The influence of alcohol content variation in UK packaged beers on the uncertainty of calculations using the Widmark equation

It is common for forensic practitioners to calculate an individual's likely blood alcohol concentration following the consumption of alcoholic beverage(s) for legal purposes, such as in driving under the influence (DUI) cases. It is important in these cases to be able to give the uncertainty of measurement on any calculated result, for this reason uncertainty data for the variables used for any calculation are required. In order to determine the uncertainty associated with the alcohol concentration of beer in the UK the alcohol concentration (%v/v) of 218 packaged beers (112 with an alcohol concentration of ≤5.5%v/v and 106 with an alcohol concentration of >5.5%v/v) were tested using an industry standard near infra-red (NIR) analyser. The range of labelled beer alcohol by volume (ABV's) tested was 3.4%v/v – 14%v/v. The beers were obtained from a range of outlets throughout the UK over a period of 12?months. The root mean square error (RMSE) was found to be ±0.43%v/v (beers with declared %ABV of ≤5.5%v/v) and ±0.53%v/v (beers with declared %ABV of >5.5%v/v) the RMSE for all beers was ±0.48%v/v. The standard deviation from the declared %ABV is larger than those previously utilised for uncertainty calculations and illustrates the importance of appropriate experimental data for use in the determination of uncertainty in forensic calculations.     

Concentration-time profiles of ethanol in capillary blood after ingestion of beer.

Blood ethanol profiles were determined in experiments with healthy volunteers after they had drunk beer. When 330 ml of light beer (1.8% w/v ethanol) was consumed in 5 min by four men and four women, the average peak blood-alcohol concentration (BAC) reached was 8 mg/100 ml (range 2-11). After nine men had drunk 660 ml of beer (3.0% w/v or 3.6% w/v ethanol) in 25 minutes on an empty stomach, the average peak BAC was 32 mg/100 ml (range 26-44) and 37 mg/100 ml (range 23-54) respectively. When the same two beers were consumed by another nine men together with a meal, the peak BAC was 24 mg/100 ml (range 20-29) and 28 mg/100 ml (range 20-39) respectively. The peak BAC occurred earlier when beer was ingested together with food; mean 32 min (range 30-50) compared with 41 min (range 30-70) with an empty stomach. The rate of disappearance of alcohol from blood (beta-slope) was 12 mg/100 ml/h in the fed state and 15 mg/100 ml/h when subjects were fasted. The apparent volume of distribution of ethanol (Vd) was 0.65 l/kg (SD 0.07) for the empty stomach condition but exceeded unity when beer was ingested together with food. It seems that part of the dose of alcohol when consumed with food never reaches the systemic circulation.     

Uncertainty in Widmark calculations: ABV variation in packaged versions of the most popular beers in the UK

Forensic practitioners regularly use the Widmark equation to determine theoretical blood alcohol concentrations for use in cases involving alcohol. It is important with these calculations to determine the uncertainty associated with any result. Previous work has investigated the uncertainty in percent alcohol by volume (%ABV) from beers produced by small independent breweries in the UK but did not study the top selling beers in the UK. The top selling lagers and ales/bitters in the UK were identified by sales volume and the %ABV determined. These data was then used to determine the percent coefficient of variation (%CV) that should be used by forensic practitioners when constructing alcohol technical defence reports for use in forensic cases. These samples, from what may be described as ‘big’ brewers, were determined to have a smaller root mean square error (RMSE) (±0.1%v/v, n?=?35), and %CV than those previously reported for beers produced by small, independent breweries in the UK. The results from this study shows that different RMSE's should be used for %ABV when determining the uncertainty of results from Widmark calculations depending if the drinks consumed have been from either ‘big’ brewers or small, independent breweries.     

