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  • 1. Fransson, M
    et al.
    Jones, A Wayne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry.
    Andersson, L
    Laboratory evaluation of a new evidential breath-alcohol analyser designed for mobile testing - The Evidenzer2005In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 45, no 1, p. 61-70Article in journal (Refereed)
    Abstract [en]

    The Evidenzer is a new kind of forensic breath-alcohol analyser, designed for use both at a police station (stationary) and also in a police vehicle (mobile) at the roadside. In this paper we report the accuracy and precision of the Evidenzer, determined under controlled laboratory conditions. The results were compared with a well-established breath-alcohol instrument (Intoxilyzer 5000S) and also with the concentration of alcohol in venous blood. Twenty healthy volunteers (10 men and 10 women) consumed ethanol (0.4 g/kg) in 15 minutes starting two to three hours after their last meal. Venous blood and breath were obtained for determination of ethanol at 15-30 minute intervals for up to four hours post-dosing. There was a good overall agreement between the two breath-alcohol instruments and the mean bias was only 0.003 mg/L (95% limits of agreement of -0.016 to 0.023 mg/L). The standard deviation (SD) of measuring ethanol in breath was about the same for both instruments, being 0.006 mg/L, and this corresponds to a relative precision or coefficient of variation (CV) of 4.7%. When the Evidenzer was used to analyse ethanol vapour (0.50 mg/L) generated from a wet-bath simulator, i.e. in-vitro conditions, the coefficient of variation was 0.7% indicating high analytical precision. The concentration of ethanol in venous blood and breath were highly correlated (r=0.95) although systematic differences existed depending on time after drinking when comparisons were made. Both breath-alcohol instruments gave results higher than venous blood alcohol in tests made at 15 minutes after the end of drinking whereas at all later times the venous blood-alcohol concentration was higher than the breath instrument readings. These observations can be explained by the time necessary for ethanol to equilibrate between arterial blood and tissue water and by the resulting arterial-venous differences. The time-course of alcohol concentration in arterial blood runs closer to the breath-alcohol concentration rather than the venous blood draining the forearm muscle tissue. The new Evidenzer instrument was easy to operate and gave accurate and precise results compared with Intoxilyzer 5000S.

  • 2.
    Iffland, R
    et al.
    Linkoping Univ Hosp, Dept Forens Toxicol, S-58185 Linkoping, Sweden Univ Cologne, Dept Legal Med, Cologne, Germany.
    Jones, A Wayne
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Evaluating alleged drinking after driving - the hip-flask defence - Part 1. Double blood samples and urine-to-blood alcohol relationship2002In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 42, no 3, p. 207-224Article, review/survey (Refereed)
    Abstract [en]

    This two-part article examines the strengths and weaknesses of various ways of investigating claims of drinking alcohol after driving, commonly known as the hip-flask or glove-compartment defence. In many countries the onus of proof in hip-flask cases rests on the prosecution. With good co-operation from the police and timely sampling of body fluids, such as blood and urine for forensic analysis of ethanol, useful evidence can be mustered to support or challenge the truthfulness of alleged drinking after driving. The person's blood-alcohol concentration (BAC) can be compared with values expected on the basis of the amount of alcohol consumed after driving, according to theoretical Widmark calculations. The actual BAC measured is then adjusted for the additional amount of alcohol consumed in the after-drink. Double blood samples, that is, taking two specimens of venous blood about 30-60 minutes apart and looking at the magnitude and direction of change in BAC provides little or no more information than a single blood specimen. However, the relationship between alcohol in blood and urine is very useful in hip-flask cases whereby the concentration expected in the primary urine is compared with the concentration in the bladder urine voided. The concentration of alcohol determined in a second urine sample collected 30-60 min later gives supporting evidence in hip-flask cases. A graphical method, which entails plotting ethanol concentrations in blood and urine as a function of time provides a robust and practical way to investigate hip-flask defences. In the second part of the review, congener analysis is presented, which entails comparing the concentrations of n-propanol, isobutanol and occasionally other congeners in the alcoholic beverage allegedly consumed after driving with the volatiles present in the suspect's blood and urine determined by headspace gas chromatography.

  • 3. Iffland, R
    et al.
    Jones, A Wayne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Evaluating alleged drinking after driving - The hip-flask defence: Part 2. Congener analysis2003In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 43, no 1, p. 39-68Article in journal (Refereed)
    Abstract [en]

    The second part of this review describes the principles and practice of forensic congener analysis as an alternative way to evaluate claims of drinking alcohol after driving. Congener analysis was developed, perfected and practised in Germany as a way to evaluate hip-flask defences. This kind of defence challenge arises frequently when the drunk driving suspect is not apprehended at the wheel and especially after hit-and-run incidents. Besides ethanol and water, alcoholic beverages contain trace amounts of many other low-molecular substances, known collectively as the congeners, which impart the characteristic smell and taste to the drink. Importantly, the congener profile can be used to identify a particular kind of alcoholic beverage. Forensic congener analysis entails making a qualitative and quantitative analysis of ethanol, methanol, n-propanol and the isomers of butanol in blood and urine from the apprehended driver and comparing the results with the known congener profile of the alcoholic beverage allegedly consumed after driving. Interpreting the results of congener analysis requires knowledge about the absorption, distribution and elimination pattern of the congener alcohols, including their oxidation and conjugation reactions, and any metabolic interactions with ethanol. Complications arise if drinks with widely different congener profiles are consumed or if the same beverage was ingested both before and after driving. Despite these limitations, congener analysis can furnish compelling evidence to challenge or support claims of drinking alcohol after driving.

