title: Ethyl glucuronide, ethyl sulfate, and ethanol in urine after intensive exposure to high ethanol content mouthwash.
abstract: To determine the degree of ethanol absorption and the resultant formation and urinary excretion of its conjugated metabolites following intensive use of high ethanol content mouthwash, 10 subjects gargled with Listerine(®) antiseptic 4 times daily for 3¼ days. First morning void urine specimens were collected on each of the four study days and post-gargle specimens were collected at 2, 4, and 6 h after the final gargle of the study. Urine ethanol, ethyl glucuronide (EtG), ethyl sulfate (EtS), and creatinine were measured. Ethanol was below the positive threshold of 20 mg/dL in all of the urine specimens. EtG was undetectable in all pre-study urine specimens, but two pre-study specimens had detectable EtS (6 and 82 ng/mL; 16 and 83 μg/g creatinine). Only one specimen contained detectable EtG (173 ng/mL; 117 μg/g creatinine). EtS was detected in the urine of seven study subjects, but was not detected in the single specimen that had detectable EtG. The maximum EtS concentrations were 104 ng/mL and 112 μg/g creatinine (in different subjects). Three subjects produced a total of eight (non-baseline) urinary EtS concentrations above 50 ng/mL or 50 μg/g creatinine and three EtS concentrations exceeding 100 ng/mL or 100 μg/g creatinine. In patients being monitored for ethanol use by urinary EtG and EtS concentrations, currently accepted EtG and EtS cutoffs of 500 ng/mL are adequate to distinguish between ethanol consumption and four times daily use of high ethanol content mouthwash.
authors.affiliation: Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32606, USA. garyr@ufl.edu
authors.forename: Gary M
authors.initials: GM
authors.lastname: Reisfield
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Goldberger
authors.forename: Amadeo J
authors.initials: AJ
authors.lastname: Pesce
authors.forename: Bridgit O
authors.initials: BO
authors.lastname: Crews
authors.forename: George R
authors.initials: GR
authors.lastname: Wilson
authors.forename: Scott A
authors.initials: SA
authors.lastname: Teitelbaum
authors.forename: Roger L
authors.initials: RL
authors.lastname: Bertholf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003404:Creatinine / Q000652:urine; D000431:Ethanol / Q000652:urine*; D005260:Female; D005965:Glucuronates / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage / Q000378:metabolism*; D015813:Substance Abuse Detection; D013463:Sulfuric Acid Esters / Q000652:urine*; D055815:Young Adult
chemical_list: D005965:Glucuronates; D009067:Mouthwashes; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; D003404:Creatinine; C011612:diethyl sulfate