The accuracy of blood alcohol analysis using headspace gas chromatography when performed on clotted samples

Subjects consumed alcoholic beverages and attained blood ethyl alcohol concentrations ranging from 0.02 to 0.15 g/dL. Sets of blood samples were drawn from these subjects, including some samples that were allowed to clot and some in which anticoagulent was added. A quantitative analysis for ethyl alcohol was performed on these samples using headspace gas chromatography. The mean deviation of the concentration of ethyl alcohol in the clotted samples from the ethyl alcohol concentration in the corresponding control samples was 0.001 g/dL. The 99% confidence interval for this mean was +/- 0.0005 g/dL.     

Alcohol metabolism of local Chinese in Hong Kong: a statistical determination on the effects of various physiological factors

A study was designed to examine the elimination rate of alcohol from the body of the local Chinese after consumption of different types of alcoholic drinks. The breath alcohol of 184 healthy volunteers was determined and converted into blood alcohol levels after they finished drinking. Information on the type and volume of alcoholic drinks consumed, age group, sex, drinking habit, and drinking on empty stomach or with/after meal was recorded for each participant. The results show that the elimination rate of an individual can be explained in terms of physiological variables including sex and drinking habit. The determined elimination rates allow forensic toxicologists to back calculate the blood alcohol concentration (BAC) of the drivers at the time of accident in drunk driving cases. The elimination rates of blood alcohol at 95% prediction intervals for male and female are in the range of 9.5-23.8 mg/100 ml/h and 11.1-37.1 mg/100 ml/h, respectively.     

Fatalities due to methyl alcohol intoxication in Turkey: an 8-year study

The aim of this study is to examine methyl alcohol poisoning cases from the medico-legal point of view. The records of the Morgue Department of Council of the Forensic Medicine were reviewed retrospectively for all methyl alcohol poisonings for the period of 27.10.1992 and 30.05.2001. The victim's age, sex, death year, death place, methyl alcohol blood levels, the source of methyl alcohol, accompanying laboratory results and histopathologic tissue changes were recorded. The number of deaths due to the methyl alcohol poisoning was 271 during that period of time. Two hundred and forty-two of the (89.3%) total 271 methyl alcohol fatalities were men and 29 (10.7%) of were women. The largest age group was 36-40 years old, followed by 41-45. The methyl alcohol blood concentrations ranged widely from 50 to 755 mg for per 100 ml. There were 222 cases (81.9%) with the methyl alcohol blood concentrations over 100 mg/dl. Twenty-nine (10.7%) victims were poisoned through the consumption of cologne and three of them with alcoholic beverage named "Raki". Consumed products were not known in all other cases because of insufficient patient history and data. As a conclusion, regarding the distribution according to years, mortality due to methyl alcohol intoxication in our country have been proceeding on a certain level. In order to decrease the mortality due to methyl alcohol intoxication, some precautions should be developed that could prevent the production and consumption of alcoholic beverages illegally produced.     

Detection of Denatonium Benzoate (Bitrex) Remnants in Noncommercial Alcoholic Beverages by Raman Spectroscopy

Illegal alcoholic beverages are often introduced into market using cheap technical alcohol, which is contaminated by denatonium benzoate (Bitrex) of very small concentration. Bitrex is the most bitter chemical compound and has to be removed before alcohol consumption. The home‐made methods utilize sodium hypochlorite to disintegrate particles of denatonium benzoate in alcohol and to remove bitter taste before trading. In this experimental studies, we propose a novel method that detects in a fast way the remnants of denatonium benzoate in dubious alcohol samples by Raman spectroscopy. This method applies a portable Raman spectrometer of excitation wavelength 785 nm and utilizes the effect of surface‐enhanced Raman spectroscopy (SERS) to recognize the suspected alcoholic beverages. High effectiveness (over 98%) of YES/NO classification of the investigated samples was observed when the nonlinear algorithm support vector machine (SVM) was exploited at carefully adjusted detection parameters. The method can identify illicit alcohol within minutes.     

Consumption of a large dose of alcohol in a short time span.

