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Urine test positive for alcohol

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Hi,

Recently took a urinalysis for court ordered abstinence from alcohol and showed up positive for consumption in the past 4 days (high amounts). though, I have not ingested any alcohol in well over a year.
Curious if the combined topical s such as hand sanitizer(s), mosquito repellent, gel deodorant, mousse, chewing gum, painting solvents and aftershave could have caused this.
I HAD been exposed to ALL of these the day prior to taking the urinalysis and was using all, with the exception of paint solvents, the day of the urinalysis.

 


Category: Internal Medicine Specialist

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Expert:  Dr. Steve Merris replied 4 Days.


Thank you for your query.



Not likely. Hand sanitizer(s), mosquito repellent, gel deodorant, mousse, chewing gum, painting solvents and aftershave -- all can contain alcohol, but the level and topical absorption is very less. If there was a significant absorption, you would have felt intoxicated! This could be false positive result. This is especially true if just urine ethanol levels are measures. Alcohol can form in the urine if there are bacteria or fungi. I recommend you to go for a retest and use newer modalities of alcohol analysis like ethyl glucuronide (EtG).



Hope this helps



Thank you



Patient replied :

Thank you for your reply;
The test in question was an EtG and it showed highly elevated alcohol levels in my urine...and I still maintain I have/had not consumed alcohol in the past year-plus.
While waiting for a reply I did some further searches and ran across http://www.samhsa.gov/samhsa_news/volumexiv_6/article5.htm which says the EtG should only be used in a clinical setting and strongly suggested it never be used in any forensic situation or when a person's (my) job is at risk.
Ultimately, my question is if combining all the elements I described over the course of 4 days... is it possible to have a false positive with strong indications I had orally consumed quite a bit of alcohol within 3 or 4 days??
And, can the diminished filtering capacity of my Hep-C liver have an effect on the toxicity levels on the day I submitted the urinalysis?
My operator's license and work potential is at risk due to a test I'm POSITIVE is flawed and need corroborating "testimony" verifying the potential for this test to be flawed under the conditions I've described.


Expert:  Dr. Steve Merris replied 3 Days.

Hello,
If you are sure that the test was based on EtG then the whole picture changes. My earlier reply was based on the assumption that urinary ethanol levels were measured, which is the accepted standard. I do not completely agree to the article you have linked. EtG is a very sensitive test and it can positive even minor amount of alcohol is being absorbed from skin or nails. From hand sanitizer to after shave can result in a positive EtG test. Because of this reason the labs will have a threshold cut off for the EtG result varies between labs. That means even if the EtG is positive it has to be positive above 100 ng/ml (cut offs can change depending on labs). This takes into consideration that any 0 - 100ng/ml values are from household objects or food items. Values greater than 500 are really suggestive of alcohol abuse.
In your particular case, since you have uses this many alcohol related products, you may argue that it caused the higher value. After a waiting period of couple of weeks and total abstinence from, we may reach any reasonable conclusion.


Dr. Steve Merris
Category: Internal Medicine Specialist
Experience: 
Medical School - New York University
Internship in Internal Medicine - Beth Israel Medical Center
Residency in Internal Medicine - Beth Israel Medical Center
Fellowship in Pulmonary and Critical Care Medicine - Columbia University Medical Center
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