June 2009 EyeCheck ® Pupillometery WELCOME PRESENTED TO: AngloGold Ashanti (Pty) Ltd Presented by: Imelda Neate June 17 th, 2009

June 2009 COMPANY INTRODUCTION Africa – DTA (Pty) Ltd Australia – DTA (Pty) Ltd New Zealand – DTP (Pty) Ltd Europe – EyeCheck ® Europe

June 2009 PRODUCTS AND SERVICES Diagnostic testing equipment –In-vitro test kits (on-site) Substance of Abuse Tests Cardiac Markers Infectious Disease tests Tumour Marker Tests –Devices EyeCheck ® Fit for Duty programs –Fatigue management –Substance of Abuse

June 2009 PRODUCTS AND SERVICES II Testing Service –On-site testing service using qualified Testing Officers –Laboratory confirmation testing Legal services –Workplace policy together with Deloitte legal Training courses –Testing Officer –Education and awareness

June 2009 WHAT IS PUPILLOMETERY? Imaging - relevant Scattered light – absolute The reaction or reflex of the human pupil to light and its characteristics provides invaluable information and insight to the brain sensory and motor function. Pupillometry is the measuring of pupil dynamics by means of a light

June 2009 PUPIL PHYSIOLOGY Impairment is controlled by the Central Nervous System (CNS) The parasympathetic nervous system Relaxed ”slows down” the electrical system of the body The sympathetic nervous system ”speeds up” the electrical system of the body The two systems working together keeps the body in balance

June 2009 PUPIL REACTION Depending on the strength of the light source, the pupil contracts and dilates.

June 2009 PUPILLOMETERY GENERAL MEDICAL PRACTICE Pen lights are usually used on pupils in medical offices to assess CNS function for response and size patterns. PUPIL CARD Police officers who are highly trained in detecting and recognizing impairment caused by substances, examines arrestee’s pupils for size and response patterns.

June 2009 THE PUPIL CARD

June 2009 PUPIL SIZE CHANGE Is there a difference between pupil size change? NormalNormal AbnormalAbnormal AbnormalAbnormal

June 2009 SELECTING A SCREENING TOOL What criteria should be taken into consideration when selecting a screening tool?

June 2009 SELECTION CRITERIA High sensitivity and specificity Strong positive and negative predictive values Medically accepted practice Simple and practical to use Low unit cost Capacity to detect impairment

June 2009 CURRENT AVAILABLE TESTING METHODS Measurement of signs using DRE-type protocols Saliva testing Urine testing Blood testing Observation of general signs of impairment

June 2009 “CONS” OF CURRENT TESTING METHOFS Expense Time consuming Invasive Body Fluid exposure Tests are limited by “ cut off levels ” In some case impairment not detected

June 2009 THE EyeCheck ® PUPILLOMETER MCJ Inc. – The USA

June 2009 THE EyeCheck ® PUPILLOMETER II Optical instrument that measures absolute pupil dynamics by a light stimulus Hand held, weighing 1.1 kg’s Software driven from a lap top or tower Screens for human impairment Pass/Fail indicator

June 2009 INPUT PRINCIPLE An optical beam is “input” into the eye The eye focuses the beam onto the retina where it is scattered Retina Pupil Scattered Beam Input IR Beam Output collimated beam

June 2009 INPUT PRINCIPLE II Some of the scattered light returns from the eye in an optical beam The optical power is measured over a period of time Retina Pupil Scattered Beam Input IR Beam Output collimated beam

June 2009 INPUT PRINCIPLE III The optical power, measured over a period of time, provides the measurements relating to pupillary dynamics Retina Pupil Scattered Beam Input IR Beam Output collimated beam

June 2009 EyeCheck ® TESTING PROCEDURE EyeCheck ® determines alignment of the test subject’s pupil looking at the target 30 second dark adaptation A flash of light (100 milliseconds) occurs causing the pupil to respond EyeCheck ® scans and measures the response for three (3) seconds Only one scan is taken Results are instant

June 2009 TEST PROCEDURE - OPTICAL PATTERN The user is instructed to focus on the cross in the middle whilst still being able to see the complete circle – eye alignment – the user can blink

June 2009 TEST PROCEDURE – DARK ADAPTION

June 2009 TEST PROCEDURE – DO NOT BLINK The user will see a small short flash of light appear