Blood alcohol concentrations (BAC) and time to peak BAC were determined in 16 subjects after ingestion of a large quantity of alcoholic beverages within a short drinking time span not exceeding 30 min. The first group (7 subjects) consumed alcohol after a 3- to 4-h fast. In the second group (9 subjects) the consumption of alcohol took place after eating a large meal. Venous blood samples taken 30 min after drinking finished were compared to the near-simultaneous Breathalyzer results. In addition, the minimum duration of a BAC plateau for these drinking circumstances was assessed.     

Comparison of ethyl glucuronide and fatty acid ethyl ester concentrations in hair of alcoholics, social drinkers and teetotallers

In previous investigations hair analysis for ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEE) proved to be suitable for the detection of excessive alcohol consumption. The aim of this study was to compare EtG and FAEE concentrations in hair of alcoholics, social drinkers and teetotallers. Hair samples from 10 alcoholics in withdrawal treatment, 11 fatalities with documented excessive alcohol consumption, four moderate social drinkers who consumed up to 20 g ethanol per day, and three strict teetotallers were analysed. After external degreasing with n-heptane, extraction with a dimethyl sulfoxide/n-heptane mixture and headspace solid-phase microextraction of the extracts, four fatty acid ethyl esters (FAEEs) (ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate) were analysed by gas chromatography-mass spectrometry (GC-MS) with deuterated internal standards. EtG was determined by GC-MS/NCI after ultrasonication of the samples with H2O, cleanup by SPE with aminopropyl columns and PFP derivatisation. The following concentrations were measured for the four groups: teetotallers EtG < 0.002 ng/mg, FAEE 0.05-0.37 ng/mg, moderate social drinkers EtG < 0.002 ng/mg, FAEE 0.26-0.50 ng/mg, alcoholic patients EtG 0.030-0.415 ng/mg, FAEE 0.65-20.50 ng/mg and the fatalities with alcohol history EtG 0.072-3.380 ng/mg, FAEE 1.30-30.60 ng/mg. The results confirm that by using a cut-off value of the sum of FAEE > 1 ng/mg and/or a positive EtG result in hair, excessive alcohol consumption can be identified using hair analysis. However, no significant correlation between the EtG and FAEE concentrations in the positive cases could be shown. Segmental analysis of some of the specimens did not reveal the same distribution for EtG compared to FAEE in hair, and no chronological accordance compared to the self-reported alcohol consumption could be observed for both parameters. These different results of both methods are discussed in terms of differences between EtG and FAEE in mechanism of formation and incorporation into hair and elimination from hair.     

Profiling of volatile impurities in tetramethylenedisulfotetramine (TETS) for synthetic-route determination

In recent years, alcohol consumption has been considered an important public health problem. Ethanol, the alcohol used in beverages, is a drug that affects the central nervous system (CNS) and impairs driving skills and co-ordination, increasing risk of deaths and injuries derived from crashes and road accidents. Consumption of alcoholic beverages is implicated with premature deaths, injuries and damages caused by motor vehicle crashes, which result in high costs to government and society. Considering that alcohol consumption is the main responsible factor for deaths and disabilities in young people, the aim of this work was to evaluate the prevalence of blood alcohol in offenders and/or fatal and non-fatal victims of traffic occurrences in the region of Ribeir?o Preto, S?o Paulo State, from 2005 to 2007. The results revealed that in 2134 cases investigated, blood alcohol positivity was generally found in young adults, 25-45 years old and male. The study showed the high risk of drinking and driving and the importance in establishing actions of prevention and intervention to promote the reduction in the number of traffic occurrences related to consumption of alcoholic beverages.     

Fatal ethanol intoxication from household products not intended for ingestion

Fatal acute ethanol intoxication is frequently encountered in medicolegal practice. Although the vast majority of acute ethanol toxicity deaths follow the ingestion of conventional alcoholic beverages, ethanol can be obtained from a variety of commercial products, which often contain high levels of ethyl alcohol but are not manufactured or designed for consumption. Such products may be easily purchased in locales where statutory limitations restrict liquor availability on Sundays or during the early morning hours. Several acute ethanol fatalities have been encountered in New Mexico that were directly related to consumption of non-beverage ethanol-containing products, all of them occurring during times when alcoholic beverage sales were restricted. Despite the fact that manufacturers deliberately include compounds in these products that discourage ingestion, this policy apparently does little to deter individuals who are searching for a source of ethanol when no conventional beverages are available. The products that were consumed in these fatalities also contained other compounds which would be toxic at much greater concentrations, but which were inconsequential in their effects in comparison with the direct toxic effect of ethanol. Investigation of the scene and awareness that alcohol-containing products can be fatally abused are essential to detecting these unconventional ethanol sources.     

