An Overview of Alcohol Testing and Interpretation in the 21st Century

2012 ◽  
Vol 25 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Anna T. Kelly ◽  
Ashraf Mozayani

Ethanol analysis is the most commonly carried out drug testing in a forensic toxicology laboratory. Determination of blood alcohol concentration (BAC) is needed in a multitude of situations, including in postmortem analysis, driving under the influence (DUI) and drug-facilitated sexual assault (DFSA) cases, workplace drug monitoring, and probation investigations. These analyses are carried out by direct measurement of ethanol concentrations as well as of metabolic by-products, such as ethyl glucuronide (EtG) and ethyl sulfate (EtS). This review article will discuss pharmacokinetics, including absorption, distribution, and elimination of ethanol, methods for the detection of ethanol, the effect of ethanol on human performance, the role of alcohol in injuries and fatalities, and information regarding the interactions that may occur between alcohol and other drugs. Finally, an explanation will be given on how to interpret alcohol levels as well as the extrapolation and calculation of blood alcohol levels at times prior to sample collection.

Author(s):  
Ursula Ehmke ◽  
Lorraine Du Toit-Prinsloo ◽  
Christelle Deysel ◽  
Joyce Jordaan ◽  
Gert Saayman

The reliability and accuracy of blood alcohol concentration (BAC) results presented in South African courts of law in respect of possible driving under the influence (DUI) cases, have in recent years been subjected to intense scrutiny and severe criticism.  Research has shown that multiple factors may negatively impact on the reliability of results obtained from the analysis of such samples - including inappropriate or non-standardised sample management after acquisition thereof.  In particular, long delays between sample acquisition and the analysis thereof may compromise the validity of results.  Such delays may also negatively affect the outcome of both criminal and civil legal proceedings in possible DUI cases.  A retrospective descriptive study was conducted on records from the Pretoria Forensic Chemistry Laboratory (PFCL) regarding the relevant dates pertaining to blood samples from deceased persons which were received for analysis. These parameters included the date of sample acquisition at medico-legal mortuaries, delays in submission of samples to the laboratory and date of actual analysis.  In addition, the expiration dates of sample collection kits were recorded.  Our results show that numerous expired kits were utilised and that there was an average delay of approximately five months between sample acquisition and laboratory analysis thereof.  This delay period varied greatly but appears to correlate with geographical distance of the medico-legal mortuary from the PFCL.  In order to optimise and facilitate the administration of justice in both criminal and civil cases of alleged DUI, these shortcomings should be urgently addressed.  It is argued that the implementation of prescribed measures and standard operating procedures in sample management, together with other interventions such as accreditation of laboratories and improved resourcing of medico-legal and toxicology laboratories, is urgently required.


2021 ◽  
Vol 5 (1) ◽  
pp. 048-052
Author(s):  
Miziara Ivan Dieb ◽  
Carmen Miziara Silvia Molleis Galego

Introduction: The tendency to impulsive behaviors and/or violence is exacerbated after alcohol consumption. Still, the relation between alcohol/violent deaths reported in the literature is not accurate, and in general, alcohol is only seen as a trigger to aggressive actions. The relationship of the victims with their blood alcohol is less studied. They were especially concerned about the role of alcohol as a risk factor for victims of unnatural death. Thus, our goal is to check the influence of alcohol in victims of violent deaths as homicides, suicides, and accidents. Materials and methods: Retrospectively the medical records of 805 autopsies performed at the Institute of Forensic Medicine (IML) of Franco da Rocha, in the period 2001 to 2017 were reviewed. The variables studied were sex, age, types of violent death rates, and alcohol - these were considered positive when above 0.3 mg/ml. The dosage of blood alcohol concentration (BAC) was performed using samples of 10 ml of blood collected at necropsy, is preferably taken from the cardiac chambers or of the right femoral vein. Dosages of alcohol in blood samples were done in the Forensic Toxicology Center of the IML by gas chromatography, using the technique of separation “headspace” and double column. Results: Drug testing for alcohol was available for 488 (79.1%) of 617 necropsies. Of the 617 subjects studied, 532 (85.7%) were male, and 85 (13.8%) were females (with high rates of adolescents). The vast majority (n = 230) were killed, and 40.5% of victims had BAC above 0.3 mg/ml of blood. Traffic accidents came next, accounting for 181 deaths, with 41% of victims presenting positive BAC. Discussion: High blood alcohol levels of the victims were associated mainly with the genesis of accidents (drowning, falls, traffic, aspiration/ smothering) and murder (with impaired ability to resist or by causing the release of impulses to engage in violent situations), about 40% of cases. Conclusion: Our results indicate that alcohol abuse is a risk factor for victims of violent death. In these cases, alcohol has two types of action. Direct: contributes to accidents of various kinds - from traffic by decreasing powers of concentration, attention, and loss of reflexes, to other types of accidents such as drowning, falls, swallowing disorders causing airway obstruction, and mechanical asphyxia. And they were indirect, making it easier for individuals to engage in conflict (and thus become victims of crimes).


