Driving license regranting: Hair EtG, serum CDT, and the role of sociodemographic and medicolegal variables

Abstract

Driving under the influence (DUI) of alcohol is a road safety problem. Driving license regranting is based on the evaluation of medicolegal and toxicological variables that may include serum carbohydrate‐deficient transferrin (CDT) and hair ethyl glucuronide (hEtG).The aim of the study was to compare the diagnostic performance of CDT and hEtG in a population of DUI offenders. Other factors potentially associated with heavy alcohol use were explored. The population included DUI offenders examined during the period of January 1, 2019, through June 30, 2022. Sociodemographic, medicolegal, and toxicological variables were collected. CDT in serum and EtG in head hair were determined in all subjects. Excessive alcohol intake (hEtG ≥30 pg/mg) was considered cause for unfitness to drive. Cohen's kappa coefficient was calculated. Descriptive analyses were performed using chi‐square and Mann–Whitney tests. Variables significantly different between the groups were included in a multivariate binary logistic regression model. The sample encompassed 838 subjects (case group: 179, comparison group: 689). CDT exhibited poor agreement (κ = 0.053) with hEtG as the reference test. Lower education, age at DUI, heavy smoking, and GGT levels associated with heavy alcohol consumption differentiated the two groups. For DUI offenders, the use of CDT to assess heavy alcohol consumption is limited, possibly due to the time‐window assessed, the time required for normalization, and the different amount of ethanol needed to reach higher CDT levels, in comparison to hEtG; thus, hEtG assessment is strongly recommended for this population. Heavy smoking, GGT, education, and age could be related to heavy alcohol consumption and higher risk of DUI.

Driving impairment due to psychoactive substances and attention deficit disorder: A pilot study

“…The choice to use the CPT-3 is innovative compared to other studies and allowed the analysis of specific aspects of attention linked to SUD and driving impairment [ 18 , 23 ] in a population of subjects examined for driver's license reinstatement. The integrated methodological approach allowed us to objectively assess the current use of psychoactive substances in this context [ 33 ]. The population studied was unusual compared to other populations reported in the literature because of its peculiar characteristics.…”

Monitoring of phosphatidylethanol in dried blood spots and of ethyl glucuronide in hair over 6 months of alcohol consumption

“…In 2022, Aboutara et al compared CDT, EtG, and PEth 16:0/18:1 concentrations in liver transplant patients, the latter being the most sensitive 12 . Cinquetti et al observed poor agreement between EtGH and CDT in driving under the influence offenders 13 . Other research groups found that detection of PEth and EtGH is limited after a one time alcohol ingestion or repetitive drinking of small amounts, respectively 14–16 …”

“…12 Cinquetti et al observed poor agreement between EtGH and CDT in driving under the influence offenders. 13 Other research groups found that detection of PEth and EtGH is limited after a one time alcohol ingestion or repetitive drinking of small amounts, respectively. [14][15][16] In addition to the determination of ethanol biomarkers, self-rating questionnaires such as Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption (AUDIT-C), or Cut down-Annoyance-Guilty-Eye opener (CAGE), as well as drinking diaries, are frequently used in clinical settings.…”

Advancing in hair testing: Insights from the Society of Hair Testing–Gruppo Tossicologi Forensi Italiani meeting in Verona 2022

“…3 Furthermore, the SoHT meeting in Verona featured research on the identification and quantification of alcohol abuse biomarkers, their stability, and their correlation with exposure and other biomarkers. 4 Forensic Applications and Interpretation: One of the vital objectives of hair testing is its application in forensic investigations and legal proceedings. The SoHT meeting in Verona emphasized the significance of rigorous interpretation of analytical results and the need for standardized protocols.…”

“…The impact of hair treatments on the oxidation/decomposition of drugs in hair was also explored, as the long‐term fate of drugs incorporated in the keratin matrix 3 . Furthermore, the SoHT meeting in Verona featured research on the identification and quantification of alcohol abuse biomarkers, their stability, and their correlation with exposure and other biomarkers 4 …”