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Jones AW. Brief history of the alcohol biomarkers CDT, EtG, EtS, 5-HTOL, and PEth. Drug Test Anal 2024; 16:570-587. [PMID: 37806783 DOI: 10.1002/dta.3584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
This article traces the historical development of various biomarkers of acute and/or chronic alcohol consumption. Much of the research in this domain of clinical and laboratory medicine arose from clinics and laboratories in Sweden, as exemplified by carbohydrate deficient transferrin (CDT) and phosphatidylethanol (PEth). Extensive studies of other alcohol biomarkers, such as ethyl glucuronide (EtG), ethyl sulfate (EtS), and 5-hydroxytryptophol (5-HTOL), also derive from Sweden. The most obvious test of recent drinking is identification of ethanol in a sample of the person's blood, breath, or urine. However, because of continuous metabolism in the liver, ethanol is eliminated from the blood at a rate of 0.15 g/L/h (range 0.1-0.3 g/L/h), so obtaining positive results is not always possible. The widow of detection is increased by analysis of ethanol's non-oxidative metabolites (EtG and EtS), which are more slowly eliminated from the bloodstream. Likewise, an elevated ratio of serotonin metabolites in urine (5-HTOL/5-HIAA) can help to disclose recent drinking after ethanol is no longer measurable in body fluids. A highly specific biomarker of hazardous drinking is CDT, a serum glycoprotein (transferrin), with a deficiency in its N-linked glycosylation. Another widely acclaimed biomarker is PEth, an abnormal phospholipid synthesized in cell membranes when people drink excessively, having a long elimination half-life (median ~6 days) during abstinence. Research on the subject of alcohol biomarkers has increased appreciably and is now an important area of drug testing and analysis.
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Affiliation(s)
- Alan Wayne Jones
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, University of Linköping, Linköping, Sweden
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Herzog J, Skopp G, Musshoff F. Development and Validation of Seven Phosphatidylethanol Homologues in Dried Blood Spots Including Preliminary Results after Excessive Use of an Ethanol-Based Hand Sanitizer. J Anal Toxicol 2023; 47:245-252. [PMID: 36287059 PMCID: PMC9620346 DOI: 10.1093/jat/bkac086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Phosphatidylethanol (PEth) has become a widespread marker offering an up to 4-week retrospective window to detect alcohol use. Due to the pandemic of coronavirus disease 2019, ethanol-based hand sanitizers are frequently used. The aim of this study was to develop and validate a method for the determination of up to seven different homologues of PEth from dried blood spots (DBSs) after use of an ethanol-based hand sanitizer. The objectives of its preliminary application were to prove whether a threshold of 20 ng/mL for PEth 16:0/18:1 is reached and whether other homologues are formed as well as if positive findings of urinary ethyl glucuronide (UEtG) can be observed with respect to assess monitoring of abstinence control programs. Ten volunteers (8 occasional and 2 regular drinkers) were recruited to excessively use an ethanol-based hand sanitizer on 5 successive days. DBSs and urine samples were collected daily. PEth and UEtG were determined by liquid chromatography--tandem mass spectrometry. In total, two volunteers with initial PEth 16:0/18:1 concentrations of 19.3 and 14.6 ng/mL exceeded the threshold of 20 ng/mL six times. Subjects drinking daily or almost daily had starting PEth 16:0/18:1 concentrations of 242 and 354 ng/mL, showing a decline of PEth concentrations in six out of the seven homologues over 5 days. In teetotalers, formation of PEth species could not be observed. Thus, not satisfying requirements in an alcohol monitoring program with initial PEth-negative blood cannot be explained by a frequent use of ethanol-based hand sanitizer only. In cases of regular alcohol consumption, PEth homologues are not likely to be further influenced. However, results indicated that individuals with a PEth concentration close to 20 ng/mL are at risk of exceeding the threshold by using ethanol-based hand sanitizer.
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Affiliation(s)
- Josefine Herzog
- Corresponding author: Josefine Herzog Forensic Toxicological Center (FTC) Munich Dessauerstr. 13-15, 80992 Munich, Germanye-Mail:
| | - Gisela Skopp
- Forensic Toxicological Center Munich, Munich, Germany
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Gloekler LE, de Gandiaga EJ, Binczewski NR, Steimel KG, Massarsky A, Kozal J, Vincent M, Zisook R, LaGuardia MJ, Dotson S, Gaffney S. Evaluation of the Safety and Efficacy of Hand Sanitizer Products Marketed to Children Available during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14424. [PMID: 36361303 PMCID: PMC9655340 DOI: 10.3390/ijerph192114424] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Hand sanitizer use in the United States (U.S.) increased after the SARS-CoV-2 outbreak. The U.S. Food and Drug Administration (FDA) released temporary manufacturer guidance, changing impurity level limits for alcohol-based hand sanitizers (ABHSs). Since the guidance took effect, the FDA has recommended against using these hand sanitizers due to concerns over safety, efficacy, and/or risk of incidental ingestion. To address current gaps in exposure characterization, this study describes a survey of ABHSs marketed to children available in the U.S., as defined by several inclusion criteria. A subset of ABHSs (n = 31) were evaluated for ethanol and organic impurities using a modified FDA method. Products with detectable impurity levels were compared to the FDA's established interim limits. Seven children's products had impurity levels exceeding the FDA's recommended interim limits, including benzene (up to 9.14 ppm), acetaldehyde (up to 134.12 ppm), and acetal (up to 75.60 ppm). The total measured alcohol content ranged from 52% to 98% in all hand sanitizers tested, ranging from 39% below, and up to 31% above, the labeled concentration. Future studies should confirm impurity contamination sources. A risk assessment could determine whether dermal application or incidental ingestion of impurity-containing hand sanitizers pose any consumer risk.