2018 ◽  
Vol 69 (9) ◽  
pp. 2407-2410
Author(s):  
Dan Perju Dumbrava ◽  
Carmen Corina Radu ◽  
Sofia David ◽  
Tatiana Iov ◽  
Catalin Jan Iov ◽  
...  

Considering the growing number of requests from the criminal investigations authorities addressed to the institutions of legal medicine, testing of blood alcohol concentration both in the living person and in the corpse, we believe that a presentation of the two methods which are used in our country, is a topic of interest at present. The purpose of this article is to provide the reader with the technical details on how blodd alcohol concentration is realised by means of the gas chromatographic method and the classical one, (Cordebard modified by D. Banciu and I. Droc) respectively. Another purpose of this article is to also show, in a comparative way, the elements that make the gas chromatographic method superior to the former one.


1994 ◽  
Vol 34 (3) ◽  
pp. 265-270 ◽  
Author(s):  
A W Jones

This article describes a drink-driving scenario where a woman was apprehended for driving under the influence (DUI) with a blood alcohol concentration (BAC) of 256mg/dl1 The correctness of this result was vigorously challenged by a medical expert witness for the defence, who was actually a specialist in alcohol diseases. Despite reanalysis to confirm the BAC as well as a DNA profile to prove the identity of the blood specimen, the woman was acquitted of the charge of drunk driving by the lower court. However, she was subsequently found guilty in the High Court of Appeals with a unanimous decision and sentenced to four weeks imprisonment. This case report illustrates some of the problems surrounding the use of expert medical evidence by the defence to challenge the validity of the prosecution evidence based solely on a suspect's BAC. In situations such as these, an expert witness should be called by the prosecution to clarify and, if necessary, rebut medical and/or scientific opinions that might mislead the court and influence the outcome of the trial.


2020 ◽  
Vol 55 (5) ◽  
pp. 564-570
Author(s):  
Cheryl J Cherpitel ◽  
Edwina Williams ◽  
Yu Ye ◽  
William C Kerr

Abstract Aims To analyze racial/ethnic disparities in risk of two alcohol-related events, alcohol-related injury and self-reported perceived driving under the influence (DUI) from hours of exposure to an elevated blood alcohol concentration (BAC). Methods Risk curves for the predicted probability of these two outcomes from the number of hours of exposure to a BAC ≥ 0.08 mg% in the past year were analyzed separately for whites, blacks and Hispanics in a merged sample of respondents from four US National Alcohol Surveys (2000–2015). Results Hours of exposure to a BAC ≥ 0.08 showed a stronger association with perceived DUI than with alcohol-related injury for all racial/ethnic groups. Greater risk was found for whites than blacks or Hispanics for outcomes at nearly all BAC exposure levels, and most marked at the highest level of exposure. Risk of both outcomes was significant for whites at all exposure levels, but small for alcohol-related injury. Little association was found for alcohol-related injury for blacks or Hispanics. For perceived DUI, risk for blacks was significantly elevated at lower levels of exposure, while risk for Hispanics was significantly elevated beginning at 30 h of exposure. Conclusions Findings showed racial/ethnic differences in risk of alcohol-related injury and perceived DUI from hours of exposure to elevated BAC. Risk increased at relatively low levels of exposure to a BAC ≥ 0.08, especially for whites, highlighting the importance of preventive efforts to reduce harmful outcomes for moderate drinkers.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026481 ◽  
Author(s):  
Yu-Chin Tsai ◽  
Shao-Chun Wu ◽  
Jin-Fu Huang ◽  
Spencer C H Kuo ◽  
Cheng-Shyuan Rau ◽  
...  

