Consensus
2014 Consensus for the use of alcohol markers in hair for assessment of both abstinence and chronic excessive alcohol consumption

https://doi.org/10.1016/j.forsciint.2014.11.001Get rights and content

Introduction

  • 1.1

    The direct determination of ethanol itself in hair is not possible due to its volatility and its potential absorption from external sources. Instead, the minor ethanol metabolites ethyl glucuronide (EtG) and/or fatty acid ethyl esters (FAEEs) can be measured in hair as direct markers of alcohol consumption.

  • 1.2

    In this consensus FAEEs are defined as: ethyl myristate, ethyl palmitate, ethyl oleate and ethyl stearate. For interpretation, the sum of the concentrations of these four esters should be used.

  • 1.3

    It is not advisable to use the results of hair testing for alcohol markers in isolation; all relevant factors surrounding a case must be considered when providing expert interpretation and opinion.

  • 1.4

    Abstinence from alcohol means no intake of any alcoholic beverages or other alcohol containing products over a pre-defined time period.

  • 1.5

    Measurement of markers to identify long-term alcohol consumption is generally used to corroborate claims of alcohol abstinence.

  • 1.6

    Occasional drinking events cannot always be excluded.

  • 1.7

    Chronic excessive alcohol drinking corresponds to an average consumption of 60 g or more of pure ethanol per day over several months.

Section snippets

General considerations

  • 2.1

    The site of hair collection plays an important role in the concentration of markers detected. Hair taken from the vertex region of the scalp is preferred.

  • 2.2

    In instances where head hair is not available, body hair can be collected. The different physiology of non-head hair has to be considered during interpretation.

  • 2.3

    Powdering hair prior to the extraction of EtG is preferred. Laboratories utilizing other sample preparation procedures should demonstrate comparable recovery of EtG.

  • 2.4

    Pre-analytical

Abstinence assessment

  • 3.1

    Abstinence assessment over a pre-defined time period is necessary in many cases. Examples include: prerequisite for regaining driving licence, child custody cases, clinical contexts, forensic cases.

  • 3.2

    EtG should be the first choice in abstinence assessment.

  • 3.3

    Ethyl glucuronide (EtG)

    • 3.3.1

      A concentration <7 pg/mg does not contradict self-reported abstinence of a person during the corresponding time period before sampling.

    • 3.3.2

      A concentration 7 pg/mg EtG in the 0–3 up to 0–6 cm proximal scalp hair segment strongly

Chronic excessive consumption

  • 4.1

    For clinical and forensic purposes, it is necessary to establish concentrations of alcohol markers in hair which correspond to assessment of chronic excessive alcohol consumption.

  • 4.2

    EtG and FAEEs can be used alone or in combination for chronic excessive alcohol consumption assessment.

  • 4.3

    Ethyl glucuronide (EtG)

    • 4.3.1

      A concentration of ≥30 pg/mg EtG in the 0–3 up to 0–6 cm proximal scalp hair segment strongly suggests chronic excessive alcohol consumption.

    • 4.3.2

      If other lengths of hair are analyzed, the results

References (0)

Cited by (0)

View full text