CORRELATION BETWEEN THE SEVERITY AND BLOOD ALCOHOL LEVEL OF TRAFFIC ACCIDENTS VICTIMS.

Objective: To evaluate the correlation between blood alcohol levels and the severity of injuries assessed by the Injury Severity Score (ISS) in patients who were victims of traffic accidents admitted to the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). Methods: Cross-sectional study carried out between July 2018 and June 2019, at the Central Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (PSC-HCFMUSP). A total of 172 hospitalized patients victims of traffic accidents were included in this study. Blood samples were analyzed by the FMUSP Toxicology Laboratory. Results: 36 patients (20.9%) had positive BAC (≥ 0.2 g/L) with a mean of 1.21 g/L. Overall, patients had a mean age of 37.2 years old, and 136 (79.1%) were men. The ISS of the total casuistry was 15.6; regarding the external cause, the motorcycle was ranked first with 100 cases (58.1%), and drivers were the majority with 57.4% of the sample. Conclusion: There was no correlation between the severity of the injuries and the blood alcohol levels of traffic accident victims admitted to a reference hospital. Level of Evidence II, Cross-Sectional Study.

Objetivo: Avaliar a correlação entre a alcoolemia e a gravidade das lesões avaliadas pelo Índice de Gravidade da Lesão ( Injury Severity Score* ­ ISS) em vítimas de acidentes de trânsito internadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). Método: Estudo transversal realizado entre julho de 2018 e junho de 2019, no Pronto Socorro Central do HC-FMUSP. Foram incluídas 172 vítimas de acidentes de trânsito. Amostras de sangue foram analisadas pelo Laboratório de Toxicologia da FMUSP. Resultados: 36 pacientes (20,9%) apresentaram alcoolemia positiva (≥ 0,2 g/L), com valor médio de 1,21 g/L. No geral, os pacientes tinham uma idade média de 37,2 anos, e 136 (79,1%) eram homens. O ISS da casuística total foi 15,6; quanto à causa externa, a motocicleta ficou em primeiro lugar com 100 casos (58,1%); e os condutores foram prevalentes entre as vítimas (57,4%). Conclusão: Não houve correlação entre a gravidade das lesões e a alcoolemia das vítimas de acidente de trânsito internadas em um hospital de referência. Nível de Evidência II, Estudo de Corte Transversal.

Prevalence of alcohol and other drug detections in non-transport injury events.

OBJECTIVE: To measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non-transport injuries who presented to an adult major trauma centre. METHODS: This registry-based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non-transport injuries; and (ii) met predefined trauma call-out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in-hospital blood alcohol and urine drug screens. RESULTS: A total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine-type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self-harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%). CONCLUSION: AOD detections were common in trauma patients with non-transport injury causes. Population-level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.

Correlation between the severity and blood alcohol level of traffic accidents victims / Correlação entre gravidade e alcoolemia de vítimas de acidentes de trânsito

ABSTRACT Objective: To evaluate the correlation between blood alcohol levels and the severity of injuries assessed by the Injury Severity Score (ISS) in patients who were victims of traffic accidents admitted to the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). Methods: Cross-sectional study carried out between July 2018 and June 2019, at the Central Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (PSC-HCFMUSP). A total of 172 hospitalized patients victims of traffic accidents were included in this study. Blood samples were analyzed by the FMUSP Toxicology Laboratory. Results: 36 patients (20.9%) had positive BAC (≥ 0.2 g/L) with a mean of 1.21 g/L. Overall, patients had a mean age of 37.2 years old, and 136 (79.1%) were men. The ISS of the total casuistry was 15.6; regarding the external cause, the motorcycle was ranked first with 100 cases (58.1%), and drivers were the majority with 57.4% of the sample. Conclusion: There was no correlation between the severity of the injuries and the blood alcohol levels of traffic accident victims admitted to a reference hospital. Level of Evidence II, Cross-Sectional Study.

