The Effect of Alcohol‐Based Hand Sanitizer Vapors on Evidential Breath Alcohol Test Results

Abstract

This study was undertaken to determine if the application of alcohol-based hand sanitizers (ABHSs) to the hands of a breath test operator will affect the results obtained on evidential breath alcohol instruments (EBTs). This study obtained breath samples on three different EBTs immediately after application of either gel or foam ABHS to the operator's hands. A small, but significant, number of initial analyses (13 of 130, 10%) resulted in positive breath alcohol concentrations, while 41 samples (31.5%) resulted in a status code. These status codes were caused by ethanol vapors either in the room air or their inhalation by the subject, thereby causing a mouth alcohol effect. Replicate subject samples did not yield any consecutive positive numeric results. As ABHS application can cause a transitory mouth alcohol effect via inhalation of ABHS vapors, EBT operators should forego the use of ABHS in the 15 min preceding subject testing.

Driving under the influence of alcohol during the COVID-19 pandemic

“…On a limited-scale study, Brewer and Streel showed that disulfiram-ethanol reaction might be caused by inhaling alcohol from ABHSs in confined spaces [9] . Strawsine and Lutmer showed that ABHSs could drive increased breath alcohol levels in around 10% of the subjects, causing mouth alcohol effects, and recommended caution in using these products 15 minutes before testing [8] . As seen from these studies, none tried to replicate the use of ABHS in cars by drivers tested with a breathalyzer.…”

“…For example, a study reported by the Texas Poison Control Centers has shown an overall 72.5% increase in reported exposures to ABHS between 2019 and 2020 [5] . In addition, some studies revealed a potential effect of alcohol vapors from hand sanitizers on the breath alcohol tests [6] , [7] , suggesting they might lead to false positives, at least for 15 minutes after their use [8] . Almost all alcohol from ABHS is inhaled, the skin absorption being unable to yield positive BAC or BrAC results with clinical significance [9] .…”

Washout kinetics of ethanol from the airways following inhalation of ethanol vapors and use of mouthwash

“…Two studies have measured BrAC in humans during, but not after, exposure to ethanol [19,20]. Several investigators have studied BrAC after use of ethanol containing hand sanitizers [8,9,21], see also review by McClean et al [10]. Although exposure via hand sanitizers is realistic from a practical point of view, the BrAC data are difficult to interpret as the inhaled concentration of ethanol were unknown.…”

“…For example, people sometimes use mouthwash as an explanation for a positive breath test [5]. Other examples of potential confounders are E-cigarette smoking (as the E-liquid may contain ethanol) [6,7], use of alcohol-based hand rubs, disinfectants or cleaners [8][9][10] and, oddly, alcohol spill in the car [11].…”

“…However, they did not follow the post-exposure decline in breath and did not relate their results to alcohol breath tests. Some research groups studied dermal and inhalation exposure to ethanol vapors during use of alcohol-based hand rubs [8][9][10]21,22]. Again, the decline of ethanol in breath was not studied.…”