Cited by 22Forensic Toxicology and Drug AnalysisClinical Laboratory Practices and Quality ControlAlcohol Consumption and Health Effects

The alcohol used for cleansing the venipuncture site does not jeopardize blood and plasma alcohol measurement with head-space gas chromatography and an enzymatic assay

Open access
Lippi, Giuseppe, Simundic, Ana-Maria, Musile, Giacomo, Danese, Elisa, Salvagno, Gianluca, Tagliaro, Franco·2017·Biochemia Medica

Abstract

Introduction: This study aimed to establish whether an alcoholic antiseptic, wiped or not before venipuncture, may jeopardize alcohol testing with a commercial enzymatic assay and a reference head-space gas chromatography (GC) technique.Materials and methods: Venous blood was collected from 23 healthy volunteers, with two sequential procedures.In the first blood collection, 2 mL of alcoholic antiseptic (0.5% chlorhexidine, 70% ethanol) were place on a gauge pad, the venipuncture site of right arm was cleaned but the antiseptic was not let to dry before phlebotomy.In the second blood collection, 2 mL of the same alcoholic antiseptic were placed on another gauge pad, the venipuncture site of left harm was cleaned and the antiseptic was accurately cleansed before phlebotomy.Ethanol was measured with a reference GC technique in whole blood and EDTA plasma, and a commercial enzymatic assay in EDTA plasma. Results:No subject complained about feeling a particular itchy sensation when the alcohol was not wiped before puncturing the vein.The concentration of alcohol in all EDTA plasma samples was always lower than the limit of detection of the enzymatic assay (i.e., 2.2 mmol/L; 0.1 g/L).Similarly, alcohol concentration was also undetectable using a reference GC technique (i.e., < 0.22 mmol/L; 0.01 g/L) in EDTA plasma and whole blood.Conclusion: It seems reasonable to conclude that using ethanol-containing antiseptics before venipuncture may not be causes of spurious or false positive results of alcohol measurement at least when ideal venipunctures can be performed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.11613/bm.2017.041

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Under ideal blood collection conditions, the use of ethanol before venous blood collection does not interfere with blood alcohol measurement.

    “Moreover, under ideal blood collection conditions, the use of ethanol before venous blood collection does not interfere with blood alcohol measurement [72].”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 26