RESUMO Objetivo: Avaliar a correlação entre a alcoolemia e a gravidade das lesões avaliadas pelo Índice de Gravidade da Lesão ( Injury Severity Score* - ISS) em vítimas de acidentes de trânsito internadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).* Método: Estudo transversal realizado entre julho de 2018 e junho de 2019, no Pronto Socorro Central do HC-FMUSP. Foram incluídas 172 vítimas de acidentes de trânsito. Amostras de sangue foram analisadas pelo Laboratório de Toxicologia da FMUSP. Resultados: 36 pacientes (20,9%) apresentaram alcoolemia positiva (≥ 0,2 g/L), com valor médio de 1,21 g/L. No geral, os pacientes tinham uma idade média de 37,2 anos, e 136 (79,1%) eram homens. O ISS da casuística total foi 15,6; quanto à causa externa, a motocicleta ficou em primeiro lugar com 100 casos (58,1%); e os condutores foram prevalentes entre as vítimas (57,4%). Conclusão: Não houve correlação entre a gravidade das lesões e a alcoolemia das vítimas de acidente de trânsito internadas em um hospital de referência. Nível de Evidência II, Estudo de Corte Transversal.

An assessment of court fees, surcharges, and penalties for alcohol-impaired driving in five midwestern U.S. states: implications for exacerbating poverty and health inequalities.

Driving under the influence (DUI) remains an important threat to public health in the United States, and a substantial literature has evaluated the effectiveness of state-mandated penalties. Researchers have overlooked accelerated use of obscured fees and surcharges levied by local and state court systems added to penalties in the past 15 years. We present data regarding DUI penalties for offenders with a blood alcohol content (BAC of 0.08) and the fees and surcharges attached to them in Minnesota, Illinois, Wisconsin, Michigan, and Iowa, and variation in these within Wisconsin at four BAC levels. In all states, surcharges and fees exceed penalty fines substantially. Variation within Wisconsin is also meaningful. Our data suggest that opaque costs in state court systems add a substantial financial burden to DUI penalties, particularly for those with lower incomes. An appraisal of the deterrent role of these added costs is warranted.

Concordance of Ethyl Glucuronide, Blood Alcohol Content, and Self-Reported Alcohol Use in Russian Women with HIV and Hepatitis C Virus Co-Infection.

Problematic alcohol use is prevalent in Russia and is deleterious for individuals with HIV and Hepatitis C Virus (HCV). Ethyl glucuronide (EtG) and blood alcohol content (BAC) provide objective biomarkers of drinking that can be compared to self-reported alcohol use. This paper describes patterns of alcohol use measured by biomarkers and self-report along with concordance across measures. Participants were Russian women with HIV and HCV co-infection (N = 200; Mean age = 34.9) from two Saint Petersburg comprehensive HIV care centers enrolled in an alcohol reduction intervention clinical trial. Measures were: (a) urine specimen analyzed for EtG; (b) breathalyzer reading of BAC; and (c) self-reported frequency of drinking, typical number of drinks consumed, and number of standard drinks consumed in the past month. At baseline, 64.0% (n = 128) had a positive EtG (> 500 ng/mL) and 76.5% (n = 153) had a positive breathalyzer reading (non-zero reading). There was agreement between EtG and BAC (kappa = 0.66, p < .001; Phi coefficient = 0.69, p < .001); self-reported alcohol measures were positively correlated with positive EtG and BAC (p's < 0.001). There was concordance between EtG and BAC measures, which have differing alcohol detection windows. Most participants endorsed frequent drinking at high quantities, with very few reporting no alcohol consumption in the past month. Concordance between biomarkers and self-reported alcohol use suggests that underreporting of alcohol use was minimal. Results highlight the need for alcohol screening within HIV care. Implications for alcohol assessment within research and clinical contexts are discussed.

Comparison of routine blood alcohol tests and ICD-10-AM coding of alcohol involvement for major trauma patients.

BACKGROUND: Alcohol use is a key preventable risk factor for serious injury. To effectively prevent alcohol-related injuries, we rely on the accurate surveillance of alcohol involvement in injury events. This often involves the use of administrative data, such as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding. OBJECTIVE: To evaluate the completeness and accuracy of using administrative coding for the surveillance of alcohol involvement in major trauma injury events by comparing patient blood alcohol concentration (BAC) with ICD-10-AM coding. METHOD: This retrospective cohort study examined 2918 injury patients aged ≥18 years who presented to a major trauma centre in Victoria, Australia, over a 2-year period, of which 78% (n = 2286) had BAC data available. RESULTS: While 15% of patients had a non-zero BAC, only 4% had an ICD-10-AM code suggesting acute alcohol involvement. The agreement between blood alcohol test results and ICD-10-AM coding of acute alcohol involvement was fair (κ = 0.33, 95% confidence interval: 0.27-0.38). Of the 341 patients with a non-zero BAC, 82 (24.0%) had ICD-10-AM codes related to acute alcohol involvement. Supplementary factors Y90 Evidence of alcohol involvement determined by blood alcohol level codes, which specifically describe patient BAC, were assigned to just 29% of eligible patients with a non-zero BAC. CONCLUSION: ICD-10-AM coding underestimated the proportion of alcohol-related injuries compared to patient BAC. IMPLICATIONS: Given the current role of administrative data in the surveillance of alcohol-related injuries, these findings may have significant implications for the implementation of cost-effective strategies for preventing alcohol-related injuries.

