title: Quantification of EtG in hair, EtG and EtS in urine and PEth species in capillary dried blood spots to assess the alcohol consumption in driver's licence regranting cases.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.affiliation: Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kummer
authors.affiliation: Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium.
authors.forename: Sarah M R
authors.initials: SM
authors.lastname: Wille
authors.affiliation: Belgian Institute of Road Safety, Brussels, Belgium.
authors.forename: Anneleen
authors.initials: A
authors.lastname: Poll
authors.affiliation: Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Willy E E
authors.initials: WE
authors.lastname: Lambert
authors.affiliation: Federal Public Service Justice, National Institute of Criminalistics and Criminology, Brussels, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Samyn
authors.affiliation: Laboratory of Toxicology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. Electronic address: christophe.stove@ugent.be.
authors.forename: Christophe P
authors.initials: CP
authors.lastname: Stove
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000097:blood / Q000378:metabolism* / Q000652:urine; D000437:Alcoholism / Q000097:blood / Q000175:diagnosis / Q000652:urine; D001530:Belgium; D015415:Biomarkers / Q000097:blood / Q000652:urine; D059788:Dried Blood Spot Testing / Q000379:methods / Q000592:standards*; D000066448:Driving Under the Influence / Q000331:legislation & jurisprudence; D005260:Female; D005965:Glucuronates / Q000097:blood / Q000378:metabolism* / Q000652:urine; D006197:Hair / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013463:Sulfuric Acid Esters / Q000097:blood / Q000378:metabolism* / Q000652:urine
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; C011612:diethyl sulfate
keywords: Abstinence period; Alcohol monitoring; Dependence; Direct biomarkers; Driver's licence; Fitness to drive