for both THC and THC-COOH, 76 positive for THC-COOH only, and 52 positive for THC only. THC-COOH-only cases included 29 with both segments positive. Median proximal hair concentrations (pg/mg) were THC-COOH 3, THC 340, CBD 270, CBN 170, higher than distal segments. Concordance with self-report improved when THC-COOH was considered when detected alone (φ up to 0.54). Wash tests of THC-COOH-only hair (n = 100) were negative, confirming endogenous origin. THC-COOH detection in hair, even without THC, is valid evidence of cannabis use. Multi-matrix analysis and recognition of THC-COOH as a primary marker improve abstinence monitoring and support updates to forensic guidelines.

Alcohol consumption is widespread worldwide and a leading cause of injuries, morbidity, and mortality. Accurately detecting alcohol use with reliable biomarkers is crucial in clinical and forensic settings. Direct alcohol biomarkers, i.e., ethanol (EtOH), ethyl glucuronide (EtG), ethyl sulphate (EtS), phosphatidylethanol 16:0/18:1 (PEth) reflect short- and long-term consumption. Nevertheless, complementary biomarkers with improved specificity and sensitivity are needed to better assess alcohol use, including generating a detailed timeline of consumption. In vitro exposure of HepaRG liver cells to EtOH resulted in the generation of ethylated phosphorylcholine (EtOChoP). This is the first study to investigate the in vivo presence of EtOChoP and its occurrence in medico-legal samples. Proof-of-concept and observational studies assessed EtOChoP, PEth, EtG, EtS, and EtOH in whole blood, and, when available, other matrices were analyzed for EtG, EtS (plasma, serum, urine, hair), EtOH (urine), and EtOChoP (plasma, serum). A single alcohol exposure event (0.5 g/kg EtOH, with blood EtOH concentration peaking at 0.76 g/L at 100 min) led to EtOChoP presence, and, similar to short-term biomarkers (e.g., EtOH, EtG, and EtS in whole blood), EtOChoP was not detected in the following day(s). However, in the observational study, EtOChoP remained detectable even when short-term biomarkers were absent, resembling long-term biomarkers (PEth and hair EtG). Notably, 14% of samples were positive only for EtOChoP, highlighting the need for additional biomarkers. These findings identify EtOChoP as a promising alcohol (ab)use biomarker formed after EtOH consumption and possibly accumulating during chronic drinking. EtOChoP could potentially differentiate between recent drinking and chronic problematic drinking in individuals with high PEth levels.

Aim During in vitro exposure of HepaRG liver cells to ethanol, untargeted metabolomics revealed the formation of ethylated phosphorylcholine (EtOChoP), a metabolite which was not reported before [1], [2]. To determine its role as a potential new biomarker for alcohol use and its detection window, a single alcohol exposure study was performed on a teetotaler. Whole blood, plasma, and serum were analysed for EtOChoP and compared with levels of established alcohol use biomarkers, such as phosphatidylethanol 16: 0/18: 1 (PEth), ethyl glucuronide (EtG), ethyl sulphate (EtS), and ethanol (EtOH) in the same samples. Method For the analysis of EtOChoP in whole blood, serum, and plasma, a 96-well microplate liquid-liquid extraction was developed and validated. Briefly, 100μL sample and 250μL of ice cold (−80°C) methanol were added, and subsequently spiked with EtOChoP-D5, internal standard. After vortexing, the 96-well plate was placed on ice, sonicated briefly and left to equilibrate for 20min. After centrifugation, the supernatant was filtered through a 96-well filtration plate and further evaporated to dryness using nitrogen. The dried extract was reconstituted in 100μL MeOH: H2O(1: 1) and 5μL was injected in an Agilent 1290 Infinity LC/6495C triple quadrupole MS using a Restek Force Biphenyl column set at 60°C. The mobile phase was a mixture of water and 0.1% formic acid as solvent A, and methanol and 0.1% formic acid, as solvent B. The total run time was 8min. The MS/MS source was operated in positive mode. The monitored m/z transitions were 212.1 >126.0 (quantifier) and 86.1, 98.1(qualifiers) for EtOChoP, and 217.1 >126.0 (quantifier) and 86.1(qualifier) for EtOChoP-D5.Single alcohol exposure study design: after being abstinent for five months, a female volunteer was instructed to abstain from food and beverages (including water) for 12hours prior to the experiment. The volunteer consumed a dose of 0.5g ethanol per kilogram body weight in one minute as a 20% (w/v) ethanol solution in water. Whole blood, plasma, and serum were collected at point T0 (before the drinking), T30, T60, T80, T100, T120, T140, T160, T180, T240min and day 1, 2, 5 and 8 after the drinking experiment. Results EtOH, PEth, EtG and EtS, EtOChoP were not detected at T0 in all matrices. EtOH in whole blood showed an increase to 0.76g/L (T100), followed by a decrease to 0.32g/L at T240. EtOChoP in whole blood showed an increase in concentration from 0.73ng/mL (T30) to 1.57ng/mL (T80) followed by a decrease to 0.55ng/mL (T240). Even though, serum samples showed a higher concentration, it followed the same pattern as whole blood and plasma samples, an increase from T30 to T80 followed by a decrease until T240. The following days (D1, D2, D5 and D8), EtOH, EtG, EtS and EtOChoP were not detected in any of the matrices. PEth showed an increase in concentration from 6.6ng/mL (T30) to 18ng/mL (D1), followed by a decrease in D2, D5 and D8. Nevertheless, the concentrations of PEth did not exceed the 20ng/mL cutoff value, compatible with abstinence/low alcohol consumption [3]. Conclusion This proof of concept study shows that EtOChoP is detectable in different matrices after a single alcohol consumption, which demonstrates EtOChoP can be a promising new alcohol biomarker. The presence of EtOChoP up to 240min and its absence in the following day(s) shows that it could be a short-term alcohol biomarker, together with EtOH, EtG and EtS. Nevertheless, future studies are needed to determine its true potential as an alcohol biomarker, as this study looked only at a controlled single alcohol exposure.

