A European study on alcohol and drug use among young drivers : The TEND by night study design and methodology

Background. Young individuals are the age group with the highest risk of car accidents. One of main explanations relies on the use of psychoactive substances (alcohol, illegal and medicinal drugs), which are known to be major risk factors of road accidents, and whose consumption is almost universally more common among younger drivers. Although the correlation between psychoactive substances use and decrease in driving performance has been established in controlled experimental or laboratory settings, few studies were conducted in naturalistic circumstances. The TEND by Night project has been designed to evaluate the relationship between driving performance and psychoactive substances assumption in young drivers enrolled at typical places of consumption. Methods/Design. The TEND by Night project, endorsed by the European Commission, is a multidisciplinary, multi-centric, cross-sectional study conducted in six European countries (Italy, Belgium/Netherlands, Bulgaria, Spain, Poland and Latvia). The study population consists of 5000 young drivers aged 16-34 years, attending recreational sites during weekend nights. The intervention is based on the portal survey technique and includes several steps at the entrance and exit of selected sites, including the administration of semi-structured questionnaires, breath alcohol test, several drug assumption test, and measurement of the reaction time using a driving simulator. The main outcome is the difference in reaction time between the entrance and exit of the recreation site, and its correlation with psychoactive substances use. As a secondary outcome it will be explored the relationship between reaction time difference and the amount of consumption of each substance. All analyses will be multivariate. Discussion. The project methodology should provide some relevant advantages over traditional survey systems. The main strengths of the study include the large and multicentric sample, the objective measurement of substance assumption (which is typically self-reported), the application of a portal survey technique and the simultaneous evaluation of several psychoactive substances.publishersversionPeer reviewe

State of Utah v. Heather Jo Rodriguez : Brief of Amici Curiae

ON WRIT OF CERTIORARI TO THE UTAH COURT OF APPEAL

Review of Ethanol Intoxication Sensing Technologies and Techniques

The field of alcohol intoxication sensing is over 100 years old, spanning the fields of medicine, chemistry, and computer science, aiming to produce the most effective and accurate methods of quantifying intoxication levels. This review presents the development and the current state of alcohol intoxication quantifying devices and techniques, separated into six major categories: estimates, breath alcohol devices, bodily fluid testing, transdermal sensors, mathematical algorithms, and optical techniques. Each of these categories was researched by analyzing their respective performances and drawbacks. We found that the major developments in monitoring ethanol intoxication levels aim at noninvasive transdermal/optical methods for personal monitoring. Many of the “categories” of ethanol intoxication systems overlap with each other with to a varying extent, hence the division of categories is based only on the principal operation of the techniques described in this review. In summary, the gold-standard method for measuring blood ethanol levels is through gas chromatography. Early estimation methods based on mathematical equations are largely popular in forensic fields. Breath alcohol devices are the most common type of alcohol sensors on the market and are generally implemented in law enforcement. Transdermal sensors vary largely in their sensing methodologies, but they mostly follow the principle of electrical sensing or enzymatic reaction rate. Optical devices and methodologies perform well, with some cases outperforming breath alcohol devices in terms of the precision of measurement. Other estimation algorithms consider multimodal approaches and should not be considered alcohol sensing devices, but rather as prospective measurement of the intoxication influence. This review found 38 unique technologies and techniques for measuring alcohol intoxication, which is testament to the acute interest in the innovation of noninvasive technologies for assessing intoxication

Identification and safety effects of road user related measures. Deliverable 4.2 of the H2020 project SafetyCube

Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported Horizon 2020 project with the objective of developing an innovative road safety Decision Support System (DSS). The DSS will enable policy-makers and stakeholders to select and implement the most appropriate strategies, measures, and cost-effective approaches to reduce casualties of all road user types and all severities. This document is the second deliverable (4.2) of work package 4, which is dedicated to identifying and assessing road safety measures related to road users in terms of their effectiveness. The focus of deliverable 4.2 is on the identification and assessment of countermeasures and describes the corresponding operational procedure and outcomes. Measures which intend to increase road safety of all kind of road user groups have been considered [...continues]

