Ethyl Glucuronide (EtG) New Developments and Concerns

Ethyl glucuronide, EtG,  is a biomarker for recent alcohol use.  The media has reported that individuals have been accused of abusing alcohol because of a positive EtG test result.  Only to find out later that the individual was accidentally exposed to alcohol in a cleaning agent or hand cream.  Similar to other drug test results, such as opiates and cannabinoids,  if the cutoff is too low, a positive due to accidental exposure is difficult to rule out.

A number of years ago the cannabinoids test cutoff was 20 ng/mL to identify marijuana abuse.  A number of instances were reported in the scientific literature of positives due to passive inhalation.  The drug testing community responded by raising the cutoff levels to 50 ng/mL in order  to rule out wrongly accusing an individual of marijuana abuse.  Similarly,  the opiate test cutoff was 300 ng/mL to identify opiates abuse.  When it was identified that poppy seed containing foods might cause a positive opiates drug test,  agencies such as the Department of Defense reacted by raising the cutoff to 2,000 ng/mL.  Thus, individuals would not be wrongly accused of opiates abuse.

EtG is a biomarker of alcohol ingestion, but definitive data about a reliable cutoff  to differentiate between alcohol abuse and accidental exposure is still under investigation.

Information in the scientific literature has reported that levels greater than 500 ng/mL are extremely unlikely to be caused by accidental exposure to alcohol.  Hearsay information describes an individual who only used a hand sanitizer and tested positive for urinary EtG  at a level of about 750 ng/mL.

Because of the concerns about accidental exposure to alcohol containing products,   Ammon Analytical Laboratory has adopted a prudent approach to testing for urinary EtG.

The screening cutoff for EtG is 500 ng/mL.  All positive EtG results are confirmed by an alternate scientific method, mass spectrometry.  Thus,  Ammon Analytical Laboratory provides a reliable means of identifying urinary  EtG.

Similar to other laboratory tests a positive EtG result should be used as a sign.  In this case a sign of alcoholic beverage consumption.  Upon reporting the result to a physician further evaluation of the donor is important.

Post Written by: Jerry Meenan

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