Trauma center risk conditions for blood alcohol-positive and alcohol misuse patients: a retrospective study.

Because few studies have assessed blood alcohol concentration (BAC)-positive risk conditions in trauma activation patients, this retrospective investigation pursued such an analysis. The parent database included consecutive trauma center admissions from January 21 to July 21 for 2018-2020. The supplementary electronic medical record audit of trauma activation patients aged 18-60 years (TA18-60) assessed alcohol misuse, smoking history, and serum bicarbonate levels. An alcohol misuse risk score was created by assigning a value of 0 (no) or 1 (yes) for each risk condition: 1) smoking history, 2) BAC-positive status, 3) BAC ≥ 100 mg/dL with Glasgow Coma Scale score (GCS) ≥ 13, 4) age ≥ 40 years, and 5) bicarbonate level ≥ 20 mmol/L in BAC-positive patients and summing the total score (range, 0-5). Of 2,076 patients, BAC testing occurred in 60.9% (n = 1,265). BAC positivity was greater in TA18-60 (36.9%) than in other patients (20.8%; P < 0.0001; odds ratio [OR] = 2.2). In the TA18-60 audit (n = 742), categorizations were available for BAC status, 98.5%; smoking history, 99.3%; alcohol misuse history, 99.5%; and bicarbonate level, 99.5%. BAC positivity was greater in smokers (41.3%) than in non-smokers (31.5%; P = 0.0061; OR = 1.5). BAC positivity was greater with alcohol misuse (87.0%) than without (17.7%; P < 0.0001; OR = 31.2). BAC-positive was associated with a greater proportion of bicarbonate levels < 20 mmol/L (52.0%) than BAC-negative (31.8%; P < 0.0001; OR = 2.3). The alcohol misuse proportion was greater with an alcohol misuse risk score of 3-5 (74.4% [142/191]) than with a risk score of 0-2 (10.4% [57/546]; P < 0.0001; OR = 24.9; area under the receiver operating characteristic curve = 0.89). This retrospective study demonstrates that BAC positivity is associated with TA18-60, smoking and alcohol misuse histories, and metabolic acidosis. An alcohol misuse history is associated with multiple risk conditions. Trauma center leadership should provide procedures to identify patients who are BAC-positive or have a positive smoking or alcohol misuse history. Then, such patients should be referred to care providers who can offer assistance and guidance for enhancing overall patient wellbeing.

Investigating the Difference in Factors Contributing to the Likelihood of Motorcyclist Fatalities in Single Motorcycle and Multiple Vehicle Crashes.

In order to better understand the factors affecting the likelihood of motorcyclists' fatal injuries, motorcycle-involved crashes were investigated based on the involvement of the following vehicles: single motorcycle (SM), multiple motorcycles (MM) and motorcycle versus vehicle (MV) crashes. METHOD: Binary logit and mixed logit models that consider the heterogeneity of parameters were applied to identify the critical factors that increase the likelihood of motorcyclist fatality. RESULTS: Mixed logit models were found to have better fitting performances. Factors that increase the likelihood of motorcyclist fatality include lanes separated by traffic islands, male motorcyclists, and riding with BAC values of less than the legally limited value. Collisions with trees or utility poles lead to the highest likelihood of fatality in SM crashes. The effects of curved roads, same-direction swipe crashes, youth, and unlicensed motorcyclists are only significant in the likelihood of fatality in SM crashes. CONCLUSIONS: Motorcyclists tend to be killed if they collide with large engine-size motorcycles and vehicles, unlicensed motorcyclists, or drivers with speeding related or right-of-way violations with positive BAC values. Driving or riding should be prohibited for any amount of alcohol or for anyone with a positive BAC value. Law enforcement should focus on unlicensed, speeding motorcyclists and drivers, and those who violate the right of way or perform improper turns. Roadside objects and facilities should be checked for appropriate placement and be equipped with reflective devices or injury protection facilities.

