Breath Alcohol Analysis

Everyday we hear and read about drivers involved in accidents who are charged with DUI or DWI.  The media will discuss a suspect’s breath alcohol level and the legal limit for alcohol.  A driver might be found to have an alcohol level of 0.15 and the legal limit is 0.08.  You probably hear or read the media discuss a “Breathalyzer” being used to test the suspected driver’s alcohol level but are not sure how breath can determine a blood alcohol level or how much someone has had to drink.

Interesting Historical Note:

The terms “Breathalyser” and” Breathalyzer” have become synonymous with all breath alcohol testing equipment.  Both names are trademarked and originated from an instrument invented by Dr. R.F. Borkenstein who worked for the Indiana State Police. It was invented in 1954 and the technology behind it is still used today. This fact is for those of you who aspire to appear on” Jeopardy” or” Who Wants to be a Millionaire”.

Back to business…How do you get a blood alcohol level from breath you ask?

Alcohol that a person drinks will always appear in their breath.  This is because alcohol is absorbed from the mouth, throat, stomach and intestines into the blood stream.  Alcohol is not digested like food or chemically changed in the blood when it is absorbed.  When blood passes through the lungs some of the ingested alcohol travels across the membranes of the lungs air sacs or alveoli and moves into the air.  This process is one of alcohol’s main properties of evaporating from a volatile solution.

So…the alcohol concentration from lung air is directly related to the alcohol concentration in the blood.  It can be detected by a breath alcohol testing device. 

What are the best ways to test blood alcohol concentration levels (BAC)?

Blood was the original medium used to test BAC’s.   A blood test offers the ability to accurately test the same sample several times, if the sample is properly maintained.  On the down side, blood tests are invasive and analysis time is longer.  The collection process requires trained medical personnel and the analysis requires precise procedures performed by trained lab technicians.  The results are not immediately available.  The test is also expensive.

Breath Alcohol Testing is very accurate, noninvasive, inexpensive and can be performed anywhere.  There is extensive training required and procedures to be followed but you do not have to have medical personnel to perform the test.  It can also be performed anywhere.  That is why it used by law enforcement, medical and safety personnel, and educators to name a few.

Urine testing may also be performed to test BAC.  It is the least desirable of all the methods.  It must be collected in a lab or medical facility and analysis be done by trained lab technicians in much the same manner as the blood test.  It is also expensive and not as accurate as blood or breath.

At ExperTox, we can collect and perform all 3 types of alcohol tests.  In our Occupational Health department we offer DOT and Non-Dot alcohol and drug testing.  We also perform court ordered and tests for the private sector.  We normally do breath alcohol tests unless another type is specified by the client.

There are four types of breath alcohol tests:

• Screening – A device is used to test a subject to see if BAC is above limits set by employers or state laws.
• Evidential – A test is done to collect evidence of BAC to be used in court or industry such as post accident cases, reasonable suspicion of use on the job or in traffic violations, and follow-up testing  for previous positive tests.
• Interlock – Tests are designated for permanent connection to an electrical system of a vehicle; its purpose is to prevent or deter its operation by persons with alcohol in their system.
• Self Test- Used by people to check their own BAC before working or driving. These have a high degree of accuracy and reproducibility but are not admissible in court.

There are three major types of breath alcohol testing devices, and there based on different principles:

• Alcosensor – Detects a chemical reaction of alcohol in a fuel cell
• Breathalyzer – Uses a chemical reaction involving alcohol that produces a color change
• Intoxilyzer – Detects alcohol by infrared spectroscopy

We use Alcosensor at ExperTox for breath alcohol testing.  They are extremely accurate, dependable, easy to use and portable.  Intoxilyzer instruments are mainly used for research and by law enforcement. They are desk top devices and are stationary.  Breathalyzers are also not used for field work and are more difficult to use and maintain.  Operators of any breath alcohol testing device must be trained in use and calibration of the device.  Scrupulous records must be maintained.

What are your best bets?

If you insist on drinking and driving, just know you can’t hold your breath long enough to avoid the consequences.  Cover-ups such as gum or mints will not do the trick.  Your best option is a designated driver or taxi.

Friday afternoons may seem like a time to celebrate, but a beer or two at lunch could get you into real trouble, either by having an accident that might injure yourself or others or by getting caught as a safety violation.  Just expect when you blow, your employer will know…. the truth.

Lou Ann Enis, Registered Nurse and Occupational Health Supervisor

K2, Spice and The Secret Ingredient, JWH018

There is a new way substance abusers are trying to get around those pre-employment and random drug tests.  They are inhaling incense (such as “Spice”), ingesting herbs and plant products, and smoking fake marijuana called K2.  Sound innocent?  Wait until you learn about JWH018, a synthetic cannabinoid.

