title: Commercial Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) Testing is Not Vulnerable to Incidental Alcohol Exposure in Pregnant Women.
abstract: BACKGROUND
  Ethyl Glucoronide (EtG) and Ethyl Sulfate (EtS) have shown promise as biomarkers for alcohol and may be sensitive enough for use with pregnant women in whom even low-level alcohol use is important. However, there have been reports of over-sensitivity of EtG and EtS to incidental exposure to sources such as alcohol-based hand sanitizer. Further, few studies have evaluated these biomarkers among pregnant women, in whom the dynamics of these metabolites may differ.
  
  
  OBJECTIVE
  This study evaluated whether commercial EtG-EtS testing was vulnerable to high levels of environmental exposure to alcohol in pregnant women.
  
  
  METHODS
  Two separate samples of five nurses-one pregnant and the other postpartum, all of whom reported high levels of alcohol-based hand sanitizer use-provided urine samples before and 4-8 hours after rinsing with alcohol-based mouthwash and using hand sanitizer. The five pregnant nurses provided urine samples before, during, and after an 8-hour nursing shift, during which they repeatedly cleansed with alcohol-based hand sanitizer (mean 33.8 uses). The five postpartum nurses used hand sanitizer repeatedly between baseline and follow-up urine samples.
  
  
  RESULTS
  No urine samples were positive for EtG-EtS at baseline or follow-up, despite use of mouthwash and-in the pregnant sample-heavy use of hand sanitizer (mean of 33.8 uses) throughout the 8-hour shift.
  
  
  CONCLUSIONS
  Current, commercially available EtG-EtS testing does not appear vulnerable to even heavy exposure to incidental sources of alcohol among pregnant and postpartum women.
authors.affiliation: a Department of Psychiatry , Wayne State University , Detroit , Michigan , USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Ondersma
authors.affiliation: b Merrill-Palmer Skillman Institute , Wayne State University , Detroit , Michigan , USA.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Beatty
authors.affiliation: c Pathology & Laboratory Medicine , Albany Medical College , Albany , New York , USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Rosano
authors.affiliation: d Division of Reproductive Medicine, Gynecology , Obstetrics, and Women's Health, Henry Ford Health System , Detroit , Michigan , USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Strickler
authors.affiliation: b Merrill-Palmer Skillman Institute , Wayne State University , Detroit , Michigan , USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Graham
authors.affiliation: e Obstetrics & Gynecology , Wayne State University , Detroit , Michigan , USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine*; D004202:Disinfectants / Q000652:urine*; D000431:Ethanol / Q000008:administration & dosage* / Q000652:urine*; D005260:Female; D005965:Glucuronates; D064548:Hand Sanitizers / Q000737:chemistry; D006801:Humans; D009067:Mouthwashes / Q000737:chemistry; D011247:Pregnancy; D013463:Sulfuric Acid Esters; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004202:Disinfectants; D005965:Glucuronates; D064548:Hand Sanitizers; D009067:Mouthwashes; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; C011612:diethyl sulfate
keywords: Ethyl glucuronide; alcohol-related neurodevelopmental disorder; ethyl sulfate; pregnancy; substance abuse detection/methods