  • 4. Iffland, R
    et al.
    Jones, A Wayne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Evaluating alleged drinking after driving - the hip-flask defense. Part I. Double blood samples and urine/blood relationships.2002In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 42, p. 207-224Article in journal (Refereed)
  • 5.
    Jones, A Wayne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Fransson, M
    Blood analysis by headspace gas chromatography: Does a deficient sample volume distort ethanol concentration?2003In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 43, no 3, p. 241-247Article in journal (Refereed)
    Abstract [en]

    This study was prompted by a recent judgment in the Royal Courts of Justice (Gregory v. Director of Public Prosecutions, 2002) in a case of driving a motor vehicle after consuming too much alcohol (Road Traffic Act 1988). An expert witness for the defence alleged that a deficient volume of blood in the tube sent for analysis meant an excess amount of sodium fluoride (NaF) preservative, which would increase the concentration of ethanol, determined by headspace gas chromatography (HS-GC), owing to a salting-out effect. The prosecution did not produce expert evidence to rebut this argument and the drunk driving suspect was acquitted. A small volume of blood and excess sodium fluoride might have increased the concentration of ethanol in the air-space in the tube sent for analysis but this does not mean that the result of the HS-GC analysis would be higher. This follows because prior to analysis an aliquot of blood is removed and diluted (~10 times) with n-propanol as the internal standard. The dilution lowers the concentration of NaF in the blood and for quantitative analysis the ratio of the ethanol to n-propanol response is measured. The use of a ratio also helps to compensate for any salting-out effect of ethanol. Our experiments showed that a deficient volume of blood and excess NaF actually lowered the concentration of ethanol by 2-3% compared with heparinised blood. Seemingly, n-propanol (n-PrOH) a 3-carbon straight chain alcohol is salted out slightly more effectively than the 2-carbon ethanol (EtOH) causing a lower peak area ratio (EtOH/n-PrOH) and a lower apparent concentration of ethanol. In a separate study, we showed that the concentration of ethanol was lowered even more when a 4-carbon alcohol (t-butanol) was used as the internal standard.

  • 6.
    Jones, A Wayne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Drug Research.
    Holmgren, Anita
    National Board for Forensic Medicine.
    Concentration distributions of the drugs most frequently identified in post-mortem femoral blood representing all causes of death2009In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 49, no 4, p. 257-273Article in journal (Refereed)
    Abstract [en]

    Interpreting the concentrations of drugs determined in post-mortem blood is not an easy task owing to poly-drug use, adverse drug-drug interactions, as well as a host of pre-analytical factors and various artefacts in post-mortem toxicology. Highly sensitive and specific methods (GC-FID, GC-NPD. GC-MS and LC-MS) were used to determine the concentrations of drugs in femoral blood from 24,876 autopsies representing all causes of death. Ethanol topped the list of psychoactive substances (N=8,108 or 33%) at mean, median and highest concentrations of 1.43 g/L, 1.20 g/L and 8.0 g/L, respectively. In second place was paracetamol (N=2,741 or 11%). Amphetamine and cannabis were the major illicit drugs at 13th and 15th positions, respectively. Newer antidepressants, citalopram (no 3), sertraline (no 14), venlafaxine (no 16) were prominent as were sedative-hypnotics, such as diazepam (no 4), zopiclone (no 5) and zolpidem (no 18). This compilation of drugs and their concentration distributions will be useful to identify and flag for a likely overdose or drug-related poisoning death. The drug concentration together with the findings at autopsy and the police report can then be used to reach a conclusion about the cause and manner of death.

  • 7. Logan, B K
    et al.
    Jones, A Wayne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry.
    Endogenous ethanol "auto-brewery syndrome" as a drunk-driving defence challenge.2000In: Medicine, Science and the Law, ISSN 0025-8024, E-ISSN 2042-1818, Vol. 40, no 3, p. 206-215Article in journal (Refereed)
    Abstract [en]

    The concentration of ethanol in blood, breath or urine constitutes important evidence for prosecuting drunk drivers. For various reasons, the reliability of the results of forensic alcohol analysis are often challenged by the defence. One such argument for acquittal concerns the notion that alcohol could be produced naturally in the body, hence the term 'auto-brewery' syndrome. Although yeasts such as Candida albicans readily produce ethanol in-vitro, whether this happens to any measurable extent in healthy ambulatory subjects is an open question. Over the years, many determinations of endogenous ethanol have been made, and in a few rare instances (Japanese subjects with very serious yeast infections) an abnormally high ethanol concentration (>80 mg/dl) has been reported. In these atypical individuals, endogenous ethanol appeared to have been produced after they had eaten carbohydrate-rich foods. A particular genetic polymorphism resulting in reduced activity of enzymes involved in hepatic metabolism of ethanol and a negligible first-pass metabolism might explain ethnic differences in rates of endogenous ethanol production and clearance. Other reports of finding abnormally high concentrations of ethanol in body fluids from ostensibly healthy subjects suffer from deficiencies in study design and lack suitable control experiments or used non-specific analytical methods. With reliable gas chromatographic methods of analysis, the concentrations of endogenous ethanol in peripheral venous blood of healthy individuals, as well as those suffering from various metabolic disorders (diabetes, hepatitis, cirrhosis) ranged from 0-0.88 mg/dl. These concentrations are far too low to have any forensic or medical significance. The notion that a motorist's state of intoxication was caused by endogenously produced ethanol lacks merit.

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