AIM:Forensic examination of the hyoid-larynx complex (HLC) is crucial in diagnosing (inflicted) neck trauma. Clinical Total-Body CT (TBCT) scans of the (non-)calcified HLC lack sensitivity for fracture detection. Micro-computed tomography (micro-CT) is an upcoming imaging modality capable of scanning samples at microscale resolution up to 1 µm. Soft-tissue contrast can be established with iodine staining, known as diffusible iodine-based contrast-enhanced CT (diceCT). We study the additional value of micro- and diceCT in detecting HLC fractures and hemorrhages in forensic cases, compared to standard forensic imaging techniques and findings at autopsy. MATERIALS AND METHODS:Fifteen, during forensic autopsy excised, adult HLCs were scanned with micro-CT. Subsequently, the samples were stained with buffered Lugol's solution (B-Lugol) and scanned with contrast-enhanced micro-CT. The scans were examined on fractures and hemorrhages. Total body CT, optimized clinical CT of the explant and autopsy reports were compared with the micro- and diceCT scans and the results were confirmed using histological examinations. RESULTS:Sixteen potential fractures were identified in the micro-CT scans and with diceCT, nine hyperdensities were detected around potential fractures. Two previously undiscovered vital fractures were found, which were verified by histological examination. CONCLUSIONS:This research demonstrated that micro-CT can be a valuable tool to detect fractures of the HLC in forensic neck trauma cases and diceCT enables us to image the injured HLC in detail and indicate possible hemorrhages. With increasingly better stain and scan protocols and more experience gained by forensic radiologists, micro-CT could become invaluable for the examination of HLC trauma.

We aimed to investigate the potential added value of postmortem MRI (PMMRI) in sudden unexpected infant death (SUID) cases referred to our center between September 2020 and June 2023. Ultimately, 19 SUID cases underwent PMMRI alongside standard autopsy procedures, which included technical examinations such as postmortem CT (PMCT). Four radiologists, two with prior PMMRI experience, provided structured reports following consensus. For each case, the responsible forensic medicine specialist documented the cause of death before and after reviewing the PMMRI report. Additionally, they assessed the overall impact of the PMMRI report and had the opportunity to provide written comments. The results of our study indicate that none of the PMMRI reports altered the prior determined cause of death, which included cases of infection, asphyxia, and sudden infant death syndrome (SIDS). However, we observed a moderate impact in one case and a low impact in 10 cases. The moderate impact arose from the PMMRI report identifying hypoxic-ischemic changes, where histologic examination of the brain was perceived as normal. Conversely, in the 10 cases with a low impact, the PMMRI reports supported the autopsy findings, specifically indicating brain injury and intra-alveolar cellular infiltrates. In conclusion, our study suggests that while PMMRI may not be pivotal in determining the cause of death in SUID cases, it could aid in detecting hypoxic-ischemic changes and reinforcing brain and lung observations. However, distinguishing genuine lung pathology from postmortem changes using PMMRI remains challenging. Further research is warranted to clarify the role of PMMRI in forensic SUID investigations.

