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Application of phosphatidylethanol (PEth) in whole blood in comparison to ethyl glucuronide in hair (hEtG) in driving aptitude assessment (DAA)

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Abstract

For driving aptitude assessment (DAA), the analysis of several alcohol biomarkers is essential for the detection of alcohol intake besides psycho-medical exploration. In Switzerland, EtG in hair (hEtG) is often the only direct marker for abstinence monitoring in DAA. Therefore, the suitability of phosphatidylethanol (PEth) was investigated as additional biomarker. PEth 16:0/18:1 and 16:0/18:2 were determined by online-SPE-LC-MS/MS in 136 blood samples of persons undergoing DAA and compared to hEtG, determined in hair segments taken at the same time. With a PEth 16:0/18:1 threshold of 210 ng/mL for excessive alcohol consumption, all (n = 30) but one tested person also had hEtG values ≥30 pg/mg. In 54 cases, results are not in contradiction to an abstinence as neither PEth (<20 ng/mL) nor hEtG (<7 pg/mg) was detected. In eight cases, both markers showed moderate consumption. Altogether, PEth and hEtG were in accordance in 68 % of the samples, although covering different time periods of alcohol consumption. With receiver operating characteristic analysis, PEth was evaluated to differentiate abstinence, moderate, and excessive alcohol consumption in accordance with hEtG limits. A PEth 16:0/18:1 threshold of 150 ng/mL resulted in the best sensitivity (70.6 %) and specificity (98.8 %) for excessive consumption. Values between 20 and 150 ng/mL passed for moderate consumption, values <20 ng/mL passed for abstinence. As PEth mostly has a shorter detection window (2–4 weeks) than hEtG (up to 6 months depending on hair length), changes in drinking behavior can be detected earlier by PEth than by hEtG analysis alone. Therefore, PEth helps to improve the diagnostic information and is a valuable additional alcohol marker for DAA.

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Acknowledgments

We would like to thank the team of the Department of Traffic Sciences of the Institute of Forensic Medicine, Bern, for collecting the blood and hair samples for comparison of PEth in blood and EtG in hair (hEtG) in driving aptitude assessment, and we would like to thank Anja Kaiser, Nadja Utiger, Sidonia Guggisberg, Anita Iannone, Severine Krönert, and Thomas Wüthrich from our institute for the determination of ethyl glucuronide in hair.

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Authors and Affiliations

  1. Institute of Forensic Medicine, Forensic Toxicology and Chemistry, University of Bern, Bühlstrasse 20, 3012, Bern, Switzerland

    Alexandra Schröck, Stefan König & Wolfgang Weinmann

  2. Institute of Forensic Medicine, Department of Traffic Sciences, University of Bern, Bern, Switzerland

    Matthias Pfäffli

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  1. Alexandra Schröck
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  2. Matthias Pfäffli
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  3. Stefan König
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  4. Wolfgang Weinmann
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Correspondence to Alexandra Schröck.

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Funding

This study was supported by the Swiss Foundation of Alcohol Research (Grant 254/2014: Studies on phosphatidylethanol (PEth)—a promising biomarker for the detection of harmful ethanol consumption—and its possible use for abstinence monitoring).

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Schröck, A., Pfäffli, M., König, S. et al. Application of phosphatidylethanol (PEth) in whole blood in comparison to ethyl glucuronide in hair (hEtG) in driving aptitude assessment (DAA). Int J Legal Med 130, 1527–1533 (2016). https://doi.org/10.1007/s00414-016-1394-4

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  • DOI: https://doi.org/10.1007/s00414-016-1394-4

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