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Affiliation(s)
| | | | | | | | | | - Jordan Kozal
- Stantec (ChemRisk), San Francisco, CA 94104, USA
| | | | | | - Mark J. LaGuardia
- Virginia Institute of Marine Science, William & Mary, Gloucester Point, VA 23062, USA
| | - Scott Dotson
- Insight Exposure and Risk Sciences Group, Cincinnati, OH 45249, USA
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Jiang J, Ding X, Isaacson KP, Tasoglou A, Huber H, Shah AD, Jung N, Boor BE. Ethanol-based disinfectant sprays drive rapid changes in the chemical composition of indoor air in residential buildings. JOURNAL OF HAZARDOUS MATERIALS LETTERS 2021; 2:100042. [PMID: 34977843 PMCID: PMC8423670 DOI: 10.1016/j.hazl.2021.100042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has resulted in increased usage of ethanol-based disinfectants for surface inactivation of SARS-CoV-2 in buildings. Emissions of volatile organic compounds (VOCs) and particles from ethanol-based disinfectant sprays were characterized in real-time (1 Hz) via a proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) and a high-resolution electrical low-pressure impactor (HR-ELPI+), respectively. Ethanol-based disinfectants drove sudden changes in the chemical composition of indoor air. VOC and particle concentrations increased immediately after application of the disinfectants, remained elevated during surface contact time, and gradually decreased after wiping. The disinfectants produced a broad spectrum of VOCs with mixing ratios spanning the sub-ppb to ppm range. Ethanol was the dominant VOC emitted by mass, with concentrations exceeding 103 μg m-3 and emission factors ranging from 101 to 102 mg g-1. Listed and unlisted diols, monoterpenes, and monoterpenoids were also abundant. The pressurized sprays released significant quantities (104-105 cm-3) of nano-sized particles smaller than 100 nm, resulting in large deposited doses in the tracheobronchial and pulmonary regions of the respiratory system. Inhalation exposure to VOCs varied with time during the building disinfection events. Much of the VOC inhalation intake (>60 %) occurred after the disinfectant was sprayed and wiped off the surface. Routine building disinfection with ethanol-based sprays during the COVID-19 pandemic may present a human health risk given the elevated production of volatile chemicals and nano-sized particles.
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Affiliation(s)
- Jinglin Jiang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, United States
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN, United States
| | - Xiaosu Ding
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, United States
| | - Kristofer P Isaacson
- Division of Environmental and Ecological Engineering, Purdue University, West Lafayette, IN, United States
| | | | - Heinz Huber
- Edelweiss Technology Solutions, LLC, Novelty, OH, United States
| | - Amisha D Shah
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, United States
- Division of Environmental and Ecological Engineering, Purdue University, West Lafayette, IN, United States
| | - Nusrat Jung
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, United States
| | - Brandon E Boor
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN, United States
- Ray W. Herrick Laboratories, Center for High Performance Buildings, Purdue University, West Lafayette, IN, United States
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5
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Letter in Reply. J Addict Med 2021; 16:e67. [DOI: 10.1097/adm.0000000000000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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6
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Letter to the Editor (RE. J Addict Med 2021; 16:e66. [DOI: 10.1097/adm.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Role of Alcohol Biomarkers in Detecting a Physician's COVID-19-Related Acute Stress Response: A Case Report. J Addict Med 2021; 16:e62-e65. [PMID: 33941756 PMCID: PMC8815638 DOI: 10.1097/adm.0000000000000865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Alcohol biomarkers are used to detect alcohol exposure in clinical and forensic settings. This includes professional health program (PHP) monitoring of healthcare workers in recovery from substance use disorders. Here we present the case of a physician whose positive alcohol biomarker test result was complicated by a traumatic stress response to frontline work during COVID-19. METHODS An anesthesiologist under PHP monitoring for substance use disorder and depression was interviewed extensively, urine and blood biomarkers were obtained, and longitudinal structured and semi-structured interviews related to anxiety, depression, posttraumatic stress, and cravings were used to monitor responses to the unanticipated death of a patient who succumbed to COVID-19. RESULTS After an initial positive ethylglucuronide (EtG) and ethylsulfate (EtS) toxicology test result, all subsequent testing was negative. Standardized assessments and clinical interviews provided documentation of a post-traumatic stress reaction. The physician described compulsive sanitizing of hands/arms and mask with highly concentrated ethanol-based products. CONCLUSIONS Inhalation of ethanol vapors is a possible explanation for the initial positive EtG/EtS results. To our knowledge, this case represents the highest reported levels of EtG/EtS likely due to workplace exposure. The importance of rapid intervention to thoroughly assess positive toxicology testing and its source(s) cannot be overstated, particularly as it relates to frontline healthcare workers during the pandemic. The PHP monitoring process provides an opportunity to promptly detect healthcare workers in distress, allowing for efficient connection to supportive resources and/or treatment when indicated, and possibly preventing escalation of symptoms or disease recurrence.