Alternative sampling strategies to monitor alcohol consumption in case of driver's licence regranting

In Belgium, the analysis of indirect biomarkers such as carbohydrate deficient transferrin (CDT%), gamma-glutamyltransferase (GGT), aspartate aminotransferase/alanine aminotransferase (AST/ALT) and mean corpuscular volume (MCV), is currently used to monitor the alcohol consumption in cases of fitness to drive assessment. To estimate how the use of direct ethanol markers (e.g. ethylglucuronide (EtG), ethylsulfate (EtS) and phosphatidylethanol species (PEths)) could improve the current process, three quantitative methods (EtG in hair; EtG and EtS in urine; and PEth 16:0/18:1, PEth 18:1/18:1 and PEth 16:0/16:0 in blood, venous (V) and capillary (C) dried blood spots (DBSs)) were developed, validated and tested. Fifty volunteers, for whom fitness to drive had to be assessed and for whom a blood analysis for indirect biomarkers was requested, were included in the study. The sampling and analysis of hair, urine and C-DBS were added to the process currently used. Hair EtG and C-DBS PEths are more sensitive to detect alcohol abuse than the currently used indirect biomarkers and allow to disprove an abstinence period. EtG and EtS in urine form a relevant parameter to detect recent alcohol intake (even one single alcohol consumption) during the days (up to 5 days) prior to the sampling and can thus be used to disprove strict abstinence. The three analyses tested here provide different levels of information and can be used separately or combined. The combined use of the three strategies allows better inference about the evolution of the alcohol consumption prior to the sampling. Moreover, the exclusive use of non- or minimally invasive sampling (hair, urine and C-DBS) allows this to be performed directly during the fitness to drive assessment by regular staff members. In conclusion, the three approaches that were evaluated in this work offer the potential to improve the Belgian driver’s licence regranting process

Breath Testing by Fourier Transform Infrared Spectroscopy for Solvent Intoxication Diagnostics

