Alcohol in Urine, Saliva, Sweat, and Breast Milk and Biomarkers of Alcohol Consumption

AuthorJames G. Wigmore
Alcohol in Urine, Saliva, Sweat, and
Breast Milk and Biomarkers of Alcohol
In addition to the more commonly used alcohol testing of breath and
blood of drinking dr ivers, other substances such as urine and saliva h ave
been employed. Transdermal (sweat) alcohol monitoring of persons on
parole or probation with the condition of no alcohol consumption is be-
coming more frequent. Biomarkers of alcohol consumption found in the
hair or urine are a lso used for this purpose. Since alcohol distributes
throughout the total body water, it is not surprising that alcohol, if con-
sumed by a lactating woman, appea rs in her breast milk.
. URINE
Urine is the only sample that can be collected from living subjects th at
can indicate the blood alcohol concentration (BAC) at a time prior to the
collection of the sample, as it is stored in the bladder (). The phase
of the BAC curve can be determined vi a the urine alcohol concentration
(UAC) by the following:
• UAC < BAC (absorption phase, BAC increasing)
• UAC > BAC (post-absorption phase, BAC plateaued or decreasing )
Alcohol causes an increase in ur ine f‌low (diuresis) during only the
f‌irst several hours after d rinking (, ). Urine samples collected
from drinki ng drivers can be used to determi ne BAC (, ).
Falsely high UACs may occur in the urine sample if collected from a
diabetic person who has a yeast infection (, ). The use of re-
frigeration and NaF prevents this alcohol formation (–). Freezing
Alcohol in Urine, Saliva, Sweat, and Breast Milk and Biomarkers of Alcohol Consumption
Reference Number: 
and re-thawing urine sa mples and improperly sealed containers cause
a decrease in UAC (, ). Alcohol intoxication can increase the
risk of bladder rupture after mi nor trauma ().
Reference Number: 
, ..,  .. . “Blood Alcohol Concentration Deter-
mined from Urine Samples as a Practical Equivalent or Alternative
to Blood and Breath Tests.” Journal of Forensic Sciences, : –,
 ( tables,  f‌igure,  references)
Abstract: The average production of urine is .–. mL/min. With
alcohol consu mption, the average product ion is approximately – mL/
min. The impulse to void occurs at  mL of urine in the bladder, and
pronounced discomfort occurs at  mL. Under normal circ umstances
the impulse to void occurs in –. hours. In law enforcement practice,
the average time for the second urine sample in drink ing drivers was 
minutes due to the diuretic ef‌fect. Assuming t hat urine is % water
and blood is % water, the urine ethanol–blood ethanol ratio should
be .:. In impaired driving cases, the two urine samples showed that
most people had reached the BAC plateau or the elimination phase
(/ or %). In only two cases was the dif‌ference between the f‌irst
and second sample greater than .g/ mL. This contradicts the
frequent claims of rapid consumption of alcohol just before driving.
Urine is a reliable and accurate alternative to sampling blood for alcohol
determination when second samples collec ted within  h from void-
ing are provided by cooperative subjects and converted using a r atio
of .:.
Reference Number: 
, .. “Excretion of Alcohol in Urine and Diuresis in Healthy Men
in Relation to Their Age, the Dose Administered and the Time after
Drinking.” Forensic Science International, : –,  ( tables, 
f‌igure,  references)
Abstract: Eight male subjects consumed ., ., or .g/kg of ethanol
as neat whiskey within  – minutes. Urine was collected immed iately
before drinking and every  m inutes for – hours and then analyzed
for ethanol by an alcohol dehydrogenase (ADH) method. Only .–.%

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