Squalene in hair--a natural reference substance for the improved interpretation of fatty acid ethyl ester concentrations with respect to alcohol misuse

Fatty acid ethyl esters (FAEE) are incorporated into hair mainly from sebum. For this reason, the use of their concentration CFAEE as marker of excessive alcohol consumption is complicated by interindividual differences of the activity of the sebum glands and of elimination by hair care and hair cosmetics. Furthermore, an influence of the investigated hair length due to increasing accumulation from proximal to distal was found. Therefore, it was examined whether these sources of error can be avoided if in addition to CFAEE the relative FAEE concentrations CFAEE/CSQ related to squalene SQ as a natural reference compound were used for interpretation. Sebum contains about 10-20% SQ. A sensitive and reliable method for the determination of SQ in addition to FAEE from the same hair extracts by high performance liquid chromatography with photo diode array detector (HPLC-DAD) was developed. The concentrations of ethyl myristate, ethyl palmitate, ethyl oleate, ethyl stearate and squalene were determined and CFAEE/CSQ was calculated for 13 teetotallers, 16 social drinkers, 12 fatalities with excessive alcohol abuse at life time and 9 cases with unclear alcohol anamnesis. CSQ ranged from 0.02 to 1.97 microg/mg (mean 0.67 microg/mg). From the results follows that squalene enables a control of the lipid content of hair and a correction of CFAEE in cases with deviations from the usual lipid content in a similar way as creatinine in urine. Preliminary values of CFAEE/CSQ were suggested for the upper limit for teetotallers (< 0.6 ng/microg) and the lower limit for excessive alcohol abuse (> 1.5 ng/microg). However, the relative concentration CFAEE/CSQ cannot completely replace the absolute concentration CFAEE, and both should regularly be used for an improved interpretation with respect to alcohol abuse.     

Postmortem blood free and total morphine concentrations in medical examiner cases

This purpose of this study was to determine the relationships between postmortem free morphine and total morphine levels in a large series of medical examiner morphine and heroin related deaths. Free morphine, total morphine, and 6-monoacetylmorphine (6-MAM) concentrations were measured by gas chromatography-mass spectrometry (GC-MS) in 87 medical examiner cases over 20 months. The mean total morphine concentration, mean free morphine concentration, and mean percent free morphine for all cases were: 2.3 mg/L (SD 5.2 mg/L), 0.5 mg/L (SD 1.6 mg/L), and 19.4% (SD 22.8%); respectively. Regression analyses showed weak correlations between total and free morphine concentrations over the entire concentration range (0 to 36.6 m/L, r = 0.603, n = 91) and over a subset concentration range of 0 to 1.0 mg/L (r = 0.369, n = 54). Twenty-three out of 56 (41%) tested positive for 6-MAM, indicative heroin abuse cases. Lower total and free morphine concentrations and a higher percent free morphine were found in individuals with detectable 6-MAM. Comparing blood concentrations for cases with and without detectable 6-MAM demonstrated mean total morphine concentrations of 0.9 mg/L versus 2.1 mg/L (p = 0.05), mean free morphine concentrations of 0.3 mg/L versus 0.4 mg/L (p = 0.21), and mean percent free morphine of 34.7% versus 13.7% (p < 0.003), respectively. Our findings demonstrate higher free to total morphine ratios in individuals with detectable 6-MAM than in individuals without 6-MAM. The database established in this study may assist medical examiners in the evaluation of postmortem blood opiates regarding the cause of death in opiate related ingestion cases.     