 K2, Spice and other “fake marijuana” products made their entrance as a legal substitute for marijuana around 2004.  It is generally sold at head shops and on the internet, easily accessible by anyone, even teens.  What many don’t know is that these alternate products are coated with a man-made toxic substance, JWH018.  JWH018 is an analgesic chemical that produces effects similar to THC, the chemical in marijuana that makes a person “high”.  However, JWH018 is 3 to 5 times more potent than THC.

 Though these products are currently legal in the U.S., the Drug Enforcement Administration has labeled them as “a drug and chemical of concern.”.   With symptoms such as:

•  Increased heart rate and/or blood pressure
• Loss of consciousness
• Paranoia and hallucinations
• Agitation
• Vomiting
• Occasional psychotic episodes

 parents, employers, schools and communities should be worried.  Just because something is legal does not mean it is safe.

 JWH018 does not show up in standard drug tests, and users know this.  Ingesting this herbal blend is becoming a sport for those who previously made a game of attempting to adulterate specimens or gauge their timing before their drug test to avoid showing up positive.

 ExperTox now offers a test for JWH018.  Urine is the only specimen that can be tested at this time, and the results will reflect “Detected” or “Not Detected” versus reference ranges.

 It’s not the ‘60s anymore, yet “incense” has made a comeback – beware.

National Poison Prevention Week March 14-20, 2010

The Southeast Texas Poison Center (SETPC) invites you to participate in this year’s National Poison Prevention Week (NPPW) starting March 14-20, 2010.  During this week, poison centers across the United States partner with various organizations such as  local pharmacies, physician offices, businesses and schools to help raise awareness about the dangers of poisons, ways to  prevent poisonings and how to access the toll free 24 hour emergency  help line at 1-800-222-1222.  We try very hard to reach all communities, but cannot reach everyone.  To make sure your community hears about the poison center, please assist in distributing our phone number 1-800-222-1222 and our website address: www.utmb.edu/setpc. 

Jon Thompson, Director of the SETPC, comments, “Poisoning is a public health problem-unintentional poisoning is the second leading cause of unintentional injury death in Texas and nationwide. Poison centers are our nation’s primary defense against injury and deaths from poisoning.”

The SETPC is a 24-hour poison information and emergency treatment resource for the public and healthcare professionals in 28 designated counties of southeast Texas. Located on the campus of the University of Texas Medical Branch in Galveston, it is certified by the American Association of Poison Control Centers as a regional poison center, and is one of six poison centers comprising the Texas Poison Center Network established in 1994 by the Texas Legislature to provide poison prevention and treatment information to Texas residents and healthcare providers. By dialing 800-222-1222, callers have access to a network of health care professionals: nurses, pharmacists, paramedics and physicians who have extensive education, training and expertise in the field of clinical toxicology or poisoning. This free access number works similarly to 911 in that all calls are directed to the designated regional poison center, and it has the capability to translate calls in a variety of languages, including Spanish. The SETPC also conducts public education activities for teachers, students, and other groups in an effort to create safer environments for Texas residents. Funding for the poison center is provided by the Texas Department of State Health Services, the U.S. Department of Health and Human Services Health Resources, and through public and private donations.

NPPW is only one week per year, but poison prevention is a 52 week, year-round activity. Be poison smart and call the poison center at 800-222-1222 anytime of day for answers to any question about poison. Thank you for your support of the poison center.

Jon D. Thompson, Director, UTMB Southeast Texas Poison Center

We would like to thank the UTMB Southeast Texas Poison Center for all that they do year-round  to support poison prevention and especially Jon Thompson and Wendy Allen, Community Education Specialist, for the information on National Poison Prevention Week.

Substance Abuse In A Can – Inhalants

First-time substance users generally don’t find their drugs on the street.  They find it in their home among everyday items used by the family.  Do you have aerosol cans, cleaning fluids, and removers scatters around your house?  These are inhalants, a “gateway” drug easily accessible by young teens.

Inhalants are products that produce breathable chemical vapors that cause mind-altering affects, similar to alcohol.  Because inhalants are breathed, they quickly enter the user’s blood system, causing an almost immediate affect.  According to the 2008 National Survey on Drug Use and Health, 729,000 young people, ages 12 and up, used some type of inhalant to get high during the past 12 month period.  70% of these first-time users were under 18.  In fact, according to The Alliance for Consumer Education (ACE), 1 in 5 children will abuse inhalants by the 8^th grade.  8^th grade students show the highest level of inhalant abuse, with a higher percentage being female.

Why do young people use inhalants?  It’s easy – they can find them anywhere around their own home or garage.  They are also cheap.  Common types of inhalant products include but are not limited to:

• Spray paint
• Nail polish remover
• Hair spray
• Cleaning fluids
• Lighter fluid
• Gasoline
• Paint thinner
• Felt-tipped markers
• Glue

How are these everyday products used to get high?  The inhalant user may sniff or snort the fumes directly from the container.  They may also spray the product directly into their nose or mouth.  Other ways fumes are introduced include “bagging”, where the vapor is sprayed directly into a plastic or paper bag, then placed over the nose and mouth to breathe the fumes; and “huffing”.  Huffing occurs when a rag or clothing is soaked with the product, then it is held over the nose and mouth or even stuffed into the mouth.

