This study was designed to verify the applicability of a modified Apt
test to blood stains on cloth and to determine whether the time of tes
ting affects the accuracy of the results. We collected cord blood samp
les from full-term newborns (n = 35) and venous blood samples from gra
vid females (n = 30) and applied them in a random fashion with a cotto
n swab to standard cloth diapers. A blinded investigator applied an al
kali solution to each stain and recorded either color change or no col
or change. In addition, a time course was performed by applying infant
(n = 4) and adult (n = 4) samples to a cloth diaper at an initial sta
rting point and varying the time of the performance of our modified te
st in intervals up to four hours. Thirty-four of 35 infant samples had
no color change, and 29 of 30 adult samples had an easily identified
color change. The time course revealed that the samples were indisting
uishable after 30 minutes had elapsed. Therefore, a modified Apt test
can be used successfully to differentiate between adult and infant blo
od stains of nonstool origin, only if performed within 30 minutes of t
he time the stain is produced. This restriction is significant in the
emergency department setting.