The impact of alcohol intoxication on early Glasgow Coma Scale-Pupil reactivity score in patients with traumatic brain injury: A prospective observational study.

Background: A simple arithmetic combination of the Glasgow Coma Scale (GCS) score and pupillary response, the GCS-Pupil (GCS-P), extends the information provided about the patient outcome to an extent comparable to that obtained using more complex methods. The objective of the study was to compare the changes in the GCS-P score of patients with traumatic brain injury (TBI) under alcohol intoxication and nontoxication over time. Methods: A prospective observational study was done in a hospital at the Level I trauma center. The patients admitted to the emergency department (ED) with TBI were the study participants. They were grouped into intoxicated and nonintoxicated based on blood alcohol concentration (BAC). BAC of 0.08% and above was considered intoxication. GCS-P score in the ED and the best day 1 GCS-P score were the outcome variables. For nonnormally distributed quantitative parameters, medians and interquartile range were compared between study groups using Mann-Whitney U-test. P <0.05 was considered statistically significant. Results: A total of 216 patients were included in the final analysis. There was no statistically significant difference between BAC in GCS-P score at different follow-up periods, GCS-P score (ED), and GCS-P score (best day 1). Conclusion: This prospective observational study showed a low GCS-P score for alcohol-intoxicated patients compared to nonintoxicated patients, which was not statistically significant. There was no significant difference in emergency GCS-P score and best day 1 score between alcohol-intoxicated and nonintoxicated patients.

A New Method for Breath and Blood Alcohol Determination in Rats Using a Breath Alcohol Meter: An Experimental Study.

Background: The use of police breath alcohol detectors in rat breath alcohol detection experiments has always been a challenge because of the small lung capacity and inability of rats to actively inhale. However, the method of using gas chromatography to detect blood alcohol concentration is time-consuming, complex, relatively expensive, and cannot achieve on-site detection and multi-point unlimited non-invasive detection. Objectives: In this study, a laboratory method was validated for rat breath ethanol concentration (BrAC) measurement to estimate blood ethanol concentration (BAC) in rats. Methods: The rats were placed in a gas collection bottle, the breath sample was drawn out with a syringe, and injected into the mouthpiece of the breath alcohol detector through a rubber tube. The results were immediately detected and automatically converted to BAC. Male rats were randomly divided into three groups. The control group received an intraperitoneal injection of normal saline, the liver injury group received an intraperitoneal injection of 50% Carbon tetrachloride (CCL4 1 mL.kg-1), and the induction group received an intraperitoneal injection of phenobarbital sodium (75 mg.kg-1). Western blot analysis was used to detect the protein expression of CYP2E1. Similar grouping and experimental methods were used for female rats. Results: This method was reproducible. The metabolic activity of CYP2E1 was downregulated in the injury group and upregulated in the induction group, which was consistent with the results obtained for CYP2E1 protein expression. Conclusions: Our results confirmed that the rat gas cylinder breath alcohol assay can be used for multiple detections with immediate and non-invasive determination of alcohol metabolizing capacity. This is important for studies that require repeated assessment of blood alcohol levels.

Associated factors to abusive alcoholic beverage consumption in suicide victims.

BACKGROUND: Suicide is a worldwide phenomenon, as well as a challenge for public health, and alcoholic beverage abuse is one of the most important risk factors. However, the association between possible factors related to alcoholic beverage consumption in suicide victims has rarely been investigated. OBJECTIVE: To evaluate the factors associated with abusive alcoholic beverage consumption among people who died from suicide in the Brazilian Federal District (BFD). METHOD: A population-based and cross-sectional study with suicide victims in the BFD between 2016 and 2017. Information was collected about sociodemographic characteristics, autopsy appraisal, and drug use. A trained team evaluated all cases to define factors associated with abusive alcoholic beverage consumption. This outcome was measured using the Blood Alcohol Concentration. Poisson regression analysis was applied to calculate the Prevalence Ratios and respective populational confidence intervals. RESULTS: The findings of the present study were collected from a database containing information related to 278 suicide victims. Being male and having cocaine identified in the toxicological test were the factors that showed a strong association with abusive alcohol beverage consumption in suicide victims. Other factors showed a slight association (PR < 1.5): having an education level with greater than 8 years of study, being black, having a professional occupation or being retired or pensioner, and having the presence of cannabis in the toxicological test. CONCLUSION: Socioeconomic-demographic and behavioral factors proved to be positively associated with abusive alcoholic beverage consumption among suicide victims, suggesting the need for effective public health policy measures to combat this health problem.

