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The Impact of Breathing Pattern and Lung Size on the Alcohol Breath Test

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Abstract

Highly soluble gases exchange primarily with the bronchial circulation through pulmonary airway tissue. Because of this airway exchange, the assumption that end-exhaled alcohol concentration (EEAC) is equal to alveolar alcohol concentration (AAC) cannot be true. During exhalation, breath alcohol concentration (BrAC) decreases due to uptake of ethanol by the airway tissue. It is therefore impossible to deliver alveolar gas to the mouth during a single exhalation without losing alcohol to the airway mucosa. A consequence of airway alcohol exchange is that EEAC is always less than AAC. In this study, we use a mathematical model of the human lung to determine the influence of subject lung size on the relative reduction of BrAC from AAC. We find that failure to inspire a full inspiration reduces the BrAC at full exhalation, but increases the BrAC at minimum exhalation. In addition, a reduced inhaled volume and can lead to an inability to provide an adequate breath volume. We conclude that alcohol exchange with the airways during the single-exhalation breath test is dependent on lung size of the subject with a bias against subjects with smaller lung size.

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Notes

  1. A list of abbreviations used in this paper is shown in Table 1.

  2. The blood:breath ratio is equal to the ratio of end-exhaled alcohol concentration divided by blood alcohol concentration (EEAC/BAC)

  3. The Blood–Breath Ratio (BBR) is a commonly used term in forensic science. Because alcohol is a very highly soluble gas, the ratio of concentration in the blood normalized by that in the breath is a very large number (typically around 2000). For a given Blood Alcohol Concentration (BAC), the Breath Alcohol Concentration (BrAC) is about 1/2000 x BAC. With smaller lung volumes, the BrAC is greater, hence the BBR (= BAC/BrAC) is lesser. In one case the BrAC is in the numerator (BrAC/AAC). In the other case, the BrAC is in the denominator. So a greater BBR is the same as a lesser BrAC/AAC.

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Acknowledgments

This work was supported, in part, by National Institute for Biomedical

Imaging and Bioengineering Grant T32 EB001650 and by National Heart,

Lung, and Blood Institute Grants HL24163 and HL073598.

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Authors and Affiliations

  1. Department of Physiology and Biophysics, University of Washington, Box 356522, Seattle, WA, 98195-6522, USA

    Michael P. Hlastala

  2. Department of Medicine, University of Washington, Box 356522, Seattle, WA, 98195-6522, USA

    Michael P. Hlastala

  3. Division of Pulmonary and Critical Care Medicine, University of Washington, Box 356522, Seattle, WA, 98195-6522, USA

    Michael P. Hlastala

  4. Department of Bioengineering, University of Washington, Seattle, WA, 98195-5061, USA

    Joseph C. Anderson

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  1. Michael P. Hlastala
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Correspondence to Michael P. Hlastala.

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Hlastala, M.P., Anderson, J.C. The Impact of Breathing Pattern and Lung Size on the Alcohol Breath Test. Ann Biomed Eng 35, 264–272 (2007). https://doi.org/10.1007/s10439-006-9216-3

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  • DOI: https://doi.org/10.1007/s10439-006-9216-3

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