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Snozek CLH, Souers R, Dizon A, Magnani B, Krasowski MD. Ethanol Biomarker Testing and Challenges: Lessons Learned From a College of American Pathologists Proficiency Testing Survey. Arch Pathol Lab Med 2021; 145:1492-1498. [PMID: 33635953 DOI: 10.5858/arpa.2020-0699-cp] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Clinical and forensic testing for ethanol biomarkers including ethyl glucuronide (EtG) and ethyl sulfate (EtS) is used to discern alcohol use from abstinence. These markers can be key in major decisions including transplant eligibility or retaining licensure after alcohol misuse. Accuracy, precision, and recognition of the implications of reporting cutoffs are all essential for correct interpretation. OBJECTIVE.— To evaluate trends in testing for EtG and EtS, including how laboratories perform testing and how comparable participant results are. DESIGN.— The study examined the College of American Pathologists' ethanol biomarker proficiency testing survey from 2013 to 2019. Trends in methodology, reporting cutoffs, and participant performance were evaluated for qualitative and quantitative EtG testing and for quantitative EtS testing. RESULTS.— There was little consensus in reporting cutoffs, which ranged from 10 to 1000 ng/mL for EtG and 10 to 1500 ng/mL for EtS. Although median EtG and EtS compared well with target concentrations, individual participants' results varied widely. For quantitative enzyme immunoassay, accuracy and precision were best in EtG challenges less than 1500 ng/mL. For EtG or EtS by mass spectrometry, overall accuracy was good over a wide concentration range, but variability between participants was high. Approximately 10% (409 of 4059) of results were unacceptable, which for mass spectrometry corresponded to more than 35% above or below the group mean. CONCLUSIONS.— Although many participants performed well, there was insufficient consensus in reporting cutoffs and a consistent fraction of laboratories failed to achieve survey standards. Guidelines for assay performance and reporting could greatly benefit laboratories and end users.
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Affiliation(s)
- Christine L H Snozek
- Supplemental digital content is available for this article. See text for hyperlink. From the Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale (Snozek)
| | - Rhona Souers
- The Biostatistics Division (Souers), College of American Pathologists, Northfield Illinois
| | - Annabel Dizon
- Proficiency Testing Division (Dizon), College of American Pathologists, Northfield Illinois
| | - Barbarajean Magnani
- The Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, Massachusetts (Magnani)
| | - Matthew D Krasowski
- The Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City (Krasowski)
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Scholz C, Baumgartner MR, Madry MM. Use of Ethanol-Based Hand Disinfectants: Source of Increased Ethyl Glucuronide Levels in Hair? Alcohol Alcohol 2021; 56:38-41. [PMID: 32960282 PMCID: PMC7543280 DOI: 10.1093/alcalc/agaa091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/27/2022] Open
Abstract
Aim Due to the COVID-19 pandemic increasing the use of hand disinfectants, we investigated the effect of frequent use of ethanol-based hand disinfectants (EBHD) on the levels of the alcohol marker ethyl glucuronide (EtG) in hair. Method Hair samples were collected from 10 health professionals (8 nondrinkers, 2 rarely drinking individuals) and EtG was examined in hair. Result EtG (~2 pg/mg) was only detected in the hair sample of a nondrinker using EBHD 60–70 times per working day. Conclusion Our data provide no evidence that frequent EBHD use results in hair EtG levels above the recommended Society of Hair Testing cutoff for repeated alcohol consumption (5 pg/mg).