ObjectivesWe aimed to profile the epidemiological changes of driving under the influence (DUI) in southern Taiwan after the legal blood alcohol concentration (BAC) limit was lowered from 50 to 30 mg/dL in 2013.SettingLevel 1 trauma medical centre in southern Taiwan.ParticipantsData from 7447 patients (4375 males and 3072 females) were retrieved from the trauma registry system of a single trauma centre to examine patient characteristics (gender, age and BAC), clinical outcome variables (Abbreviated Injury Score, Injury Severity Score and mortality) and vehicular crash-related factors (vehicle type, airbag use in car crashes, helmet use in motorcycle crashes and time of crash) before and after the BAC limit change.ResultsOur results indicated that the percentage of DUI patients significantly declined from 10.99% (n=373) to 6.64% (n=269) after the BAC limit was lowered. Airbag use in car crashes (OR: 0.30, 95% CI 0.10 to 0.88, p=0.007) and helmet use in motorcycle crashes (OR: 0.20, 95% CI 0.15 to 0.26, p<0.001) was lower in DUI patients compared with non-DUI patients after the BAC limit change, with significant negative correlation. DUI behaviour increased crash mortality risk before the BAC limit change (OR: 4.33, 95% CI 2.20 to 8.54), and even more so after (OR: 5.60, 95% CI 3.16 to 9.93). The difference in ORs for mortality before and after the change in the BAC legal limit was not significant (p=0.568).ConclusionThis study revealed that lowering the BAC limit to 30 mg/dL significantly reduced the number of DUI events, but failed to result in a significant reduction in mortality in these trauma patients.


2005 ◽  
Vol 32 (3) ◽  
pp. 387-404 ◽  
Author(s):  
Hans Bergman ◽  
Beata Hubicka ◽  
Hans Laurell

The purpose of the study was to map alcohol problems in relation to blood alcohol concentration in a large representative sample of male and female Swedish drivers suspected of drunk driving. Twenty-one hundred suspected DUI offenders (drivers suspected of driving under the influence of alcohol) were assessed with the Alcohol Use Disorders Identification Test (AUDIT). Information from the police regarding BAC, age, gender, and place and time of the stop was also collected. More than half (58%) of the suspected DUI offenders had alcohol problems, and among these 24% had high levels of alcohol problems. Of specific interest was the observation that almost half (46%) of the suspects with a BAC below the Swedish legal limit of 0.02% had alcohol problems, a prevalence that did not increase until a BAC of 0.10%–0.15%. It can be concluded that the mere suspicion of drunk driving indicates alcohol problems.


CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S96-S96
Author(s):  
R. Green ◽  
N. Kureshi ◽  
L. Fenerty ◽  
G. Thibault-Halman ◽  
M. Erdogan ◽  
...  

Introduction: Although alcohol use increases the risk of experiencing a traumatic brain injury (TBI), it remains unclear whether outcomes in alcohol-impaired patients are different from those of unimpaired patients. The objective of this study was to evaluate the effect of alcohol on length of stay (LOS) and mortality in patients with major TBI. Methods: Using data collected from the Nova Scotia Trauma Registry, we performed a retrospective analysis of all patients with major TBI (defined as having an abbreviated injury score (AIS) head ≥3) seen in Nova Scotia hospitals between 2002 and 2013. Patients were compared by blood alcohol concentration (BAC) at time of injury: negative (0-1.9 mmol/L), low (2-21 mmol/L), and moderate/high (≥22 mmol/L). A logistic regression model was constructed to test for outcomes and adjusted for the effects of age, gender, location, injury severity score (ISS), and BAC level. Results: In a twelve-year period, there were 4152 major TBI patients in Nova Scotia. Alcohol testing was performed in 43% of cases (80% male, mean age 44±20 years), with 48% having a positive BAC. Mean acute LOS was similar for all three BAC groups. Increasing age (odds ratio [OR]=1.01; p<0.001), high ISS (OR=4.92; p<0.001), injuries occurring outside of Halifax Regional Municipality (OR=1.72; p<0.001), and having a lower BAC level (OR = 0.99; p<0.001) independently predicted mortality. Conclusion: Our findings suggest that low BAC levels are associated with increased mortality in major TBI patients. Further study is warranted to elucidate alcohol’s mechanism in TBI outcomes.


Author(s):  
R. Wade Allen ◽  
Zareh Parseghian ◽  
Anthony C. Stein

There is a large body of research that documents the impairing effect of alcohol on driving behavior and performance. Some of the most significant alcohol influence seems to occur in divided attention situations when the driver must simultaneously attend to several aspects of the driving task. This paper describes a driving simulator study of the effect of a low alcohol dose, .055 BAC (blood alcohol concentration %/wt), on divided attention performance. The simulation was mechanized on a PC and presented visual and auditory feedback in a truck cab surround. Subjects were required to control speed and steering on a rural two lane road while attending to a peripheral secondary task. The subject population was composed of 33 heavy equipment operators who were tested during both placebo and drinking sessions. Multivariate Analysis of Variance showed a significant and practical alcohol effect on a range of variables in the divided attention driving task.


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