Analytical and Bioanalytical Chemistry

, Volume 400, Issue 1, pp 175–181 | Cite as

Comparison of ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) concentrations in hair for testing abstinence

  • M. E. Albermann
  • F. Musshoff
  • B. Madea
Original Paper


Hair analysis is a powerful tool for retrospective drug analysis. By determining the minor ethanol metabolites ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs) in hair, even a previous consumption of alcohol is detectable. However, previous studies showed a lack of correlation if both parameters are determined simultaneously. A further study was conducted to confirm or refute these results. One hundred and sixty hair samples were analyzed for EtG and FAEE in the context of driving ability. In 109 cases, alcohol abstinence was clearly proven and was excluded in 15 cases. In 36 cases, ambiguous results were found. Possible reasons for the deviating results are discussed. It is recommended, that in context of driving ability diagnostics the EtG result is determinant. In critical cases FAEE concentrations can be determined for checking purposes, but a negative FAEE result cannot refute a determined EtG concentration >7 pg/mg.


Comparative illustration of EtG and FAEE concentrations in 160 hair samples analyzed in the context of driving ability diagnostics. The horizontal lines indicate the cut-off values. Color coding: green → teetotalers, red → social or excessive chronic drinkers, yellow and blue → ambiguous results.


Hair analysis Abstinence test Ethyl glucuronide Fatty acid ethyl esters Comparative analysis 


