Ethanol distribution ratios between urine and capillary blood in controlled experiments and in apprehended drinking...

Healthy men drank 0.51, 0.68, and 0.85 g of ethanol per kilogram of body weight as neat whisky in the morning after an overnight fast. During 6 to 8 h after the whisky was consumed, nearly simultaneous specimens of fingertip blood and pooled bladder urine were obtained for analysis of ethanol using an enzymatic method. The mean ratios of ethanol concentration [urine alcohol concentration (UAC)/blood alcohol concentration (BAC)] were mostly less than unity during the absorption phase. The UAC exceeded the BAC in the postpeak phase. The mean UAC/BAC ratios varied between 1.4 and 1.7 when the BAC exceeded 0.50 mg/mL. When the BAC decreased below 0.40 mg/mL, the UAC/BAC ratios increased appreciably. The mean UAC/BAC ratios of ethanol were not dependent on the person's age between the ages of 20 and 60 years old, but there were large variations within the age groups. In apprehended drinking drivers (N = 654) with a mean BAC of 1.55 mg/mL, the UAC/BAC ratio of ethanol varied widely, with a mean value of 1.49. In 12 subjects (3.2%), the ratio was less than or equal to unity. In a second specimen of urine obtained approximately 60 min after an initial void (N = 135), the mean UAC/BAC ratio was 1.35 (standard deviation = 0.17). The magnitude of the UAC/BAC ratio of ethanol can help to establish whether the BAC curve was rising or falling at or near the time of voiding. The status of alcohol absorption needs to be documented if drinking drivers claim ingestion of alcohol after the offence or when back-estimation of the BAC from the time of sampling to the time of driving is required by statute.