Wipe-test and patch-test for alcohol misuse based on the concentration ratio of fatty acid ethyl esters and squalene CFAEE/CSQ in skin surface lipids

Fatty acid ethyl esters (FAEE) are known to be formed in blood and almost all human tissues after alcohol consumption and to be incorporated from sebum into hair where they can be used as long-term markers for excessive alcohol consumption. In order to examine whether skin surface lipids which consist mainly of sebum are an equally useful matrix for measurement of FAEE as alcohol abuse markers, samples were collected by a wipe-test from the forehead of 13 teetotallers, 16 social drinkers, 10 death cases with known recent alcohol misuse and five death cases without indications of alcohol misuse. The samples were analysed by headspace solid-phase microextraction and gas chromatography-mass spectrometry for ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate and by high performance liquid chromatography with photodiode array detector for squalene, (SQ), as a natural reference substance which the FAEE concentrations were related to. The ratio mFAEE/mSQ ranged between 0.16 and 1.12 ng/microg (mean 0.34 ng/microg) for the teetotallers and between 0.08 and 0.94 ng/microg (mean 0.37 ng/microg) for the social drinkers with no significant difference between both groups. For the alcoholics 2.4-24.2 ng/microg (mean 13.1 ng/microg) were found. For two volunteers the course of mFAEE/mSQ 2 weeks before and 3 weeks after a single high alcohol dose was pursued by daily wipe tests. A strong increase of mFAEE/mSQ occurred between 7 and 12 days after the drinking event. This delay can be explained by the transition time of about 8 days between sebum production and its appearance on the skin surface known from literature. For seven social drinkers skin surface lipid samples were also collected using drug of abuse patches of the firm PharmCheck. The ratios mFAEE/mSQ in these samples were in the same range as from the wipe-test. The comparison with the self-reported ethanol amounts consumed the week before and during the test gave no good correlation (R2 = 0.42). It can be concluded from the results that FAEE in skin surface lipids can be used for medium-term retrospective detection of heavy drinking.     

Problem solving and youth violence: an evaluation of the Boston Gun Project

The Boston Gun Project is a problem-solving policing initiativeaimed at reducing homicide victimization among young peoplein the city of Boston. It represented an innovative partnershipbetween researchers and practitioners to assess the city's youthhomicide problem and implement an intervention intended to havepowerful impacts in the near term. In early 1996, a workinggroup representing a variety of law enforcement and social serviceagencies implemented an intervention that strategically respondedto gang violence, focused enforcement efforts on gun trafficking,and emphasized communication of the strategy to generate deterrence.The intervention is associated with a 60% decline in youth homicidevictimization (i.e., two fewer victims per month). There aresmaller declines in other measures of violence. The declinein youth homicide is sharp and occurs coincident with the introductionof the intervention. Competing hypotheses appear unable to accountfor the decline.     

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.