  1. 1.
    Pragst F, Auwaerter V, Spokert F, Spiegel K (2001) Analysis of fatty acid ethyl esters in hair as possible markers of chronically elevated alcohol consumption by headspace solid-phase microextraction (HS-SPME) and gas chromatography-mass spectrometry (GC-MS). Forensic Sci Int 121:76–88CrossRefGoogle Scholar
  2. 2.
    Palmer RB (2009) A review of the use of ethyl glucuronide as a marker for ethanol consumption in forensic and clinical medicine. Semin Diagn Pathol 26:18–27CrossRefGoogle Scholar
  3. 3.
    Pragst F, Yegles M (2008) Determination of fatty acid ethyl esters (FAEE) and ethyl glucuronide (EtG) in hair: a promising way for retrospective detection of alcohol abuse during pregnancy? Ther Drug Monit 30:255–263CrossRefGoogle Scholar
  4. 4.
    Politi L, Leone F, Morini L, Polettini A (2007) Bioanalytical procedures for determination of conjugates of fatty acid esters of ethanol as markers of ethanol consumption: a review. Anal Biochem 368:1–16CrossRefGoogle Scholar
  5. 5.
    Janda I, Weinmann W, Kuehnle T, Lahode M, Alt A (2002) Determination of ethyl glucuronide in human hair by SPE and LC-MS/MS. Forensic Sci Int 128:59–65CrossRefGoogle Scholar
  6. 6.
    Morini L, Politi L, Groppi A, Stramesi C, Polettini A (2006) Determination of ethyl glucuronide in hair samples by liquid chromatography/electrospray tandem mass spectrometry. J Mass Spectrom 41:34–42CrossRefGoogle Scholar
  7. 7.
    Lamoureux F, Gaulier J-M, Sauvage F-L, Mercerolle M, Vallejo C, Lachâtre G (2009) Determination of ethyl-glucuronide in hair for heavy drinking detection using liquid chromatography-tandem mass spectrometry following solid-phase extraction. Anal Bioanal Chem 394:1895–1901CrossRefGoogle Scholar
  8. 8.
    Concheiro M, Cruz A, Mon M, de Castro A, Quintela O, Lorenzo A, López-Rivadulla M (2009) Ethyl glucuronide: determination in urine and hair from alcohol withdrawal patients. J Anal Toxicol 33:155–161Google Scholar
  9. 9.
    Albermann ME, Musshoff M, Madea B (2010) A fully validated high-performance liquid chromatography-tandem mass spectrometry method for the determination of ethyl glucuronide in hair for the proof of strict alcohol abstinence. Anal Bioanal Chem 396:2435–2440CrossRefGoogle Scholar
  10. 10.
    Tarcomnicu I, van Nuijs ALN, Aerts K, De Donker M, Covaci A, Neels H (2010) Ethyl glucuronide determination in meconium and hair by hydrophilic interaction liquid chromatography-tandem mass spectrometry. Forensic Sci Int 196:121–127CrossRefGoogle Scholar
  11. 11.
    Alt A, Janda I, Seidl S, Wurst F (2000) Determination of ethyl glucuronide in hair samples. Alcohol Alcohol 35:313–314Google Scholar
  12. 12.
    Skopp G, Schmitt G, Pötsch L, Drönner P, Aderjan R, Mattern R (2000) Ethyl glucuronide in human hair. Alcohol Alcohol 35:283–285Google Scholar
  13. 13.
    Jurado C, Soriano T, Giménez MP, Menédez M (2004) Diagnosis of chronic alcohol consumption. Hair analysis for ethyl-glucuronide. Forensic Sci Int 145:161–166CrossRefGoogle Scholar
  14. 14.
    Yegles M, Labarthe A, Auwärter V, Hartwig S, Vater H, Wennig R, Pragst F (2004) Comparison of ethyl glucuronide and fatty acid ethyl ester concentrations in hair of alcoholics social drinkers and teetotallers. Forensic Sci Int 145:167–173CrossRefGoogle Scholar
  15. 15.
    Paul R, Kingston R, Tsanaclis L, Berry A, Guwy A (2008) Do drug users use less alcohol than non drug users? A comparison of ethyl glucuronide concentrations in hair between the two groups in medico-legal cases. Forensic Sci Int 176:82–86CrossRefGoogle Scholar
  16. 16.
    Kharbouche H, Spokert F, Troxler S, Augsburger M, Mangin P, Staub C (2009) Development and validation of a gas chromatography-negative chemical ionization tandem mass spectrometry method for the determination of ethyl glucuronide in hair and its application to forensic toxicology. J Chromatogr B 877:2337–2343CrossRefGoogle Scholar
  17. 17.
    Álvarez I, Bermejo AM, Tabernero MJ, Fernández P, Cabarcos P, López P (2009) Microwave-assisted extraction: a simpler and faster method for the determination of ethyl glucuronide in hair by gas chromatography-mass spectrometry. Anal Bioanal Chem 393:1345–1350CrossRefGoogle Scholar
  18. 18.
    Agius R, Nadulski T, Kahl H-G, Schräder J, Dufaux B, Yegles M, Pragst F (2010) Validation of a headspace solid-phase microextraction-GC-MS/MS for the determination of ethyl glucuronide in hair according to forensic guidelines. Forensic Sci Int 196:3–9CrossRefGoogle Scholar
  19. 19.
    Zimmermann CM, Jackson G (2010) Gas chromatography tandem mass spectrometry for biomarkers of alcohol abuse in human hair. Ther Drug Monit 32:216–223Google Scholar
  20. 20.
    Auwärter V, Spokert F, Hartwig S, Pragst F, Vater H, Diefenbacher A (2001) Fatty acid ethyl esters in hair as markers of alcohol consumption. Segmental hair analysis of alcoholics, social drinkers and teetotalers. Clin Chem 47:2114–2123Google Scholar
  21. 21.