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Assessing air quality's impact on human health involves monitoring pollutant concentrations such as NO2, O3, CO, SO2, and particulate matter. While high-income countries rely on expensive reference instruments, low-income nations face technological limitations. This study explores the potential of low-cost scientific devices as a viable solution for these regions. The research focuses on evaluating the reliability of low-cost NO2 sensors and consistency across five identical sensors. Calibration tests in controlled settings reveal a linear model with high coefficients of determination, contrasting with lower coefficients observed during field tests. Variability in intercepts and slopes is evident across time and campaign contexts. Time series analysis using low-cost NO2 sensors showed that many of the tall peaks atop a fluctuating baseline correlates with peaks identified by reference instruments. Additionally, NO gas sensors are also able to identify pollution peaks in monitoring campaigns. Therefore, such affordable sensors provide valuable insights into pollutant concentration trends, offering indicative magnitude information. However, improving calibration and reliability of these sensors necessitates further research.

The COVID-19 pandemic, which reached Belgium in early 2020, significantly impacted the country's healthcare system, including forensic medicine. Illustrating the knowledge vacuum the medical world was working in, the first ten patients arriving in Belgium were hospitalized in a police-secured medical facility. By 2021, Belgium was among the most severely affected countries in Europe, reporting over 730,000 cases and more than 21,000 COVID-19-related deaths. In response to these unprecedented challenges, forensic medicine implemented critical reforms to enhance operational safety and maintain service continuity during the crisis. The pandemic altered practices by intensifying morgue-based examinations and relying on postmortem CT (PMCT) scans as an initial screening method. Autopsy protocols were revised to incorporate protective measures and collaboration between forensic and anatomical pathology departments. Despite a surge in domestic violence and mental health issues during the pandemic, there was no corresponding increase in forensic cases. Through close interdepartmental collaboration, forensic services maintained pre-pandemic autopsy rates, contributing valuable insights into COVID-19 pathology and strengthening future preparedness. Lessons learned emphasize the importance of resilient forensic systems in addressing public health crises and enhancing the role of forensic medicine within healthcare.

Bladder toxicity associated with high-dose recreational ketamine use, is well-documented. However, the upper tract merits more attention because hydronephrosis may not solely stem from impaired bladder compliance and vesicoureteral reflux. We report an autopsy case of a 28-year-old man with extensive upper tract pathology, indicating that the direct effects of ketamine and its metabolites extend beyond the bladder. Urothelial denudation, chronic transmural inflammation, ureteric fibrosis, interstitial nephritis, and papillary necrosis in the kidney were observed. Our findings underscore the importance of assessing ureteral integrity before bladder surgery given that unrecognized strictures may complicate reconstructive procedures and lead to kidney failure.

The indoor air quality in the wheelhouse of an inland tanker was assessed through monitoring campaigns. The continuous-time measurements gathered data on NO2, O3, NO, CO, total volatile organic compounds (TVOC), and particulate matter (PM2.5). The time series exhibited irregular concentration profiles characterized by narrow and broader peaks atop a gradually fluctuating baseline. These peaks denote sudden environmental changes, occurring within specific time frames and locations, indicating moments of poorer indoor air quality. The synchrony between peaks of different pollutants suggests that many of the narrow pollution peaks originate from exhaust emissions. Previous research has indicated that exhaust gas in outdoor air could infiltrate the wheelhouse via the ventilation system. However, multiple factors within the ship's vicinity (e.g., nearby industries, specific manoeuvres, or passing vessels) could also contribute to the occurrence of pollution peaks in the wheelhouse. To explore the synchrony between pollution peaks in the wheelhouse and events in the surroundings of the ship, a time-lapse camera capturing time-stamped images of the ship's front view has been installed. Analysis of these images in conjunction with the simultaneous occurrence of pollution peaks as observed in time series indicates the existence of multiple pollution sources influencing the indoor air quality in the wheelhouse. The various sources of pollution form an interlinked network of hazards that collectively influence indoor air quality. Each source has the potential to induce changes within this network and can, to a certain extent, affect other hazards. Furthermore, non-polluting elements within this network also contribute significantly to the variable behaviour of the network. For example, crew decisions regarding navigation and manoeuvers play affect the dynamics of this network.