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Affiliation(s)
- Clementine Scholz
- University of Zurich, Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, Kurvenstrasse 17, 8006 Zurich, Switzerland
| | - Markus R Baumgartner
- University of Zurich, Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, Kurvenstrasse 17, 8006 Zurich, Switzerland
| | - Milena M Madry
- University of Zurich, Zurich Institute of Forensic Medicine, Center for Forensic Hair Analytics, Kurvenstrasse 17, 8006 Zurich, Switzerland
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Neumann J, Keller T, Monticelli F, Beck O, Böttcher M. Ethyl glucuronide and ethanol concentrations in femoral blood, urine and vitreous humor from 117 autopsy cases. Forensic Sci Int 2020; 318:110567. [PMID: 33234349 DOI: 10.1016/j.forsciint.2020.110567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 10/11/2020] [Accepted: 10/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vitreous humor (VH) is a specimen of great value in forensic investigations and is being used for evaluating possible post-mortem formation of ethanol. Ethyl glucuronide (EtG) is an ethanol metabolite that has found interest for the same purpose. Both compounds can be measured in VH and because of differences in rate of distribution and elimination they may offer complementary information. METHODS VH, femoral blood (FB) and urine were collected from 117 autopsy cases for forensic investigation. Ethanol was measured with headspace gas chromatography, while EtG was measured with liquid chromatography - tandem mass spectrometry. RESULTS AND CONCLUSION Ethanol was detected in all matrices in 39 cases, while EtG was present in 62 cases. The VH-FB and the VH-urine ethanol concentrations in the 39 cases were statistically correlated (p < 0.00001). In one case with an ethanol concentration of 0.11 g/L in FB, no ethanol was detected in VH and urine, and no EtG in any specimen, indicating a possible post-mortem formation. EtG was present in VH in more cases than in FB and urine. The correlation between the EtG concentrations in VH and FB was statistically significant (p < 0.0003) as was the case also for VH and urine (p < 0.001). The combined information on ethanol and EtG concentrations in the three matrices can be used to interpret alcohol drinking habit before death. This study confirms the value of using VH as a specimen in forensic investigations regarding recent exposure to ethanol. EtG can be used not only for investigating post-mortem ethanol formation but also for estimating recent alcohol drinking.
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Affiliation(s)
| | - Thomas Keller
- Institute of Forensic Medicine, University of Salzburg, Austria
| | | | - Olof Beck
- MVZ Labor Dessau GmbH, Dessau, Germany
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Brewer C, Streel E. Is Alcohol in Hand Sanitizers Absorbed Through the Skin or Lungs? Implications for Disulfiram Treatment. Alcohol Alcohol 2020; 55:354-356. [PMID: 32400852 PMCID: PMC7454269 DOI: 10.1093/alcalc/agaa045] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 12/03/2022] Open
Abstract
Aim In view of the increase in the use of ethanol-containing hand sanitizers throughout the world due to the current COVID-19 pandemic, we wished to review the possible risks to patients treated with disulfiram, following a case report in which an apparent DER (disulfiram–ethanol reaction) was attributed to the cutaneous absorption of alcohol from hand sanitizers as well as by inhalation of vapour. Method Simple experiments to assess the levels of absorption by each route separately. Results Our results strongly suggest that while amounts of alcohol sufficient to cause a DER may be inhaled when hand sanitizers are used in confined spaces, absorption can be avoided by dispersal of the fumes, and absorption from the skin alone does not occur in pharmacologically significant quantities. Conclusion Warnings about absorption of alcohol through the skin from hand sanitizers and products such as perfumes, deodorants and after-shave (whose use is often warned against when disulfiram is prescribed) should be modified accordingly.
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Affiliation(s)
- Colin Brewer
- Retired Psychiatrist and addiction Physician, London, SE1, London, UK
| | - Emmanuel Streel
- CHU Brugmann, Free University of Brussels, 1020, Brussels, Belgium
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Ratner MH, Ewing WM, Rutchik JS. Neurological effects of chronic occupational exposure to alcohol mists and vapors in a machinist. TOXICOLOGY COMMUNICATIONS 2020. [DOI: 10.1080/24734306.2020.1768341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Marcia H. Ratner
- Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | | | - Jonathan S. Rutchik
- Division of Medicine, Occupational Medicine, University of California at San Francisco, San Francisco, CA, USA
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Salomone A, Bozzo A, Di Corcia D, Gerace E, Vincenti M. Occupational Exposure to Alcohol-Based Hand Sanitizers: The Diagnostic Role of Alcohol Biomarkers in Hair. J Anal Toxicol 2018; 42:157-162. [PMID: 29206963 DOI: 10.1093/jat/bkx094] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 11/16/2017] [Indexed: 01/19/2023] Open
Abstract
Ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair are effective direct biomarkers of ethanol ingestion, whose analytical determination can be used to discriminate between chronic and occasional ethanol intake. Ethanol is a compound widely used in some workplaces (e.g., clinics, hospitals) and is present in considerable amounts in mouthwash for oral cleaning, medications, cosmetic products, hydro-alcoholic disinfectants and antiseptics for hands. This study examined the ethyl alcohol exposure derived from hand disinfectants (in gel form) by simulating the typical occupational situation of medical-health workers (healthcare workers, nurses, surgeons, etc.) who frequently wash their hands with antiseptic sanitizer. Two types of hand disinfectants with 62% w/w of ethanol content were daily applied to the hands of a teetotaler for 20 times a day, for 4 consecutive weeks, thus simulating a typical workplace situation and a cumulative dermal exposure to ethanol of ~1,100 g. Different matrices (head, chest and beard hair, urine) were regularly sampled and analyzed using a ultra high-performance liquid chromatography tandem massspectrometry validated method for EtG and a (HS)SPME-GC-MS validated technique for FAEEs. The data obtained showed that a significant dermal absorption and/or inhalation of ethanol occurred, and that the use of detergents produce urinary EtG concentrations both higher than the cut-offs normally used for clinical and forensic analyses (either 100 and 500 ng/mL, depending on the context). The concentrations of the ethanol metabolites in the keratin matrices were, respectively, below the cut-off of 7 pg/mg for EtG and below 0.5 ng/mg for FAAEs (0.35 ng/mg for ethyl palmitate). In conclusion, the regular use of alcohol-based hand sanitizers can affect the concentration of urinary EtG and lead to positive analytical results, particularly when specimens are obtained shortly after sustained use of ethanol-containing hand sanitizer. On the other hand, direct biomarkers of alcohol abuse in the keratin matrix are capable of distinguishing between ethanol consumption and incidental exposures.
