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ABSTRACT
Background: Ethyl Glucoronide (EtG) and Ethyl Sulfate (EtS) have shown promise as biomarkers for alcohol and may be sensitive enough for use with pregnant women in whom even low-level alcohol use is important. However, there have been reports of over-sensitivity of EtG and EtS to incidental exposure to sources such as alcohol-based hand sanitizer. Further, few studies have evaluated these biomarkers among pregnant women, in whom the dynamics of these metabolites may differ. Objectives: This study evaluated whether commercial EtG-EtS testing was vulnerable to high levels of environmental exposure to alcohol in pregnant women. Methods: Two separate samples of five nurses—one pregnant and the other postpartum, all of whom reported high levels of alcohol-based hand sanitizer use—provided urine samples before and 4–8 hours after rinsing with alcohol-based mouthwash and using hand sanitizer. The five pregnant nurses provided urine samples before, during, and after an 8-hour nursing shift, during which they repeatedly cleansed with alcohol-based hand sanitizer (mean 33.8 uses). The five postpartum nurses used hand sanitizer repeatedly between baseline and follow-up urine samples. Results: No urine samples were positive for EtG-EtS at baseline or follow-up, despite use of mouthwash and—in the pregnant sample—heavy use of hand sanitizer (mean of 33.8 uses) throughout the 8-hour shift. Conclusions/Importance: Current, commercially available EtG-EtS testing does not appear vulnerable to even heavy exposure to incidental sources of alcohol among pregnant and postpartum women.
Additional information
Notes on contributors
Steven J. Ondersma
Steven J. Ondersma, PhD: Primary research interest is in brief, computer-delivered motivational interventions for substance use and other risk factors among pregnant and postpartum women. Other interests include indirect screening for stigmatized risk behaviors among parents and the application of the common factors in psychotherapy/human-computer interaction literatures to the design of computer-delivered interventions.
Jessica R. Beatty
Jessica R. Beatty, PhD: Primary research interest focuses on the impact of substance abuse on families. More specifically her research focuses on using technology and brief interventions to decrease perinatal substance use to impact birth outcomes and exploring new ways of measuring parent–child interactions.
Thomas G. Rosano
Thomas G. Rosano, PhD, DABFT, DABCC: Primary research interest focuses on advances in analytical drug-detection techniques and interpretation in the clinical and postmortem setting. More recently this research has focused on the biomarker Ethyl Glucoronide (EtG).
Ronald C. Strickler
Ronald C. Strickler, MD: Areas of interest are clinical medicine, specifically hormone therapies in the reproductive and menopausal years and reducing substance use during reproductive years.
Amy E. Graham
Amy E. Graham, BA: Research interests include motivations for behavior change, brief tailored interventions using technology to reduce substance use in the preconception and perinatal period, motivational interviewing, FASD prevention.
Robert J. Sokol
Robert J. Sokol, MD: Research interests have focused on long-term outcomes, particularly neurobehavioral, of perinatal risks, including asphyxia and prenatal exposures to alcohol, cocaine, and other substances. Recent work has focused on prevention of Fetal Alcohol Spectrum Disorders.