Toxicological data on overdose with HIV-inhibitors is scarce. We present a case report of two independent suicide attempts by self-administered overdose with the same antiretroviral medicine Genvoya® (emtricitabine/elvitegravir/tenofovir alafenamide/cobicistat). Both patients were admitted to the hospital and presented with a loss of consciousness, lactic acidosis, elevated hepatic transaminase levels and hemodynamic instability. While one patient survived with advanced supportive measures, the other passed away. Emtricitabine levels were measured in vivo in various consecutive serum samples and post-mortem urine, peripheral and cardiac serum samples and confirmed excessive use in both cases. This is the first time emtricitabine levels following overdose are reported. Although measured concentrations for emtricitabine were quite similar in these cases, metabolic acidosis was more pronounced in the fatal case. The difference in outcome between the two could be due to a difference in physiological status, susceptibility to accumulation and adverse effects, and perhaps a varying interval between ingestion and the start of supportive measures.

Monitoring long-term alcohol use and/or abstinence is essential in clinical and medico-legal cases. Analysis of ethyl glucuronide (EtG) in hair provides information on alcohol consumption over several months. However, there is a lag time between ethanol consumption, incorporation of EtG in the hair bulb and hair growing out of the scalp. Phosphatidylethanol (PEth) 16:0/18:1 analysis in whole blood has a detection window of 2-4 weeks, allowing for the detection of recent alcohol consumption. In this study, 2340 paired samples (of hair and venous whole blood from 1170 individuals) were analysed for EtG in hair (hEtG) and PEth 16:0/18:1 in venous whole blood. PEth 16:0/18:1 and hEtG results were subdivided into three categories according to the consensus of SoHT (hEtG) and PEth-NET (PEth): abstinence/low, moderate or excessive alcohol consumption. For hEtG analysis, 446 individuals presented abstinence/low alcohol consumption, of which 2% were classified as excessive alcohol users through PEth 16:0/18:1 analysis. This suggests excessive alcohol consumption in the weeks before sample collection. Out of 483 individuals classified as heavy alcohol users based on hEtG analysis, 14% showed abstinence/low alcohol consumption for PEth 16:0/18:1 analysis, implying that these subjects stopped drinking 2-4 weeks before sample collection. Our results show that the analysis of the two different biomarkers can lead to a more accurate categorisation of individuals. Therefore, we emphasize that for the retrospective investigation of alcohol use, it is necessary to include two alcohol use biomarkers with different detection windows.

Emergency departments are facing increasing numbers ofaccidents relatedto electrictwo-wheeleruse, resulting incraniocerebraland maxillofacial trauma. This article reports two cases of fatalneurotraumaaftere-scooter/speedpedelec (s-pedelec) falls. Bothcaseswere referred to the centre of forensic medicine because the relatedcircumstances were unclear and to rule out hit-and-run accidents.Case 1: A 23-year-old man was found lifeless next to his s-pedelec.Resuscitation was attempted but to no avail. Autopsy confirmedan occipital fracture with accompanying subdural hemorrhage.Toxicological analysis revealed a blood alcohol concentration (BAC)of 0.15% ( 150mg/dL g/I (Suggest to include here the relevantlegal limit for alcohol concentration in this jurisdiction)). Case 2:A 31-year-old man was found unconscious (GCS 3/15) next to hise-scooter. A CT scan revealed a fracture following the coronal sutureacross the vertex with accompanying subdural hemorrhage and afracture of the right zygomatic arch. Despite urgent neurosurgicaldecompression, intracerebral pressure continuedto rise. On admission,the patient was intoxicated with a BAC of 0.24% ( 240mg/dL).In Belgium, when riding an e-scooter with a maximum speed of 25km/h, there is no obligation to wear a helmet. The recently establishedminimum age for use is 16 years. S-pedelecs with a maximum speedof 45 km/h, are considered mopeds. Drivers must be over 16 yearsof age, required to have a driving license and to wear a helmet.In both fatalities, the drivers did not wear a helmet. Public campaignshave been started to draw attention to this risk .The Belgian legal framework for alcohol use is similar to that for driving a car.Relevant legislation in different continents is compared, along withrecommended advocacy for international harmonization of the legalframework.

