Introduction/ framework/ objectives:

Most occupational health professionals have experienced situations in which some employee consumed alcohol in quantities greater than those considered adequate to perform their professional tasks. Sometimes it is very relevant to understand if the individual has stopped and is already fit. Not all medical offices have approved instruments for testing exhaled or urinary ethanol and this only gives information on consumption in the last few hours. There may be a need to know if in the last days, weeks or months there has been consumption. Over the past few years, various substances have been emerging on various substrates (urine, blood, hair, nail, exhaled air) that have the ability to, with a reasonable margin of safety, quantificate what has been the ethyl consumption up to the last six months, in some cases.

This review was intended to summarize what most recent and pertinent was published on the topic.

Methodology:

This is an Integrative Bibliographic Review, initiated by a June 2019 search of the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”.

Content:

Among the classic or indirect markers (quantifying some alcohol-related injuries) ALT, AST, GGT, plaquelets and mean corpuscular volume, as well as CDT stand out. The main direct biomarkers are Ethanol, PEth, FAEEs, EtG and EtS, among others very recent and still under study (note: all these abbreviations are explaned in the text).

Discussion and Conclusions:

Although there is no absolute consensus, it seems clear that direct markers give more reliable information on acute and especially chronic consumption, and are less modulated by liver pathology, which is reasonably frequent among addicted individuals. However, indirect or classic markers are more easily dosed in virtually any laboratory and at a much more affordable cost.

In addition to these technical/ scientific issues, the Occupational Health Team will have to set up an infrastructure in advance, agreed with the employer and the laboratory, to permit the confidentiality of these dosages, paying the employer the agreed amount (fixed or depending on the really dosed), not knowing what was tested or to whom, even if the dependency is known to everyone in the company, as sometimes happens.

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