Natalie Kummer1, Sarah M R Wille1, Anneleen Poll2, Willy E E Lambert3, Nele Samyn1, Christophe P Stove4. 1. Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium. 2. Belgian Institute of Road Safety, Brussels, Belgium. 3. Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. 4. Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. Electronic address: christophe.stove@ugent.be.
Abstract
BACKGROUND: In Belgium, the analysis of indirect biomarkers such as carbohydrate deficient transferrin (CDT%), gamma-glutamyltransferase (GGT), aspartate aminotransferase/alanine aminotransferase (AST/ALT) and mean corpuscular volume (MCV), is currently used to monitor the alcohol consumption in cases of fitness to drive assessment. We evaluated the use of direct ethanol markers for this purpose, exclusively determined in matrices obtained via non- or minimally invasive sampling. METHODS: Three validated quantitative methods (ethylglucuronide (EtG) in hair and urine, ethylsulfate (EtS) in urine, and phosphatidylethanol species (PEth 16:0/18:1, PEth 18:1/18:1 and PEth 16:0/16:0) in capillary dried blood spots (C-DBS)) were used. Fifty volunteers, for whom fitness to drive had to be assessed and for whom a blood analysis for indirect biomarkers was requested, were included in the study. The sampling and analysis of hair, urine and C-DBS were added to the process currently used. RESULTS: Hair EtG (24/50) and C-DBS PEths (29/50) are more sensitive than the currently used indirect biomarkers (13/50 for CDT%) to detect excessive and chronic alcohol consumption and allow to disprove an abstinence period. Urinary EtG and EtS are useful parameters to determine recent alcohol consumption. CONCLUSION: The combined use of the three strategies allows better inference about the evolution of the alcohol consumption prior to the sampling. Moreover, the exclusive use of non- or minimally invasive sampling (hair, urine and C-DBS) allows this to be performed directly during the fitness to drive assessment by regular staff members. This approach offers the potential to improve the Belgian driver's licence regranting process.
BACKGROUND: In Belgium, the analysis of indirect biomarkers such as carbohydrate deficient transferrin (CDT%), gamma-glutamyltransferase (GGT), aspartate aminotransferase/alanine aminotransferase (AST/ALT) and mean corpuscular volume (MCV), is currently used to monitor the alcohol consumption in cases of fitness to drive assessment. We evaluated the use of direct ethanol markers for this purpose, exclusively determined in matrices obtained via non- or minimally invasive sampling. METHODS: Three validated quantitative methods (ethylglucuronide (EtG) in hair and urine, ethylsulfate (EtS) in urine, and phosphatidylethanol species (PEth 16:0/18:1, PEth 18:1/18:1 and PEth 16:0/16:0) in capillary dried blood spots (C-DBS)) were used. Fifty volunteers, for whom fitness to drive had to be assessed and for whom a blood analysis for indirect biomarkers was requested, were included in the study. The sampling and analysis of hair, urine and C-DBS were added to the process currently used. RESULTS: Hair EtG (24/50) and C-DBS PEths (29/50) are more sensitive than the currently used indirect biomarkers (13/50 for CDT%) to detect excessive and chronic alcohol consumption and allow to disprove an abstinence period. Urinary EtG and EtS are useful parameters to determine recent alcohol consumption. CONCLUSION: The combined use of the three strategies allows better inference about the evolution of the alcohol consumption prior to the sampling. Moreover, the exclusive use of non- or minimally invasive sampling (hair, urine and C-DBS) allows this to be performed directly during the fitness to drive assessment by regular staff members. This approach offers the potential to improve the Belgian driver's licence regranting process.
Authors: Yan Wang; Xinguang Chen; Judith A Hahn; Babette Brumback; Zhi Zhou; Maria J Miguez; Robert L Cook Journal: Alcohol Clin Exp Res Date: 2017-12-05 Impact factor: 3.455
Authors: Kelly E Moore; Olga J Santiago Rivera; Bradley Anderson; Jennifer E Johnson; Judith A Hahn; Megan E Kurth; Madhavi K Reddy; Yael C Schonbrun; Michael D Stein Journal: Alcohol Clin Exp Res Date: 2018-01-31 Impact factor: 3.455
Authors: Majid Afshar; Kenneth Baker; Josefine Corral; Erin Ross; Erin Lowery; Richard Gonzalez; Ellen L Burnham; Rachael A Callcut; Lucy Z Kornblith; Carolyn Hendrickson; Elizabeth J Kovacs; Cara Joyce Journal: Ann Surg Date: 2021-03-10 Impact factor: 13.787