In the Western world, the SO2 concentration in ambient air dropped to low levels, but some emission sources (e.g., merchant ships) and some regions (e.g., low-income countries) still emit substantial amounts of SO2. At those locations, SO2 monitoring is critical. However, low-income countries do not have much access to expensive reference instruments. Low-cost gas sensors might be an alternative, but it is unclear how reliable such measurements are. To evaluate the performance of the low-cost alternative, the same SO2 gas sensor has been subjected to three different calibration methods: (1) low-cost calibration performed in the tropical climate of Cuba; (2) high-end calibration performed in Belgium; (3) a field calibration at an air quality measuring station in Belgium. The first two methods showed similar trends, suggesting that the gas sensor can be calibrated with a low-cost method. The field calibration was hampered by the low SO2 concentrations. For the monitoring campaign in Cienfuegos, Cuba, the low-cost SO2 sensor calibrated by the low-cost method appeared to be sufficiently reliable. The reliability of the sensor increases with the increase in SO2 concentration, so it can be used in Cuba instead of Belgium.

AIMS:Severe acute respiratory syndrome coronavirus-2 infection causes COVID-19, which in severe cases evokes life-threatening acute respiratory distress syndrome (ARDS). Transcriptome signatures and the functional relevance of non-vascular cell types (e.g. immune and epithelial cells) in COVID-19 are becoming increasingly evident. However, despite its known contribution to vascular inflammation, recruitment/invasion of immune cells, vascular leakage, and perturbed haemostasis in the lungs of severe COVID-19 patients, an in-depth interrogation of the endothelial cell (EC) compartment in lethal COVID-19 is lacking. Moreover, progressive fibrotic lung disease represents one of the complications of COVID-19 pneumonia and ARDS. Analogous features between idiopathic pulmonary fibrosis (IPF) and COVID-19 suggest partial similarities in their pathophysiology, yet, a head-to-head comparison of pulmonary cell transcriptomes between both conditions has not been implemented to date. METHODS AND RESULTS:We performed single-nucleus RNA-sequencing on frozen lungs from 7 deceased COVID-19 patients, 6 IPF explant lungs, and 12 controls. The vascular fraction, comprising 38 794 nuclei, could be subclustered into 14 distinct EC subtypes. Non-vascular cell types, comprising 137 746 nuclei, were subclustered and used for EC-interactome analyses. Pulmonary ECs of deceased COVID-19 patients showed an enrichment of genes involved in cellular stress, as well as signatures suggestive of dampened immunomodulation and impaired vessel wall integrity. In addition, increased abundance of a population of systemic capillary and venous ECs was identified in COVID-19 and IPF. COVID-19 systemic ECs closely resembled their IPF counterparts, and a set of 30 genes was found congruently enriched in systemic ECs across studies. Receptor-ligand interaction analysis of ECs with non-vascular cell types in the pulmonary micro-environment revealed numerous previously unknown interactions specifically enriched/depleted in COVID-19 and/or IPF. CONCLUSIONS:This study uncovered novel insights into the abundance, expression patterns, and interactomes of EC subtypes in COVID-19 and IPF, relevant for future investigations into the progression and treatment of both lethal conditions.

Indoor air quality on board a 36-year-old ship has been characterized at several locations. The ship is dedicated to nearshore operations at the Belgian coast. This paper presents time-averaged and continuous-time measurements of several indoor pollutant concentrations such as NO2, O-3, NO, CO, total volatile organic compounds (TVOC), polycyclic aromatic hydrocarbons (PAH), particulate matter PM2.5 and PM10, black carbon, and individual organic compounds. Time-averaged measurements suggest that the ship's indoor air quality is sufficiently safe according to the prescribed occupational and nonoccupational health limits. However, the concentration of some indoor pollutants is comparable to that of the outdoor air of a large city such as Brussels, Belgium. Continuous-time analyses show that the temporal trends of indoor pollutant concentrations are inherently unstable. A large number of peaks or valleys are observed on a slowly fluctuating background. At some occasions, pollutant concentrations exceed the nonoccupational thresholds. Several pollutant peaks occur simultaneously, resulting in a pattern of peaks that is typical for a pollution source (e.g., exhaust gases entering the ship's castle through the ventilation inlet, human presence, and bunkering). This study illustrates that multiparameter monitoring campaigns give valuable information about the behaviour of pollution sources, facilitating the definition of mitigation actions.