Technical or contaminated ethanol products are sometimes ingested either accidentally or on purpose. Typical misused products are black-market liquor and automotive products, e.g., windshield washer fluids. In addition to less toxic solvents, these liquids may contain the deadly methanol. Symptoms of even lethal solvent poisoning are often non-specific at the early stage. The present series of studies was carried out to develop a method for solvent intoxication breath diagnostics to speed up the diagnosis procedure conventionally based on blood tests. Especially in the case of methanol ingestion, the analysis method should be sufficiently sensitive and accurate to determine the presence of even small amounts of methanol from the mixture of ethanol and other less-toxic components. In addition to the studies on the FT-IR method, the Dräger 7110 evidential breath analyzer was examined to determine its ability to reveal a coexisting toxic solvent. An industrial Fourier transform infrared analyzer was modified for breath testing. The sample cell fittings were widened and the cell size reduced in order to get an alveolar sample directly from a single exhalation. The performance and the feasibility of the Gasmet FT-IR analyzer were tested in clinical settings and in the laboratory. Actual human breath screening studies were carried out with healthy volunteers, inebriated homeless men, emergency room patients and methanol-intoxicated patients. A number of the breath analysis results were compared to blood test results in order to approximate the blood-breath relationship. In the laboratory experiments, the analytical performance of the Gasmet FT-IR analyzer and Dräger 7110 evidential breath analyzer was evaluated by means of artificial samples resembling exhaled breath. The investigations demonstrated that a successful breath ethanol analysis by Dräger 7110 evidential breath analyzer could exclude any significant methanol intoxication. In contrast, the device did not detect very high levels of acetone, 1-propanol and 2-propanol in simulated breath. The Dräger 7110 evidential breath ethanol analyzer was not equipped to recognize the interfering component. According to the studies the Gasmet FT-IR analyzer was adequately sensitive, selective and accurate for solvent intoxication diagnostics. In addition to diagnostics, the fast breath solvent analysis proved feasible for controlling the ethanol and methanol concentration during haemodialysis treatment. Because of the simplicity of the sampling and analysis procedure, non-laboratory personnel, such as police officers or social workers, could also operate the analyzer for screening purposes.Maassamme on päihdeongelmaisten joukko, joka käyttää eri alkoholeja sisältäviä kemikaalivalmisteita alkoholinkorvikkeina. Eniten käytetään huoltoasemilla myytäviä autokemikaaleja. Metanolimyrkytykset yleistyivät metanolia sisältävien lasinpesunesteiden tultua markkinoille Suomen EU-jäsenyyden myötä 1990-luvun puolivälissä. Nykyisin metanoli aiheuttaa vuosittain 20 - 40, etyleeniglykoli 15 - 20 ja isopropyylialkoholi 1 - 5 kuolemaan johtavaa myrkytystä. Lievempiä liuotinainemyrkytyksiä ja -epäilyjä on moninkertainen määrä. Sairaalahoitoon tulleen myrkytyspotilaan hoidossa erityisesti metanoli- ja etyleeniglykolimyrkytyksen nopea tunnistaminen on ensiarvoisen tärkeää. Valitettavasti liuotinainemyrkytyksen oireet ovat usein epämääräisiä ja taustatiedot puutteellisia tai harhaanjohtavia. Koska kaikissa hoitopaikoissa ei ole saatavilla tarvittavaa laboratorioanalytiikkaa, saatetaan metanoli- ja etyleeniglykolimyrkytys havaita liian myöhään. Tämän väitöskirjatyön tavoitteena oli kehittää nopea ja täsmällinen menetelmä liuotinainemyrkytyksen toteamiseksi uloshengitysilmasta. Alun perin teollisuuden käyttöön tarkoitettu Fourier transformoituun infrapunaspektrometriaan perustuva mittalaite (Gasmet ) muutettiin uloshengitysilmanäytteiden tutkimiseen sopivaksi siten, että yksi uloshengitys riittää näytteeksi ilman esikäsittelyä. Automaattisen analyysiohjelmiston ansiosta laite pystyy yhdellä kertaa tunnistamaan näytteestä merkittävät uloshengitysilman komponentit ja määrittämään myös niiden pitoisuuden. Aikaa näytteen ottoon ja analyysiin kuluu vain muutama minuutti. Laitteen analyyttistä suorituskykyä arvioitiin useiden laboratorio-olosuhteissa tehtyjen kokeiden perusteella. Mittalaitteen käyttökelpoisuuden arvioimiseksi otettiin lisäksi uloshengitysnäytteitä terveiltä koehenkilöiltä, ensiapupoliklinikan potilailta, kriittisesti sairailta metanolimyrkytyspotilailta sekä miehiltä, jotka olivat juoneet denaturoitua etanolia. Tutkimukseen osallistui yhteensä 659 koehenkilöä. Saatujen kokemusten perusteella uloshengitysilmanäytteen otto oli pääosin ongelmatonta, jopa tajuttomilta ja hyvin juopuneilta potilailta. Mittalaitteen käyttö onnistui vaivatta myös hoitohenkilöstöltä, jolla ei ollut laboratorioalan koulutusta. Tutkimuksissa laite osoittautui riittävän herkäksi ja tarkaksi hengenvaarallisen metanolimyrkytyksen osoittamiseksi. Tämä helppokäyttöinen ja nopea laite todettiin hyödylliseksi myös myrkytyksen hoidon vasteen seurannassa. Kehittämällämme menetelmällä voidaan uloshengitysnäytteestä todeta merkittävät liuotinainemyrkytykset, etyleeniglykolimyrkytystä lukuun ottamatta