June 2009 TEST PROCEDURE – USER BLINK Within a few seconds, the user will be able to blink again

June 2009 TEST PROCEDURE - SCAN RESULTS

June 2009 TEST PROCEDURE – PASS / FAIL RESULT

June 2009 CURRENT TESTING SOFTWARE AVAILABLE Substances –Alcohol and drugs including narcotics Fatigue Bio-Chemicals Diabetes Deception

June 2009 SOFTWARE BEING DEVELOPED HIV Malaria Dengue Fever Chikungunya Fever Alzheimers

June 2009 WORKING DEFINITION OF “DRUGS” Any substance which, when taken into the human body, can impair the ability of the person to operate a motor vehicle or function properly. Source: US National Highway Transportation Safety Administration

June 2009 NORMAL RESPONSE CURVE

June 2009 RESPONSE CURVE – BAC 0.10

June 2009 RESPONSE CURVE - BENZODIAZEPINES Such as Valium

June 2009 RESPONSE CURVE - MARIJUANA

June 2009 RESPONSE CURVE – NARCOTIC ANALGESICS

June 2009 DEFINITION OF “FATIGUE” Fatigue: A condition characterized by a lessened capacity for work and reduced efficiency of accomplishment. Fatigue can be acute and come on suddenly or chronic and persist.

June 2009 FATIGUE AND SUBSTANCES Fatigue sufferers are susceptible to increase their intake of Alcohol Drugs Medication (cross counter and prescribed) Leads to further stresses on the body, increases the fatigue levels and can also lead to substance dependence (addiction)

June 2009 MANAGING FATIGUE IN THE WORKPLACE Management program Testing Monitoring

June 2009 MANAGING AND MONITORING Fatigue Management program Continues monitoring Testing Adjusting

June 2009 MEXICO SUCCESS – GRUPO TRANSPAIS Tampico – Monterrey – Tampico. (1042 km. Round Trip) –Start on September 9th. –Total Drivers Tested: 159. –Total Kms. drived: 1,012,122 FATIGUED Drivers Tested: 58 Kms drived: 333,740 Drivers Tested: 46 Kms drived: 338,100 Drivers Tested: 55 Kms drived: 340,282

June 2009 MEXICO SUCCESS – GRUPO TRANSPAIS II Tampico – Reynosa – Tampico. (1012 Kms. Round Trip) –Start on Octuber 20th –Total Drivers Tested: 213 –Total Kms. drived: 1,357,410 FATIGUED Drivers Tested: 72 Kms drived: 452,767 Drivers Tested: 76 Kms drived: 460,719 Drivers Tested: 65 Kms drived: 443,924

June 2009 MEXICO SUCCESS – GRUPO TRANSPAIS III Tampico – Matamoros – Tampico. (1000 Kms. Round Trip) –Start on Octuber 20th –Total Drivers Tested: 246 –Total Kms. drived: 1,147,580 Drivers Tested: 107 Kms drived: 388,570 Drivers Tested: 63 Kms drived: 388,080 Drivers Tested: 76 Kms drived: 370,930 FATIGUED

June 2009 SOME OF EyeCheck ® END USERS USA… –Law Enforcement, –Probation, –Prisons, –Industry Australia.. –Law Enforcement, –Mines, –Sugar Industry Mexico.. –Transportation Denmark… –Military United Kingdom.. –Under Ground Metro Spain…... –Law Enforcement, –Aviation, –Drug Rehab.

June 2009 STUDIES - Illinois State Police Study December 2003 – CONCLUSION “ EyeCheck  Pupillometry can measure a physiological sign of impairment. It will not determine if a person was impaired several days ago and now has recovered to normal. Conversely, the use of urine tests may indicate the presence of a drug or substance, but not impairment at that time. “ “ EyeCheck  Pupillometry has demonstrated its usefulness as a tool in screening for impairment. Overall, it appears to be a valid and cost effective tool for its intended purpose. It requires minimal training to operate, is portable, and is adaptable to a variety of testing and screening programs. “ Dr. Jack Richman, Board member IACP, TAP

June 2009 FURTHER STUDIES AND REPORTS Refer to handouts

June 2009 THANK YOU