ALDH2基因多态性与乙醇代谢及外周乙醛积蓄程度的关系

目的了解不同乙醛脱氢酶2（acetaldehydedehydrogenase2,ALDH2）基因型人群饮酒后,其乙醇药代动力学和外周乙醛积蓄程度。方法收集无血缘关系的志愿者14名,采集静脉血液并且通过聚合酶链反应限制性片段长度多态性技术提取DNA并检测ALDH2基因型,按一定剂量饮酒后,以顶空气相色谱法于不同时间点同时测定血中乙醇及乙醛的含量并计算药代动力学参数。结果根据电泳结果,野生组为5名野生纯合型ALDH2＊1／＊1个体．突变组为9名突变杂合型ALDH2＊1／＊2个体,血中乙醇和乙醛分别在0～1570．7μg/mL和0～5．1772μg／mL范围内线性关系良好。突变组乙醇及乙醛药时曲线下面积（AUC）以及乙醇的末端消除半衰期（tl／2Z）均大于野生组,乙醇的经生物利用度校正的表观消除率（CL／F）小于野生组（P〈0．05）。结论饮酒后,ALDH2＊I／＊2突变组受酶活性抑制影响,血中乙醇和乙醛代谢减慢,造成外周乙醛的蓄积,从而进一步强化其在体内的作用。     

Segmental determination of ethyl glucuronide in hair: a pilot study

Ethyl glucuronide (EtG) is a minor metabolite of ethanol. Its detection in hair is more and more studied in both clinical and forensic context for the purpose of alcohol abuse monitoring. In this pilot study, hair specimens from 15 patients included in a treatment program after alcohol abuse cessation, were segmented and analyzed for EtG. The results were then compared to their self-reported past alcohol consumption and to their blood biomarkers values (GGT, MCV, ASAT, ALAT). EtG concentrations measured in hair varied from 8 to 261 pg/mg. The pattern of EtG concentration detected in the different hair segments matched with the drinking history of patients, displaying variations (increase and decrease) in alcohol consumption and also time of cessation. Results also demonstrated the existence of a significant correlation (r(p)=0.5357; p=0.0390) between EtG concentration in hair and the amount of alcohol intake. Variations in the EtG concentrations with respect to hair segments may provide an overview of the drinking history of patients. Moreover, EtG concentration in hair may help to estimate the daily alcohol intake.     

Post mortem markers of chronic alcoholism

We compared the post mortem diagnostic value of γ-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), alcoholic liver disease (ALD), blood alcohol concentration (BAC), the presence of multiple bruises and poor hygiene of the feet as markers of chronic alcoholism (heavy continuous drinking) in 32 alcoholics with 32 age-sex matched controls drawn from a forensic autopsy population. Alcoholics and controls were selected on the basis of positive and negative medical history but controls were excluded if BAC exceeded 70 mg%. Femoral venous blood, urine and vitreous humour alcohol concentrations were determined by headspace gas chromatography (GC). BAC was positive in 19 alcoholics (mean 234 mg%, range 2–570 mg%) and six controls (mean 32 mg%, range 2–52 mg%). Serum GGT was measured by a kinetic photometric method, and CDT by both isoelectric focusing/laser densitometry and by a commercial radioimmunoassay kit (CDTect^™). Features of alcoholic liver disease were graded histologically using two weighted scoring systems. Eleven alcoholics tested positive for GGT, CDTq and ALD, nine were positive for two tests, five for one test and three were negative for all three tests. No controls were positive for all three tests but six were positive for two tests and nine for only one test; 17 were negative for all three tests. Using the normal clinical cut-off values GGT, CDTq and CDTect^™ gave poor specificity which was improved at moderate cost to sensitivity by raising cut off values for each test. Comparison of receiver operating characteristic curves, likelihood ratios and post-test odds showed CDT to be the best individual test, followed by ALD and GGT. Quantitation of CDT by IEF/laser densitometry performed slightly better than MAEC/RIA by CDTect^™. CDT shows considerable promise as a post mortem marker of chronic alcoholism.     