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Affiliation(s)
- A Salomone
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - A Bozzo
- Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
| | - D Di Corcia
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - E Gerace
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy
| | - M Vincenti
- Centro Regionale Antidoping "A. Bertinaria", Regione Gonzole 10/1, 10043 Orbassano, Turin, Italy.,Dipartimento di Chimica, Università degli Studi di Torino, via P. Giuria 7, 10125 Turin, Italy
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Dziadosz M. Adduct Formation-Supported Two-Way Electrospray Ionization Strategy for the Determination of Urinary Creatinine Concentration with LC–MS-MS in Abstinence Control. J Anal Toxicol 2018; 42:625-629. [DOI: 10.1093/jat/bky042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/31/2018] [Indexed: 01/02/2023] Open
Affiliation(s)
- Marek Dziadosz
- Institute of Legal Medicine, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, Hannover, Germany
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Böttcher M, Kühne D, Beck O. Sevoflurane metabolite cross-react in the ethyl glucuronide DRI® immunoassay. Drug Test Anal 2018; 10:379-380. [DOI: 10.1002/dta.2233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 06/18/2017] [Accepted: 06/19/2017] [Indexed: 11/12/2022]
Affiliation(s)
| | - David Kühne
- MVZ Labor Dessau GmbH; Dessau-Rosslau Germany
| | - Olof Beck
- MVZ Labor Dessau GmbH; Dessau-Rosslau Germany
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Hsieh S, Sapkota A, Wood R, Bearer C, Kapoor S. Neonatal ethanol exposure from ethanol-based hand sanitisers in isolettes. Arch Dis Child Fetal Neonatal Ed 2018; 103:F55-F58. [PMID: 28588125 DOI: 10.1136/archdischild-2016-311959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/30/2017] [Accepted: 04/20/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The aims of this study is to measure the ethanol vapours in the isolette after use of hands cleaned with ethanol-based hand sanitiser (EBHS). METHODS Two squirts (1.5 mL) of hand sanitiser were rubbed on hands for 10 or 20 s before inserting the hands in the isolette for 5 min. Ethanol vapours were measured in the isolette with photoionisation detector and alcohol breathalyser for 30 min. RESULTS Peak ethanol concentration in the isolette was considerably higher with a 10 s hand rub (381±192 ppm) compared with a 20 s hand rub (99±50 ppm), and dissipated to ≤5 ppm within 30 min. Under routine care, EBHS use by care providers exposes neonates in isolettes to 3.7-7.3 or 1.4-2.8 mg/kg ethanol per day with 10 or 20 s hand rubs, respectively. The expected blood level from average single exposure is 0.036 mg/dL with 10 s hand rub and may increase further with multiple exposures in a short period. CONCLUSION Preterm neonates in the isolette are at risk of inadvertent exposure to ethanol. The expected blood alcohol level from this exposure is small and below 1 mg/dL level recommended by European Medicines Agency to limit the ethanol exposure in children. The unintended ethanol exposure can be avoided by rubbing hands for at least 20 s after applying EBHS.
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Affiliation(s)
- Shizuka Hsieh
- Chemistry Department, Trinity Washington University, Washington, DC, USA
| | - Amir Sapkota
- School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Rebecca Wood
- School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Cynthia Bearer
- Division of Neonatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Shiv Kapoor
- Division of Neonatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Strawsine E, Lutmer B. The Effect of Alcohol-Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results. J Forensic Sci 2017; 63:1284-1290. [PMID: 29143333 DOI: 10.1111/1556-4029.13691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/16/2017] [Accepted: 10/19/2017] [Indexed: 11/26/2022]
Abstract
This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15 min preceding subject testing.