How can parents recognize the signs and symptoms of inhalant use?  We would first like to recommend prevention, and this is a good month to get started, National Poison Prevention Month.  Lock up or protect any products that could potentially be abused.  Keep an inventory of items and pay attention to how quickly products are used up.  Then look for these common signs and symptoms:

• Intoxication similar to someone that has used alcohol
  • A drunken appearance
  • Slurred speech
  • Muscle weakness
  • Impairment
  • Hallucinations/Delusions
  • Confusion
  • A chemical odor on a person’s breath or clothing
  • Stains on a person’s face, hands and clothes
  • Hidden empty spray containers or rags that reek of fumes

Inhalant abuse is not something to be taken lightly.  The products used are toxic and hazardous.  Improper use of inhalants can cause damage to the brain and nervous system; organ damage; convulsions and seizures; choking caused from inhaled vomit; secondary injuries from accidents; and even death.

To learn more about inhalant abuse and how to talk to your teen, visit The National Institute on Drug Abuse’s website on inhalants for more information.

“Can you speak up please? I can’t hear you!”

I think everyone will agree that we live in a noisy world.  Not only are most of us exposed to noise at work, but our leisure activities are also excessively loud!  Gardening, woodworking, motorcycles, Ipods, concerts, surround sound on our gigantic TV’s, hunting, boating – the list is endless!

Now days, the noise exposure at our work environments is monitored by NIOSH and OSHA.  Companies are required to do noise studies and control noise exposure when possible.  Hearing protection is made available and employees are required to use it.  Signs are posted in areas where noise is excessive warning employees to take extra precautions.

No one comes home with us and posts a sign on our vacuum cleaners and grass blowers to warn us that using them without hearing protection can cause hearing loss.  It is called NIHL – Noise Induced Hearing Loss. 

What ever your hobbies or leisure activities… extended exposure to excessive amounts of noise can result in permanent hearing loss.  In fact, excessive noise exposure is the leading cause of hearing loss today.

The ear is a miraculous and efficient organ!  Sound waves are collected by the outer ear and funneled through the ear canal to the eardrum.  Sound waves cause the eardrum to vibrate.  The three bones of the middle ear transmit and amplify the vibrations to the oval window of the inner ear.  Fluid in the inner ear stimulates the nerve endings called hair cells.  Electrical impulses are sent from the hair cells along the auditory nerve to the brain.  The tiny hair cells in the inner ear are easily damaged by loud noise and once you loose them, they never grow back!

The symptoms of hearing loss are:

• Hearing but not understanding
• Turning up the volume on the TV
• Must lip read to understand speech, as well as constantly asking people to repeat themselves or saying “Huh”.
• Cannot hear environmental sounds such as game calls, crickets, birds chirping, sirens and car horns
• Strained personal relationships, denial
• Social withdrawal
• Fatigue and stress

NIHL can be caused by a one-time exposure to an intense sound such as a gun shot, firecracker or an explosion, or by continuous exposure to loud sounds over an extended period of time such as woodworking or riding a motorcycle.

Sound is measured in units called decibels.  On the decibel scale an increase of 10 means that a sound is 10 times more powerful.  For example, a sound that measures 80 decibels is 10 times more intense that on that measures 70 decibels.   A refrigerator humming usually measures around 30-40 decibels.  Normal conversation is approximately 60 decibels.  Traffic noise can measure 85 decibels or more.     Long or repeated exposure to noises from 120 – 150 decibels can cause hearing loss.  The louder the sound, the shorter the time period you can be around it before hearing loss occurs.  A good rule of thumb is to avoid noises that are “too loud” and “too close” or that last “too long”.  If you cannot avoid them use hearing protection!

NIHL is 100% preventable.  All individuals should understand the hazards of noise and how to practice good hearing health in everyday life.  To protect your hearing:

• Know which noises can cause damage (those greater than 85 decibels).
• Wear hearing protection when involved in a loud activity. (There are many types available at hardware and sporting good stores).
• Be alert to hazardous noise in the environment.
• Protect the ears of children that are too young to protect their own.
• Make family and friends aware of the hazards of noise.
• If you suspect hearing loss, have an exam by an otolaryngologist (a physician who specializes in diseases of the ear, nose and throat) and a hearing test by an audiologist.

You can get more information at www.noisyplanet.nidcd.nih.gov.  If you do a Google search you can try key words such as hard-of-hearing and noise-induce hearing loss.

Being aware of noise exposure at work and at home will help everyone control the risk of noise-induced hearing loss.  Take care of your hearing!  Try to imagine a world where you don’t hearing the crickets on a summer night or the birds chirping on a sunny day.  Imagine not be able to hear the fire engine barreling down on you or getting a ticket for evading the police.  I bet they are not sympathetic to “I didn’t hear you”!

Lou Ann Enis, Registered Nurse and Occupational Health Supervisor