title: Evaluation of biomarkers assessing regular alcohol consumption in an occupational setting.
abstract: OBJECTIVE
  An estimation of ethanol intake is frequently of importance in the frame work of studies, but not trivial to achieve. Problems are "underreporting", a very short time frame for the detection of ethanol as direct marker and interference of many in- and outside body factors with strain parameters. The aim of this study was to explore the suitability of the direct urinary biomarkers ethyl glucuronide (EtG) and ethyl sulphate (EtS) to assess moderate but regular alcohol consumption.
  
  
  METHODS
  A total of 175 male workers without any known occupational contact to substances influencing liver functions or metabolism of ethanol were examined. Strain parameters of alcohol consumption, i.e. the liver function tests (LFTs: aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase), carbohydrate-deficient transferrin (CDT), mean corpuscular erythrocyte volume (MCV) and the markers of alcohol consumption (EtG and EtS) have been analysed and compared.
  
  
  RESULTS
  Up to 14 % of workers had been outside reference range for strain parameters. 62.3 % of the workers had at least traceable amounts of EtG and 84.6 % of EtS. Values above cut-off (indicating voluntary ethanol intake) were found in 34.9 and 51.4 % of the workers for EtG and EtS, respectively. In multiple linear regression analyses, CDT and MCV but not the LFTs showed a dependency from the non-oxidative ethanol metabolites. The LFTs were influenced by BMI.
  
  
  CONCLUSIONS
  Determination of EtG and EtS in urine is an adequate tool to assess moderate but regular alcohol consumption.
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen, Schillerstr. 25, 91054, Erlangen, Germany. Sonja.Kilo@fau.de.
authors.forename: Sonja
authors.identifier: http://orcid.org/0000-0003-4966-2497
authors.initials: S
authors.lastname: Kilo
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen, Schillerstr. 25, 91054, Erlangen, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Hofmann
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen, Schillerstr. 25, 91054, Erlangen, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Eckert
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen, Schillerstr. 25, 91054, Erlangen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Göen
authors.affiliation: Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen, Schillerstr. 25, 91054, Erlangen, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Drexler
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000097:blood / Q000652:urine*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D004909:Erythrocyte Indices; D005965:Glucuronates / Q000652:urine*; D006801:Humans; D016014:Linear Models; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013463:Sulfuric Acid Esters / Q000652:urine*; D014168:Transferrin / Q000031:analogs & derivatives / Q000032:analysis; D017132:Workplace; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D013463:Sulfuric Acid Esters; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; C011612:diethyl sulfate
keywords: Ethyl glucuronide; Ethyl sulphate; Hepatotoxicity; Non-oxidative ethanol metabolites