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Affiliation(s)
- Ellen Strawsine
- Breath Alcohol Program, Missouri Department of Health and Senior Services, Poplar Bluff, MO, 63901
| | - Brian Lutmer
- Breath Alcohol Program, Missouri Department of Health and Senior Services, Poplar Bluff, MO, 63901
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Arndt T, Buschmann HC, Schulz K, Stemmerich K. Lessons learned from a case of tert-butyl glucuronide excretion in urine - "New" psychoactive alcohols knocking on the back door? Forensic Sci Int 2017; 281:9-12. [PMID: 29101909 DOI: 10.1016/j.forsciint.2017.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ethyl glucuronide (EtG) in urine is considered a marker of recent ethanol consumption or ethanol exposition. tert-Butanol is primarily used as a solvent and intermediate chemical. Like tert-amyl alcohol, tert-butanol is discussed in Internet forums as ethanol replacement. We discuss false-positive immunological EtG screenings by excretion of different alcohol glucuronides (EtG homologs), mainly tert-butyl glucuronide in urine of a polytoxikomanic in-patient. METHODS Three consecutive urine samples from an in-patient with a long history of multiple substance abuse including solvents were analyzed by DRI EtG enzyme immunoassay (ThermoFisher Scientific Microgenics) on a Beckman Coulter AU680 analyzer, an in-house LC-MS/MS for EtG, 1-propyl, 2-propyl, 1-butyl, 2-butyl, and tert-butyl glucuronide, and an in-house headspace GC-FID of free congener substances methanol, 1-propanol, 2-butanone, 2-butanol, isobutanol, 1-butanol, 3-methyl-1-butanol, 2-methyl-1-butanol, and additionally for ethanol, acetone, 2-propanol, tert-butanol and 2-methyl-2-butanol. RESULTS EtG immunoassay yielded two positive urine samples (0.2 and 0.6mg/L or 0.1 and 0.2mg/g creatinine; cut-off 0.1mg/L) which were tested EtG negative by LC-MS/MS (cut-off 0.1mg/L) but positive for tert-butyl glucuronide (3.7 and 27.1mg/L), 2-butyl glucuronide (1.1 and 3.5mg/L), and 2-propyl glucuronide (0.1 and 0.4mg/L). Headspace GC-FID detected tert-butanol (0.97 and 4.01mg/L), methanol (0.96 and 0.62mg/L), 2-butanone (0.84 and 1.65mg/L), and 2-butanol (0.04 and 0.09mg/L), but no ethanol and no 2-methyl-2-butanol. CONCLUSION Cross-reaction of EtG homologs, mainly tert-butyl glucuronide after suspected tert-butanol or isobutane abuse, explains the false-positive EtG immunoassay findings. Future investigations could address the usefulness of alcohol glucuronides (EtG homologs) in urine as (a) biomarkers of an exposition to alkans or their corresponding alcohol metabolites and (b) as markers for using "old"-well known alcohols like tert-butanol or tert-amyl alcohol as easy to obtain, cheap, potent and "undetectable" ethanol replacements or "New" Psychoactive Alcohols.
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Affiliation(s)
- Torsten Arndt
- Bioscientia Institut für Medizinische Diagnostik GmbH, Konrad-Adenauer-Straße 17, D-55218 Ingelheim, Germany.
| | - Hubert C Buschmann
- MEDIAN Klinik Tönisstein, Hochstraße 25, D-53474 Bad Neuenahr-Ahrweiler, Germany
| | - Katja Schulz
- Institut für Rechtsmedizin, Medizinische Fakultät Carl Gustav Carus der TU Dresden, Fetscherstraße 74, D-01307 Dresden, Germany
| | - Karsten Stemmerich
- Bioscientia Institut für Medizinische Diagnostik GmbH, Konrad-Adenauer-Straße 17, D-55218 Ingelheim, Germany
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Cipolla M, Izzotti A, Ansaldi F, Durando P, Piccardo MT. Volatile Organic Compounds in Anatomical Pathology Wards: Comparative and Qualitative Assessment of Indoor Airborne Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E609. [PMID: 28590436 PMCID: PMC5486295 DOI: 10.3390/ijerph14060609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/26/2017] [Accepted: 05/29/2017] [Indexed: 11/16/2022]
Abstract
The impact of volatile organic compounds (VOCs) on indoor air quality and on human health is widely recognized. However, VOC contamination in hospital indoor air is rarely studied and chemical compounds that singularly do not show high toxicity are not submitted to any regulation. This study aimed to compare VOC contamination in two different anatomical pathology wards in the same hospital. Hydrocarbons, alcohols, and terpenes were sampled by passive diffusive samplers. Analytical tests were performed by thermal desorption coupled with gas chromatography and mass spectrometry detector. Results highlighted a different VOC pollution in the two wards, due to the structural difference of the buildings and different organizational systems. The scarcity of similar data in the literature shows that the presence of VOCs in pathology wards is an underestimated problem. We believe that, because of the adverse effects that VOCs may have on the human health, this topic is worth exploring further.
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Affiliation(s)
- Massimo Cipolla
- Mutagenesis Unit, IRCCS AOU San Martino IST, Genoa 16132, Italy.
| | - Alberto Izzotti
- Mutagenesis Unit, IRCCS AOU San Martino IST, Genoa 16132, Italy.
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
- Hospital Direction, IRCCS AOU San Martino IST, Genoa 16132, Italy.
| | - Paolo Durando
- Department of Health Sciences, University of Genoa, Genoa 16132, Italy.