Methyl alcohol poisoning in Trabzon (Turkey)

The aim of this retrospective study was to examine methyl alcohol intoxications in Trabzon (Turkey) and to determine any relations between the laboratory results and histopathologic changes. A total of 4492 forensic autopsies were performed from 1998 to 2008. Thirteen of the cases (0.3%) were because of methanol poisoning, and all were men. Their ages ranged from 25 to 62 years. The blood methanol concentrations ranged widely, from 15 to 482 mg/dL. In six cases, poisoning was because of consumption of the alcoholic beverage "Raki," while in five cases, poisoning was because of the ingestion of cologne. The products consumed were unknown in the other two cases because of insufficient history and data records. Mortality because of methanol poisoning may be prevented/decreased with the implementation of some precautions, such as public education regarding the harms of methyl alcohol, routine monitoring of the vendors that sell alcoholic beverages and cologne, and appropriate legal retribution for the illegal production of methanol.     

酒的种类对乙醇代谢动力学的影响

目的乙醇代谢动力学受诸多因素影响,关于酒的种类对其影响少见报道。方法本研究让志愿者在相同的饮酒时间内,饮用含相同乙醇量的啤酒、白酒,将所得数据用药代动力学计算程序DAS Ver1.0进行处理。结果乙醇的体内过程符合一级吸收、非线性消除、一室模型,权重为1。啤酒与白酒相比,吸收速度快,峰浓度高,达峰时间早,消除速度快。结论酒的种类对乙醇代谢动力学有影响,如果根据乙醇的代谢动力学规律来推测饮酒个体某一时刻的BAC,或根据BAC推测实际饮酒量,应该充分考虑到酒的种类对乙醇代谢动力学的影响。     

Enzymatic detection of γ-hydroxybutyrate using aldo-keto reductase 7A2

Gamma-hydroxybutyrate (GHB) is a prescribed medication as well as a drug of abuse. Its detection in various matrices for in-field forensic scientists remains a challenge. We have developed an assay that uses aldo-keto reductase 7A2 (AKR7A2) for the specific determination of GHB in various drinks. AKR7A2 was purified using Ni-affinity chromatography. The Michaelis-Menten constant for the GHB oxidation reaction was 10 mM, and the minimum detection limit was 4 mM. Ethanol was not a substrate for AKR7A2. In a coupled reaction with NADP(+), phenazine methosulfate (PMS), and 2,6-dichlorophenolindophenol, various beverages (orange juice, milk, soda, and numerous alcoholic drinks) containing GHB turned from blue to light yellow. In a second coupled reaction where diaphorase replaced PMS, the presence of GHB also caused the expected change of color in various beers.     

Alcohol and rape: An “economics-of-crime” perspective

Using a panel of state-level data over the years 1982–2000, this study explores the potential relationship between alcohol policy, alcohol consumption, and rape by considering a number of theoretical and methodological issues. First, the potential relationship is examined in the context of an economics-of-crime model, controlling for various deterrence and opportunity cost variables. Second, unlike most studies, consumption of liquor and wine are considered as well as consumption of beer. A third focus is on the potential endogeneity of alcohol consumption. A fourth consideration dictates the focus on rape-rates rather than other violent crime rates. Several studies have discovered a tendency for relatively high alcohol consumption by both offenders and victims. Since rape victims are virtually all female, and at least some alcohol policy variables appear to have differential impacts on females and heavy-drinking males, an examination of policy impacts for rape-rates, unlike other types of violent crime, can suggest the nature of the alcohol-consumption–violence relationship. The empirical results support an “alcohol-increases-potential-victims-vulnerability” hypothesis. In the context of the economic theory of crime, this lowers the expected cost of rape to potential offenders and raises rape-rates. Tests for endogeneity of alcohol consumption and resulting simultaneous equation estimates reinforce this implication because they suggest that potential victims respond to relatively high rape-rates by reducing alcohol consumption.