Underreporting of alcohol use in trauma patients: A retrospective analysis.

BACKGROUND: This study assessed the inconsistencies between self-reported alcohol consumption and blood alcohol content (BAC) in trauma patients. We aimed to identify the incidence of positive BAC in trauma patients who reported a zero score on the Alcohol Use Disorders Identification Test (AUDIT). We also sought to identify characteristics of individuals who were likely to negate alcohol use, yet yielded a positive BAC, to improve our ability to provide alcohol screening and healthcare to these at-risk alcohol consumers. Methods: We conducted a retrospective study from 2010 to 2018 at a university-based, level-one trauma emergency department. We identified 2581 adult trauma patients who reported a zero score on the AUDIT from the trauma registry. We collected BAC, age, gender, race, education level, mechanism of injury, language and injury severity score (ISS) from patient charts, and used descriptive analyses and multivariate logistic regression to analyze the data. Results: One hundred and thirty-one (5.08%) trauma patients who reported AUDIT of zero had a positive BAC. We found that being male (OR 1.53), assaulted or injured from a penetrating mechanism (OR 2.29) and having an ISS greater than 25 (OR 3.76) were independent positive predictors of trauma patients who reported an AUDIT of zero and had a positive BAC. Age (OR 0.99) was an independent negative predictor of trauma patients who reported an AUDIT of zero and had a positive BAC in this cohort. Conclusions: Inaccurate self-reporting of alcohol drinking behavior does exist in trauma patients. A composite of objective alcohol screening modalities, in addition to AUDIT, is needed to screen for alcohol use in this population. Healthcare providers should remain highly suspicious of alcohol-related injuries in individuals with the identified characteristics.

Drink, death, and driving: Do blood alcohol content limit reductions improve road safety?

This study exploits a natural experiment in Scotland where the legal blood alcohol content (BAC) limit was reduced from 0.8 to 0.5 mg per 100 ml of blood while staying constant in all other parts of the United Kingdom. Using a difference-in-differences design, we find that this change in the BAC level had no impact on either traffic accident or fatality rates.

Does alcohol play the role of confounder or neuroprotective agent in acute carbon monoxide poisoning?

Objectives: This study investigated whether alcohol influences the predictive value of initial blood lactate concentration and Glasgow Coma Scale (GCS) score at presentation for the severity of acute carbon monoxide (CO) poisoning and neurologic outcome in patients with acute CO poisoning. Additionally, whether alcohol has a neuroprotective effect after acute CO poisoning was evaluated.Methods: This retrospective study included 158 patients who presented with acute CO poisoning between January 2017 and July 2018 and had an available blood alcohol content (BAC) at presentation. The baseline characteristics, clinical course during hospitalization and neurologic status at 30 days after acute CO poisoning were collected and compared according to BAC. To account for possible confounding or neuroprotective effects of alcohol, BAC was introduced as a continuous variable and a stratified categorical variable in the analysis.Results: The mean and maximum BAC at presentation were 56.8 mg/dl and 408 mg/dl, respectively, in 158 patients presented at a mean of 1.0 hour after acute CO poisoning. Lactate, adjusted for previously suggested predictors, was not associated with acute CO poisoning severity; however, after additional adjustment with BAC variables, lactate was associated with CO poisoning severity. Initial GCS score was associated with CO poisoning severity during hospitalization and neurologic outcome at 30 days after acute CO poisoning, regardless of BAC adjustment. BAC variables were negatively associated with CO poisoning severity but not neurologic outcome at 30 days.Discussion and conclusion: The severity of CO poisoning should never be predicted based on serum lactate alone without adjusting for BAC. However, the initial GCS score can be used as a predictor of CO poisoning severity and the neurologic outcome at 30 days after acute CO poisoning, regardless of alcohol consumption history. Alcohol does not have a neuroprotective effect on acute CO poisoning. Further study is needed to validate these results.

Blood alcohol levels in road traffic accidents: Factors associated and the relationship between history of alcohol consumption and blood alcohol level detection.