Low-cost sensors provide an affordable alternative to monitor environmental parameters with acceptable performance. There is a substantial amount of literature where low-cost sensors are compared with high-end reference measurements. However, not all organizations have access to such reference infrastructure. We propose low-cost calibration methods for temperature, relative humidity, and CO2 to allow them to collect their own reliable data. These methods are based on simple techniques and procedures that allow temperature calibration to be achieved in the range of 0 to 50 °C, relative humidity from 0 to 90%, and CO2 between 0 and 1100 ppm. The materials used to create the calibration setups can be purchased online, at hardware stores, and in pharmacies. The reliability of the calibration methods was evaluated using several indicators, such as the airtightness of the calibration box, similarity with the factory calibration, similarity with the reference, similarity between different sensors, replicability of the calibration method, and the similarity with a golden standard. In addition, the results of the low-cost calibration methods were compared with the more advanced calibration methods. A short measurement campaign in the city of Santa Clara, Cuba, demonstrated that such calibrations transform in-house developed monitoring systems into valid low-cost scientific instruments for decision-making. This work creates opportunities for institutions and researchers hosted in low- and mid-income countries to build and validate their own equipment to reliably solve local problems.

This contribution shows the possibilities of applying a low-cost, multi-purpose data logger built around an Arduino Mega 2560 single-board computer. Most projects use this kind of hardware to develop single-purpose data loggers. In this work, a data logger with a more general hardware and software architecture was built to perform measurement campaigns in very different domains. The wide applicability of this data logger was demonstrated with short-term monitoring campaigns in relation to outdoor air quality, human activity in an office, motion of a journey on a bike, and exhaust gas monitoring of a diesel generator. In addition, an assessment process and corresponding evaluation framework are proposed to assess the credibility of low-cost scientific devices built in-house. The experiences acquired during the development of the system and the short measurement campaigns were used as inputs in the assessment process. The assessment showed that the system scores positively on most product-related targets. However, unexpected events affect the assessment over the longer term. This makes the development of low-cost scientific devices harder than expected. To assure stability and long-term performance of this type of design, continuous evaluation and regular engineering corrections are needed throughout longer testing periods.

Forensic pathology increasingly uses postmortem magnetic resonance imaging (PMMRI), particularly in pediatric cases. It should be noted that each (sudden and unexpected) death of an infant or child should have a forensic approach as well. Current postmortem imaging protocols do not focus adequately on forensic queries. First, it is important to demonstrate or rule out bleeding, especially in the brain. Thus, when incorporating PMMRI, a blood sensitive sequence (T2* and/or susceptibility weighted imaging (SWI)) should always be included. Secondly, as intracranial air might mimic small focal intracerebral hemorrhages, PMMRI should be preceded by postmortem CT (PMCT) since air is easily recognizable on CT. This will be illustrated by a case of a deceased 3-week-old baby. Finally, note that postmortem scans will often be interpreted by clinical radiologists, sometimes with no specific training, which makes this case report relevant for a broader audience.

Air quality in and around ships is governed by a variety of pollution sources that are unique for the shipping context. This makes the living and working conditions on ships substantially different from situations in cities or inside buildings. To gain insight into these differences, information about trends and absolute pollutant amounts on board ships is needed. However, the installation of reference instruments to monitor NO2, NO, O3, particulate matter and other environmental parameters is often not possible because of their size, weight or because of safety reasons. For that reason, more compact devices incorporating a variety of sensors are a good alternative. However, the use of such sensors is only possible when their behaviour and performance in a shipping context are well understood. To study this context, we were allowed to compare sensor-based measurements performed on a 36-year old ship dedicated to near shore operations with measurements of reference-grade instruments. Additional behavioural information of sensors is obtained by measuring campaigns organized on several inland ships. This contribution demonstrates that trends registered by gas and particulate matter sensors are reliable but that insufficient detection limits, higher noise, imperfect calibration and sensor errors result in some reliability constraints.