    Wurst FM, Alexson S, Wolfersdorf M, Bechtel G, Forster S, Alling C, Aradóttier S, Jachau K, Huber P, Allen JP, Auwärter V, Pragst F (2004) Concentration of fatty acid ethyl esters in hair of alcoholics: comparison to other biological state markers and self reported-ethanol intake. Alcohol Alcohol 39:33–38Google Scholar
  22. 22.
    Politi L, Morini L, Leone F, Polettini A (2006) Ethyl glucuronide in hair: is it a reliable marker of chronic high levels of alcohol consumption? Addiction 101:1408–1412CrossRefGoogle Scholar
  23. 23.
    Appenzeller BMR, Agirman R, Neuberg P, Yegles M, Wennig R (2007) Segmental determination of ethyl glucuronide in hair: a pilot study. Forensic Sci Int 173:87–92CrossRefGoogle Scholar
  24. 24.
    De Giovanni N, Donaldio G, Chiarotti M (2007) The reliability of fatty acid ethyl esters (FAEE) as biological markers for the diagnosis of alcohol abuse. J Anal Tox 31:93–97Google Scholar
  25. 25.
    Wurst FM, Kelso E, Weinmann W, Pragst F, Yegles M, Sundström Poromaa I (2008) Measurement of direct ethanol metabolites suggests higher rate of alcohol use among pregnant woman than found with the AUDIT—a pilot study in a population-based sample of Swedish women. Am J Obstet Gynecol 198:407–411Google Scholar
  26. 26.
    Bendroth P, Kronstrand R, Helander A, Greby J, Stephanson N, Krantz P (2008) Comparison of ethyl glucuronide in hair with phosphatidylethanol in whole blood as post-mortem markers of alcohol abuse. Forensic Sci Int 176:76–81Google Scholar
  27. 27.
    Morini L, Politi L, Polettini A (2009) Ethyl glucuronide in hair. A sensitive and specific marker of chronic heavy drinking. Addiction 104:915–920CrossRefGoogle Scholar
  28. 28.
    Morini L, Politi L, Acito S, Groppi A, Polettini A (2009) Comparison of ethyl glucuronide in hair with carbohydrate-deficient transferring in serum as markers of chronic high levels of alcohol consumption. Forensic Sci Int 188:140–143CrossRefGoogle Scholar
  29. 29.
    Høiseth G, Morini L, Polettini A, Christophersen A, Mørland J (2009) Ethyl glucuronide in hair compared with traditional alcohol biomarkers—a pilot study of heavy drinkers referred to an alcohol detoxification unit. Alcohol Clin Exp Res 33:812–816CrossRefGoogle Scholar
  30. 30.
    Süße S, Selavka CM, Mieczkowski T, Pragst F (2010) Fatty acid ethyl esters concentrations in hair and self-reported alcohol consumption in 644 cases from different origin. Forensic Sci Int 196:111–117CrossRefGoogle Scholar
  31. 31.
    Marques P, Tippetts S, Allen J, Javors M, Alling C, Yegles M, Pragst F, Wurst F (2010) Estimating driver risk using alcohol biomarkers, interlock blood alcohol concentration tests and psychometric assessments. Initial descriptives 105:226–239Google Scholar
  32. 32.
    Pragst F, Rothe M, Moench B, Hastedt M, Herre S, Simmert D (2010) Combined use of fatty acid ethyl esters and ethyl glucuronide in hair for diagnosis of alcohol abuse: interpretation and advantages. Forensic Sci Int 196:101–110CrossRefGoogle Scholar
  33. 33.
    Society of Hair Testing Consensus of the Society of Hair Testing on hair testing for chronic excessive alcohol consumption (2009). Available at: Accessed 18 August 2009.
  34. 34.
    Schubert W, Mattern R (2009) Beurteilungskriterien zur Fahreignungsdiagnostik, 2nd edn. Kirschbaum Verlag, BonnGoogle Scholar
  35. 35.
    Kerekes I, Yegles M, Grimm U, Wennig R (2009) Ethyl glucuronide determination: head hair versus non-head hair. Alcohol Alcohol 44:62–66Google Scholar
  36. 36.
    Society of Toxicological and Forensic Chemistry (GTFCh) (2009) Anforderungen an die Validierung von Analysenmethoden. T + K 76:185–208.Google Scholar
  37. 37.
    Foti RS, Fisher MB (2005) Assessment of UDP-glucuronosyltransferase catalyzed formation of ethyl glucuronide in human liver microsomes and recombinant UGTs. Forensic Sci Int 153:109–116CrossRefGoogle Scholar
  38. 38.
    Laposata EA, Lange LG (1986) Presence of nonoxidative ethanol metabolism in human organs commonly damaged by ethanol abuse. Science 231:497–499CrossRefGoogle Scholar
  39. 39.
    Laposata M (1999) Fatty acid ethyl esters: nonoxidative ethanol metabolites with emerging biological and clinical significance. Lipids 34:S281–S285CrossRefGoogle Scholar
  40. 40.
    Hartwig S, Auwärter V, Pragst F (2003) Effect on hair care cosmetics on the concentrations of fatty acid ethyl esters in hair as markers of chronically elevated alcohol consumption. Forensic Sci Int 131:90–97CrossRefGoogle Scholar
  41. 41.
    De Giovanni N, Donadio G, Chiarotti M (2008) Ethanol contamination leads to fatty acid ethyl esters in hair samples. J Anal Tox 32:156–159Google Scholar
  42. 42.
    Pragst F, Auwärter V, Kießling B, Dyes C (2004) Wipe-test and patch-test for alcohol misuse based on the concentration ratio of fatty acid ethyl esters and squalene C FAEE/C SQ in skin surface lipids. Forensic Sci Int 143:77–86CrossRefGoogle Scholar
  43. 43.
    Tsanaclis L, Kinston R, Wicks J (2009) Testing for alcohol use in hair: is ethyl glucuronide (EtG) stable in hair? Ann Toxicol Anal 21:67–71CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Institute of Forensic MedicineUniversity Hospital BonnBonnGermany

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