INTRODUCTION: Alcohol consumption contributes to a significant number of road traffic accidents (RTAs), and data regarding the reliability of history and blood alcohol content (BAC) in RTA victims are scant. METHODOLOGY: This retrospective study was conducted in the emergency departments (EDs) over 6 weeks. All adult RTAs presenting within 12 h of the incident were included for analysis. RESULTS: The study cohort included 369 RTA patients, with the mean interval before presentation being 3 h (standard deviation: 2.22). Two-wheeler accidents (77.2%) were the predominant mode of injury. Usage of a helmet and seat belt was documented in a meager (6.4% [17/267] and 8.8% [3/34], respectively). A positive history of alcohol consumption was reported by 19.5% of cases (72/369). However, BAC was detectable in 30.1% of cases (111/369), with an alarming 19.78% (73/369) being above the legal limit for driving. Nearly 77.5% (86/111) of those who tested positive for alcohol consumption were driving the vehicle involved. Positive BAC levels showed a significant association with young age (18-39 years), male gender, two-wheeler usage, and between 5 PM and 12 AM. CONCLUSION: A history of alcohol consumption leading to an RTA is not reliable in the ED. Hence, measuring BAC levels in all RTA patients provides an objective and reliable form of documentation for medico-legal purposes.

Why are caffeinated alcoholic beverages especially risky?

PURPOSE: Evidence suggests that people drink more alcohol and experience more adverse alcohol-related consequences (ARCs) on occasions when they also consume caffeine. The current study examined whether this increase in risk is a result of caffeine attenuating the subjective effects of alcohol intoxication (i.e., the masking hypothesis). METHODS: Undergraduate students (n = 148) reported their drinking patterns using a modified Timeline Followback approach. For each recalled drinking occasion, alcohol consumption, caffeine consumption, perceived blood alcohol concentration, and ARCs were assessed. Generalized linear mixed models were used to examine the influence that alcohol and caffeine consumption had on perceived intoxication and the experience of ARCs. RESULTS: At the occasion level, greater caffeine consumption was associated with increased consumption of alcohol and increased ARCs. There was also a significant curvilinear relationship between the amount of alcohol consumed and perceived intoxication, such that the more alcohol was consumed on each occasion the less each additional drink increased perceived intoxication. Increased caffeine consumption weakened the association between alcohol consumption and perceived intoxication and it also weakened the association between alcohol consumption and ARCs. Specifically, the weakest relationship between ARCs and alcohol consumption existed at the highest level of caffeine consumption (240+ mg). Caffeine increased subjective intoxication. CONCLUSIONS: These findings do not support the masking hypothesis. Caffeine was strongly associated with ARCs when consumed at high doses and this effect does not appear to be the result of drinking more alcohol or underestimating one's blood alcohol content. Efforts to reduce caffeinated alcohol beverage use are greatly needed.

Vive la Difference! The Effects of Natural and Conventional Wines on Blood Alcohol Concentrations: A Randomized, Triple-Blind, Controlled Study.

Different alcoholic beverages can have different effects on blood alcohol concentration (BAC) and neurotoxicity, even when equalized for alcohol content by volume. Anecdotal evidence suggested that natural wine is metabolized differently from conventional wines. This triple-blind study compared the BAC of 55 healthy male subjects after consuming the equivalent of 2 units of alcohol of a natural or conventional wine over 3 min in two separate sessions, one week apart. BAC was measured using a professional breathalyzer every 20 min after consumption for 2 h. The BAC curves in response to the two wines diverged significantly at twenty minutes (interval T20) and forty minutes (interval T40), and also at their maximum concentrations (peaks), with the natural wine inducing a lower BAC than the conventional wine [T20 = 0.40 versus 0.46 (p < 0.0002); T40 = 0.49 versus 0.53 (p < 0.0015); peak = 0.52 versus 0.56 (p < 0.0002)]. These differences are likely related to the development of different amino acids and antioxidants in the two wines during their production. This may in turn affect the kinetics of alcohol absorption and metabolism. Other contributing factors could include pesticide residues, differences in dry extract content, and the use of indigenous or selected yeasts. The study shows that with the same quantity and conditions of intake, natural wine has lower pharmacokinetic and metabolic effects than conventional wine, which can be assumed due to the different agronomic and oenological practices with which they are produced. It can therefore be hypothesized that the consumption of natural wine may have a different impact on human health from that of conventional wine.

