The PEth Blood Test in the Security Environment: What it is; Why it is Important; and Interpretative Guidelines

J Forensic Sci. 2018 Nov;63(6):1634-1640. doi: 10.1111/1556-4029.13874. Epub 2018 Jul 13.

Abstract

Testing for phosphatidylethanol (PEth) is a relatively new tool for detecting and grossly quantifying a person's use of alcohol in a variety of security, medical, and legal environments. The basic chemistry of PEth is explained with a particular focus on factors that make it highly suitable as a biomarker for alcohol use in such situations. This article meets the need for a literature review that synthesizes PEth laboratory findings and suggests updated guidelines for interpretation. Several ethanol biomarkers have been used for detection or monitoring alcohol use but have significant limitations. Based on this review, the authors propose three guidelines for evaluating PEth values: Light or no Consumption (<20 ng/mL), Significant Consumption (20-199 ng/mL), and Heavy Consumption (>200 ng/mL). These guidelines are important in employment and security environments, but also have applicability in such diverse activities as alcohol treatment programs, organ transplant decisions, and monitoring impaired medical professionals.

Keywords: compliance monitoring; ethanol biomarkers; forensic science; guidelines; phosphatidylethanol; security.

Publication types

  • Review

MeSH terms

  • Alanine Transaminase / analysis
  • Alcohol Drinking / blood*
  • Alcoholism / diagnosis
  • Aspartate Aminotransferases / analysis
  • Biomarkers / blood
  • Breath Tests
  • Central Nervous System Depressants / pharmacokinetics
  • Erythrocyte Indices
  • Ethanol / pharmacokinetics
  • Forensic Toxicology
  • Glucuronates / analysis
  • Glycerophospholipids / blood*
  • Hair / chemistry
  • Humans
  • Reference Values
  • Substance Abuse Detection / methods*
  • Sulfuric Acid Esters / urine
  • Transferrin / analysis
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • Central Nervous System Depressants
  • Glucuronates
  • Glycerophospholipids
  • Sulfuric Acid Esters
  • Transferrin
  • phosphatidylethanol
  • ethyl glucuronide
  • Ethanol
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • diethyl sulfate