- Occupational Medicine Unit, IRCCS AOU San Martino IST, Genoa 16132, Italy.
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MacLean RR, Valentine GW, Jatlow PI, Sofuoglu M. Inhalation of Alcohol Vapor: Measurement and Implications. Alcohol Clin Exp Res 2017; 41:238-250. [PMID: 28054395 DOI: 10.1111/acer.13291] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/08/2016] [Indexed: 02/06/2023]
Abstract
Decades of alcohol research have established the health risks and pharmacodynamic profile of oral alcohol consumption. Despite isolated periods of public health concern, comparatively less research has evaluated exposure to alcohol vapor. Inhaled alcohol initially bypasses first-pass metabolism and rapidly reaches the arterial circulation and the brain, suggesting that this route of administration may be associated with pharmacological effects that increase the risk of addiction. However, detailed reviews assessing the possible effects of inhaled alcohol in humans are lacking. A comprehensive, systematic literature review was conducted using Google Scholar and PubMed to examine manuscripts studying exposure to inhaled alcohol and measurement of biomarkers (biochemical or functional) associated with alcohol consumption in human participants. Twenty-one publications reported on alcohol inhalation. Fourteen studies examined inhalation of alcohol vapor associated with occupational exposure (e.g., hand sanitizer) in a variety of settings (e.g., naturalistic, laboratory). Six publications measured inhalation of alcohol in a controlled laboratory chamber, and 1 evaluated direct inhalation of an e-cigarette with ethanol-containing "e-liquid." Some studies have reported that inhalation of alcohol vapor results in measurable biomarkers of acute alcohol exposure, most notably ethyl glucuronide. Despite the lack of significantly elevated blood alcohol concentrations, the behavioral consequences and subjective effects associated with repeated use of devices capable of delivering alcohol vapor are yet to be determined. No studies have focused on vulnerable populations, such as adolescents or individuals with alcohol use disorder, who may be most at risk of problems associated with alcohol inhalation.
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Affiliation(s)
- Robert Ross MacLean
- Department of Psychiatry, School of Medicine, Yale University, West Haven, Connecticut.,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Gerald W Valentine
- Department of Psychiatry, School of Medicine, Yale University, West Haven, Connecticut.,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Peter I Jatlow
- Laboratory Medicine, Yale University, West Haven, Connecticut
| | - Mehmet Sofuoglu
- Department of Psychiatry, School of Medicine, Yale University, West Haven, Connecticut.,VA Connecticut Healthcare System, West Haven, Connecticut
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Gessner S, Below E, Diedrich S, Wegner C, Gessner W, Kohlmann T, Heidecke CD, Bockholdt B, Kramer A, Assadian O, Below H. Ethanol and ethyl glucuronide urine concentrations after ethanol-based hand antisepsis with and without permitted alcohol consumption. Am J Infect Control 2016; 44:999-1003. [PMID: 27079243 DOI: 10.1016/j.ajic.2016.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 02/20/2016] [Accepted: 02/25/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND During hand antisepsis, health care workers (HCWs) are exposed to alcohol by dermal contact and by inhalation. Concerns have been raised that high alcohol absorptions may adversely affect HCWs, particularly certain vulnerable individuals such as pregnant women or individuals with genetic deficiencies of aldehyde dehydrogenase. METHODS We investigated the kinetics of HCWs' urinary concentrations of ethanol and its metabolite ethyl glucuronide (EtG) during clinical work with and without previous consumption of alcoholic beverages by HCWs. RESULTS The median ethanol concentration was 0.7 mg/L (interquartile range [IQR], 0.5-1.9 mg/L; maximum, 9.2 mg/L) during abstinence and 12.2 mg/L (IQR, 1.5-139.6 mg/L; maximum, 1,020.1 mg/L) during alcohol consumption. During abstinence, EtG reached concentrations of up to 958 ng/mL. When alcohol consumption was permitted, the median EtG concentration of all samples was 2,593 ng/mL (IQR, 890.8-3,576 ng/mL; maximum, 5,043 ng/mL). Although alcohol consumption was strongly correlated with both EtG and ethanol in urine, no significant correlation for the frequency of alcoholic hand antisepsis was observed in the linear mixed models. CONCLUSIONS The use of ethanol-based handrub induces measurable ethanol and EtG concentrations in urine. Compared with consumption of alcoholic beverages or use of consumer products containing ethanol, the amount of ethanol absorption resulting from handrub applications is negligible. In practice, there is no evidence of any harmful effect of using ethanol-based handrubs as much as it is clinically necessary.