Postmortem blood alcohol content among late-middle aged and older suicide decedents: Associations with suicide precipitating/risk factors, means, and other drug toxicology.

BACKGROUND: This study examined blood alcohol content (BAC) among suicide decedents aged 50+ and its associations with suicide precipitating/risk factors, means, and other drug toxicology. METHODS: The National Violent Death Reporting System, 2005-2015, provided data (N = 56,118 for all suicide decedents and N = 29,115 with alcohol test results). We used logistic regression models, with BAC > 0.0 (BAC positive) and BAC > = 0.08 (intoxication) as the dependent variables. RESULTS: Almost a third of decedents who were tested for alcohol were BAC positive, and almost two-thirds of those who were positive had a BAC > = 0.08. Alcohol problems prior to suicide (AOR = 6.71, 95% CI = 6.24-7.21), relationship problems (AOR = 1.53, 95% CI = 1.44-1.63), and death/suicide of family/friends (AOR = 1.22, 95% CI = 1.11-1.35) were associated with greater odds of a positive BAC, but suicide means were not significantly associated with a positive BAC. Alcohol problems (AOR = 2.98, 95% CI = 2.68-3.31), relationship problems (AOR = 1.18, 95% CI = 1.06-1.30), firearm use (AOR = 1.85, 95% CI = 1.59-2.16), and hanging/suffocation (AOR = 1.38, 95% CI = 1.16-1.64) were associated with greater odds of a BAC > = 0.08. A toxicology positive for antidepressants, marijuana, cocaine, or amphetamines was associated with greater odds of a positive BAC; however, a toxicology positive for antidepressants, opiates, or amphetamines was associated with lower odds of a BAC > = 0.08. BAC > = 0.08 rates increased over the study period. CONCLUSIONS: Alcohol intoxication may have contributed to using more violent suicide means. The significant association between relationship problems and intoxication before suicide calls for restricting access to alcohol and suicide means for individuals with these problems. Suicide prevention may require crisis counseling/support for acute life stressors and ongoing emotional support.

An Artificial Neural Network for Movement Pattern Analysis to Estimate Blood Alcohol Content Level.

Impairments in gait occur after alcohol consumption, and, if detected in real-time, could guide the delivery of "just-in-time" injury prevention interventions. We aimed to identify the salient features of gait that could be used for estimating blood alcohol content (BAC) level in a typical drinking environment. We recruited 10 young adults with a history of heavy drinking to test our research app. During four consecutive Fridays and Saturdays, every hour from 8 p.m. to 12 a.m., they were prompted to use the app to report alcohol consumption and complete a 5-step straight-line walking task, during which 3-axis acceleration and angular velocity data was sampled at a frequency of 100 Hz. BAC for each subject was calculated. From sensor signals, 24 features were calculated using a sliding window technique, including energy, mean, and standard deviation. Using an artificial neural network (ANN), we performed regression analysis to define a model determining association between gait features and BACs. Part (70%) of the data was then used as a training dataset, and the results tested and validated using the rest of the samples. We evaluated different training algorithms for the neural network and the result showed that a Bayesian regularization neural network (BRNN) was the most efficient and accurate. Analyses support the use of the tandem gait task paired with our approach to reliably estimate BAC based on gait features. Results from this work could be useful in designing effective prevention interventions to reduce risky behaviors during periods of alcohol consumption.

Effect of storage temperature on blood alcohol content detection / 中国法医学杂志

Objective To select the best storage temperature and accurate detection way of the blood alcohol content of drunk driving and provide technical support of judging objectively drunk driving behaviors for traffic management department. Methods This study selects EDTA-2 vacuum tubes, take human vein blood after drinking and respectively store at four temperature conditions -20℃、4℃~8 ℃、 25 ℃ normal temperature and high temperature of 35℃~42 ℃.GC method is used by testing 0,3d, 7d, 14d, 21d and 28d blood alcohol content, and the test result statistics and data are compared and analyzed. Results The blood alcohol contents within 0-3d stored at 35℃~42 ℃and 25 ℃temperature remain stable, decrease significantly after 3d (P<0.05); the blood alcohol contents stored at 4℃~8 ℃ temperature in 0~14d is basically stable and decrease significantly after 14d (P<0.05); at -20℃temperature there are no significant differences among the 28d testing results of blood alcohol contents. Conclusions It is suggested that the blood samples should be collected at low temperature and the best preservation temperature of blood samples is -20℃.