  1. [1]Lavery I Ingram P Venepuncture: best practice. Nurs Stand. 2005; 19: 55– 65. 10.7748/ns2005.08.19.49.55.c3936 16134421 · DOI
  2. [3]Booth KA. Clinical Procedures for Medical Assisting. McGraw-Hill, New York, USA; 2010. ISBN-13: 9780077340087.
  3. [4]Lippi G Salvagno GL Montagnana M Franchini M Guidi GC Phlebotomy issues and quality improvement in results of laboratory testing. Clin Lab. 2006; 52: 217– 30. 16812947
  4. [5]World Health Organization. WHO guidelines on drawing blood: best practices in phlebotomy. WHO Press, Geneva, Switzerland; 2010. 23741774
  5. [7]Nikolac N Šupak-Smolčić V Šimundić AM Ćelap I Croatian Society of Medical Biochemistry and Laboratory Medicine Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling. Biochem Med (Zagreb). 2013; 23: 242– 54. 10.11613/BM.2013.031 24266294 PMC3900082 · DOI · Paper page
  6. [8]Lippi G Caputo M Banfi G Buttarello M Cerotti F Daves M Recommendations for collection of venous blood. Biochim Clin. 2008; 32: 569– 77.
  7. [9]Lippi G Plebani M Pharmacogenomics of alcohol metabolism: implications for legal testing. Clin Chem Lab Med. 2011; 49: 9– 11. 10.1515/CCLM.2011.025 21143016 · DOI
  8. [10]Church AS Witting MD Laboratory testing in ethanol, methanol, ethylene glycol, and isopropanol toxicities. J Emerg Med. 1997; 15: 687– 92. 10.1016/S0736-4679(97)00150-9 9348060 · DOI
  9. [11]Tagliaro F Lubli G Ghielmi S Franchi D Marigo M Chromatographic methods for blood alcohol determination. J Chromatogr. 1992; 580: 161– 90. 10.1016/0378-4347(92)80534-W 1400821 · DOI
  10. [12]Logan BK Lowrie KJ Turri JL Yeakel JK Limoges JF Miles AK Recommendations for toxicological investigation of drug-impaired driving and motor vehicle fatalities. J Anal Toxicol. 2013; 37: 552– 8. 10.1093/jat/bkt059 23943437 · DOI · Paper page
  11. [13]Salvagno GL Danese E Lima-Oliveira G Guidi GC Lippi G Avoidance to wipe alcohol before venipuncture is not a source of spurious hemolysis. Biochem Med (Zagreb). 2013; 23: 201– 5. 10.11613/BM.2013.023 23894865 PMC3900069 · DOI · Paper page
  12. [14]Sarmah D Sharma B Sharma D Mathew S Alcohol Used as Disinfectant before Venipuncture does not Lead to Sample Haemolysis or Sample Dilution. J Clin Diagn Res. 2016; 10: BC16– 8. 10.7860/jcdr/2016/15967.7245 27042446 PMC4800511 · DOI
  13. [15]Müller FO Hundt HKL Letter: Ethyl alcohol: contamination of blood specimens. S Afr Med J. 1976; 50: 91. 1251284
  14. [16]Turner P Saeed B Kelsey MC Dermal absorption of isopropyl alcohol from a commercial hand rub: implications for its use in hand decontamination. J Hosp Infect. 2004; 56: 287– 90. 10.1016/j.jhin.2004.01.005 15066739 · DOI
  15. [17]Lima-Oliveira G Lippi G Salvagno GL Montagnana M Picheth G Guidi GC The effective reduction of tourniquet application time after minor modification of the CLSI H03-A6 blood collection procedure. Biochem Med (Zagreb). 2013; 23: 308– 15. 10.11613/BM.2013.037 24266300 PMC3900072 · DOI
  16. [19]Taylor LE, Oberman S, Oberman T, editors. Drunk Driving Defense, 7th Edition. Philadelphia: Aspen Publishers Inc; 2010.
  17. [20]Higuchi A Kurihara R Yoshimoto T Sano T Katsumata K Ishii A Problems in blood alcohol testing of severely injured drivers brought to emergency departments in Japan. Leg Med (Tokyo). 2005; 7: 299– 305. 10.1016/j.legalmed.2005.05.003 16054856 · DOI
  18. [21]Lippi G Cornes MP Grankvist K Nybo M Simundic AM Working Group for Preanalytical Phase (WG-PRE) European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). EFLM WG-Preanalytical phase opinion paper: local validation of blood collection tubes in clinical laboratories. Clin Chem Lab Med. 2016; 54: 755– 60. 10.1515/cclm-2015-1274 26849876 · DOI
  19. [23]Kocak FE Isiklar OO Kocak H Meral A Comparison of blood ethanol stabilities in different storage periods. Biochem Med (Zagreb). 2015; 25: 57– 63. 10.11613/BM.2015.006 25672467 PMC4401314 · DOI
  20. [24]Goldfinger TM Schaber D A comparison of blood alcohol concentration using non-alcohol- and alcohol-containing skin antiseptics. Ann Emerg Med. 1982; 11: 665– 7. 10.1016/S0196-0644(82)80260-6 7149357 · DOI
  21. [25]Peek GJ Marsh A Keating J Ward RJ Peters TJ The effects of swabbing the skin on apparent blood ethanol concentration. Alcohol Alcohol. 1990; 25: 639– 40. 10.1093/oxfordjournals.alcalc.a045060 2085347 · DOI
  22. [26]McIvor RA Cosbey SH Effect of using alcoholic and non-alcoholic skin cleansing swabs when sampling blood for alcohol estimation using gas chromatography. Br J Clin Pract. 1990; 44: 235– 6. 2206816
  23. [27]Malingré M Ververs T Bos S van Kesteren C van Rijn H Alcohol swabs and venipuncture in a routine hospital setting: no effect on blood ethanol measurement. Ther Drug Monit. 2005; 27: 403– 4. 10.1097/01.ftd.0000158868.74618.dd 15905814 · DOI
  24. [28]Miller MA Rosin A Levsky ME Gregory TJ Crystal CS Isopropyl alcohol pad use for blood ethanol sampling does not cause false-positive results. J Emerg Med. 2007; 33: 9– 10. 10.1016/j.jemermed.2006.10.005 17630067 · DOI
  25. [29]Tucker A Trethewy C Lack of effect on blood alcohol level of swabbing venepuncture sites with 70% isopropyl alcohol. Emerg Med Australas. 2010; 22: 9– 12. 10.1111/j.1742-6723.2009.01248.x 20015248 · DOI
  26. [30]Yigit O Arslan S Swabbing skin with alcohol could change the blood alcohol level significantly. J Emerg Med. 2012; 43: 718– 9. 10.1016/j.jemermed.2011.07.025 22051844 · DOI

Cited by

Sorted by citations

Authors
Lippi, G., Simundic, A.-M., Musile, G., Danese, E., Salvagno, G., & Tagliaro, F.
Affiliations
University of Verona (IT)
Venue
Biochemia Medica
Published
2017
Volume
27
Issue
2
Pages
398-403
ISSN
  • 1330-0962 (ISSN-L)
  • 1846-7482
OpenAlex
W2625666606
Cited by
22
References
1
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 1 · 2019: 4 · 2018: 1 · 2017: 1
FWCI
1.43
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Biochemia Medica (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • University of Zagreb University Computing Centre (SRCE) (submittedVersion, other-oa)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
alcohol measurement, ethanol, chlorhexidine, EDTA plasma, whole blood, headspace gas chromatography, enzyme activity assay, spurious results, phlebotomy
MeSH terms
Adult, Ethanol, Anti-Infective Agents, Local, Antisepsis, Blood Specimen Collection, Chromatography, Gas, Female, Humans, Male, Middle Aged, Risk Factors, Risk Assessment, Phlebotomy, Enzyme Assays

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review