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Affiliation(s)
- Stephan Gessner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Elke Below
- Institute of Forensic Science, University Medicine Greifswald, Greifswald, Germany
| | - Stephan Diedrich
- Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Christian Wegner
- Department for Information Technology Systems, University Medicine Greifswald, Greifswald, Germany
| | - Wiebke Gessner
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kohlmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Claus-Dieter Heidecke
- Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Britta Bockholdt
- Department for Information Technology Systems, University Medicine Greifswald, Greifswald, Germany
| | - Axel Kramer
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ojan Assadian
- Institute for Skin Integrity and Infection Prevention, School of Human & Health Sciences, University of Huddersfield, Huddersfield, UK.
| | - Harald Below
- Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
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Excessive urinary excretion of isopropyl glucuronide after isopropanol abuse. Forensic Sci Int 2016; 266:250-253. [DOI: 10.1016/j.forsciint.2016.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/18/2016] [Accepted: 05/27/2016] [Indexed: 11/18/2022]
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Wurst FM, Thon N, Yegles M, Schrück A, Preuss UW, Weinmann W. Ethanol Metabolites: Their Role in the Assessment of Alcohol Intake. Alcohol Clin Exp Res 2015; 39:2060-72. [DOI: 10.1111/acer.12851] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/22/2015] [Indexed: 01/12/2023]
Affiliation(s)
- Friedrich M. Wurst
- Paracelsus Medical University; Salzburg Austria
- Center for Interdisciplinary Addiction Research; University of Hamburg; Hamburg Germany
| | | | - Michel Yegles
- Service de Toxicologie; Laboratoire National de Sante; Luxembourg Luxembourg
| | - Alexandra Schrück
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
| | - Ulrich W. Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine; University of Halle; Halle Germany
| | - Wolfgang Weinmann
- Institute of Forensic Medicine; University of Bern; Bern Switzerland
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Johnson-Davis KL, Slawson MH. Ethyl Glucuronide Positivity Rate in a Pain Management Population. J Anal Toxicol 2015; 39:686-90. [PMID: 26324207 DOI: 10.1093/jat/bkv096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ethanol may be consumed by some patients as a means to manage their pain or psychiatric disorder. Consequently, there is the potential to consider ethanol a co-therapeutic in pain management. The purpose of this study was to perform a retrospective analysis to evaluate the rate of ethanol use in a population of patients in pain management programs that were evaluated by our in-house pain management drug panel test. Results from this retrospective study showed that 12.6% of patients in a pain management population were positive for the direct ethanol metabolite, ethyl glucuronide (EtG), by immunoassay. Furthermore, 86% of the individuals positive for EtG were also positive for prescription pain medication and illicit drugs. Results presented here suggest that ethanol use should be routinely monitored in pain management populations in an effort to determine any potential adverse effects of ethanol-drug interactions and as a way to further evaluate the effect of ethanol on pain management outcomes. Testing this population of patients suggests that ethanol use is prevalent and the risk of drug-ethanol adverse effects should be monitored in a pain management population.
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Affiliation(s)
- Kamisha L Johnson-Davis
- University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA
| | - Matthew H Slawson
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA ARUP Laboratories, Salt Lake City, UT 84108, USA
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Nanau RM, Neuman MG. Biomolecules and Biomarkers Used in Diagnosis of Alcohol Drinking and in Monitoring Therapeutic Interventions. Biomolecules 2015; 5:1339-85. [PMID: 26131978 PMCID: PMC4598755 DOI: 10.3390/biom5031339] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/15/2015] [Accepted: 05/29/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. METHODS A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010-2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. FINDINGS Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum γ-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine.
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Affiliation(s)
- Radu M Nanau
- In Vitro Drug Safety and Biotechnology, University of Toronto, Toronto, ON M5G 0A3, Canada.
| | - Manuela G Neuman
- In Vitro Drug Safety and Biotechnology, University of Toronto, Toronto, ON M5G 0A3, Canada.
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 0A3, Canada.
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Cross-reaction of propyl and butyl alcohol glucuronides with an ethyl glucuronide enzyme immunoassay. Forensic Sci Int 2014; 241:84-6. [DOI: 10.1016/j.forsciint.2014.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 04/30/2014] [Accepted: 05/15/2014] [Indexed: 11/21/2022]
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Abstract
Alcohol misuse is associated with significant morbidity and mortality. Although clinical history, examination, and the use of self-report questionnaires may identify subjects with harmful patterns of alcohol use, denial or under-reporting of alcohol intake is common. Existing biomarkers for detecting alcohol misuse include measurement of blood or urine ethanol for acute alcohol consumption, and carbohydrate-deficient transferrin and gamma-glutamyl transferase for chronic alcohol misuse. There is a need for a biomarker that can detect excessive alcohol consumption in the timeframe between 1 day and several weeks. Ethyl glucuronide (EtG) is a direct metabolite of ethanol detectable in urine for up to 90 h and longer in hair. Because EtG has high specificity for excess alcohol intake, it has great potential for use in detecting "binge" drinking. Using urine or hair, this noninvasive marker has a role in a variety of clinical and forensic settings.
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Affiliation(s)
- Natalie E Walsham
- Department of Clinical Biochemistry, University Hospital Lewisham, London, United Kingdom
| | - Roy A Sherwood
- Department of Clinical Biochemistry, King's College Hospital NHS Foundation Trust, London, United Kingdom.
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