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Detection of Phosphatidylethanol (PEth) in the Blood of Drivers in an Alcohol Ignition Interlock Program

Marques, Paul; Hansson, Therese LU ; Isaksson, Anders LU ; Walther, Lisa; Jones, Joseph; Lewis, Douglas and Jones, Mary (2011) In Traffic Injury Prevention 12(2). p.136-141
Abstract
Objective: The rate of failed interlock blood alcohol content (BAC) tests is a strong predictor of recidivism post-interlock and a partial proxy for alcohol use. Alcohol biomarkers measured at the start of an interlock program are known to correlate well with rates of failed BAC tests over months of interlock use. This study evaluates 2 methods of measuring low blood levels of the biomarker phosphatidylethanol (PEth). PEth is a 100 percent alcohol-specific biomarker and strongly intercorrelated with several independent indicators of drinking driving risk, including 8 other biomarkers, 3 psychometric assessments, and the rate of failed interlock BAC tests during many months of interlock use. Does a more sensitive method of measuring PEth at... (More)
Objective: The rate of failed interlock blood alcohol content (BAC) tests is a strong predictor of recidivism post-interlock and a partial proxy for alcohol use. Alcohol biomarkers measured at the start of an interlock program are known to correlate well with rates of failed BAC tests over months of interlock use. This study evaluates 2 methods of measuring low blood levels of the biomarker phosphatidylethanol (PEth). PEth is a 100 percent alcohol-specific biomarker and strongly intercorrelated with several independent indicators of drinking driving risk, including 8 other biomarkers, 3 psychometric assessments, and the rate of failed interlock BAC tests during many months of interlock use. Does a more sensitive method of measuring PEth at program entry detect drinking even among those who subsequently log no failed interlock tests? Methods: In a sample of 281 driver blood samples, PEth was measured by both high-performance liquid chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LCMSMS) in order to compare sensitivity and accuracy. The average rate of failed interlock BAC tests was the criterion measure for marker sensitivity. LCMSMS, calibrated to detect low levels of drinking as a possible measure of abstinence violation, was judged relative to the standard HPLC assay for PEth measured up to 4 mol/L. Results: The 2 methods showed a good quantitative relationship (r2 .86). LCMSMS detected positive PEth levels in samples that were below the limit of detection of the HPLC method. PEth measured by LCMSMS was positive for a higher proportion of driving under the influence (DUI) offenders who logged zero failed interlock BAC tests than were detected by HPLC. Conclusion: Although HPLC is the widely used standard for measuring PEth in clinical alcoholism samples, the LCMSMS method, when calibrated to detect trace amounts of the major component of PEth, can detect abstinence levels of alcohol near zero intake and still correlate strongly with other indicators related to alcohol use and road safety. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Phosphatidylethanol, HPLC, LCMSMS, DUI drivers, Alcohol, Interlocks, Abstinence
in
Traffic Injury Prevention
volume
12
issue
2
pages
136 - 141
publisher
Taylor & Francis
external identifiers
  • wos:000289254700004
  • scopus:79953862890
ISSN
1538-9588
DOI
10.1080/15389588.2010.544048
language
English
LU publication?
yes
id
0178a158-3c7a-4515-9105-25b05d60b48f (old id 1965158)
date added to LUP
2011-06-01 10:41:16
date last changed
2017-10-22 04:06:17
@article{0178a158-3c7a-4515-9105-25b05d60b48f,
  abstract     = {Objective: The rate of failed interlock blood alcohol content (BAC) tests is a strong predictor of recidivism post-interlock and a partial proxy for alcohol use. Alcohol biomarkers measured at the start of an interlock program are known to correlate well with rates of failed BAC tests over months of interlock use. This study evaluates 2 methods of measuring low blood levels of the biomarker phosphatidylethanol (PEth). PEth is a 100 percent alcohol-specific biomarker and strongly intercorrelated with several independent indicators of drinking driving risk, including 8 other biomarkers, 3 psychometric assessments, and the rate of failed interlock BAC tests during many months of interlock use. Does a more sensitive method of measuring PEth at program entry detect drinking even among those who subsequently log no failed interlock tests? Methods: In a sample of 281 driver blood samples, PEth was measured by both high-performance liquid chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LCMSMS) in order to compare sensitivity and accuracy. The average rate of failed interlock BAC tests was the criterion measure for marker sensitivity. LCMSMS, calibrated to detect low levels of drinking as a possible measure of abstinence violation, was judged relative to the standard HPLC assay for PEth measured up to 4 mol/L. Results: The 2 methods showed a good quantitative relationship (r2 .86). LCMSMS detected positive PEth levels in samples that were below the limit of detection of the HPLC method. PEth measured by LCMSMS was positive for a higher proportion of driving under the influence (DUI) offenders who logged zero failed interlock BAC tests than were detected by HPLC. Conclusion: Although HPLC is the widely used standard for measuring PEth in clinical alcoholism samples, the LCMSMS method, when calibrated to detect trace amounts of the major component of PEth, can detect abstinence levels of alcohol near zero intake and still correlate strongly with other indicators related to alcohol use and road safety.},
  author       = {Marques, Paul and Hansson, Therese and Isaksson, Anders and Walther, Lisa and Jones, Joseph and Lewis, Douglas and Jones, Mary},
  issn         = {1538-9588},
  keyword      = {Phosphatidylethanol,HPLC,LCMSMS,DUI drivers,Alcohol,Interlocks,Abstinence},
  language     = {eng},
  number       = {2},
  pages        = {136--141},
  publisher    = {Taylor & Francis},
  series       = {Traffic Injury Prevention},
  title        = {Detection of Phosphatidylethanol (PEth) in the Blood of Drivers in an Alcohol Ignition Interlock Program},
  url          = {http://dx.doi.org/10.1080/15389588.2010.544048},
  volume       = {12},
  year         = {2011},
}