2025 Medical Review Officer Online Course with Live Discussion (Includes Digital Syllabus)-Tab 11: Alcohol Specimen Collection and Analysis

Tab 11: Alcohol Specimen Collection and Analysis

Pdf Summary

This document provides comprehensive information on DOT alcohol testing procedures and toxicology interpretation.<br /><br />Alcohol Testing Procedures:<br />- DOT alcohol testing involves no direct Medical Review Officer (MRO) involvement, with confirmatory testing conducted using evidentiary breath instruments (EBTs).<br />- Screening tests may use breath or saliva specimens, requiring devices approved by the National Highway Traffic Safety Administration (NHTSA).<br />- Trained personnel include Breath Alcohol Technicians (BATs), who must undergo initial and refresher training, and Screening Test Technicians (STTs) for screening only.<br />- Alcohol testing devices must be NHTSA certified and listed on the conforming products list (CPL), each requiring a Quality Assurance Plan for accuracy and maintenance.<br />- Standard DOT Alcohol Testing Forms (ATFs) include printed results and signatures from donors and testers.<br />- Screening tests yielding a result of 0.02 or higher must be confirmed; confirmation testing requires a 15-minute deprivation period and must occur within 30 minutes of screening.<br />- Confirmatory test results ≥ 0.04 constitute a violation; results between 0.02-0.039 prohibit safety-sensitive duties.<br />- Procedures for insufficient specimens include alternative testing options and medical examination if breath samples cannot be provided.<br />- Certain fatal flaws such as improper use or calibration invalidate tests; some errors are correctable if addressed immediately.<br /><br />Alcohol Toxicology Interpretation:<br />- Breath and blood alcohol concentrations correlate directly with impairment; levels as low as 0.02% w/v can impair performance.<br />- Alcohol is absorbed mainly within 30-60 minutes; absorption rates are influenced by food, drink carbonation, gender differences in gastric alcohol dehydrogenase, and chronic alcohol use.<br />- Distribution occurs primarily in body water, with men having higher percentages than women.<br />- Alcohol metabolism is primarily via Alcohol Dehydrogenase and Aldehyde Dehydrogenase enzymes at a fixed elimination rate of approximately 0.018% per hour.<br />- Breath alcohol is calibrated using a blood-to-breath ratio of 2100:1, per Henry’s Law, though biological variation exists.<br />- Urine alcohol levels do not reliably indicate blood/breath alcohol at the time of collection.<br />- Ethanol biomarkers like Ethyl Glucuronide (EtG) and Ethyl Sulfate (EtS) provide information on recent drinking, with interpretive thresholds established by SAMHSA.<br /><br />Overall, this resource emphasizes strict adherence to procedural protocols, proper training, and careful interpretation of alcohol test results to ensure safety compliance in regulated environments.

Keywords

DOT alcohol testing

Medical Review Officer

Evidentiary Breath Instruments

NHTSA approved devices

Breath Alcohol Technician

Screening Test Technician

Quality Assurance Plan

Alcohol Toxicology

Blood-to-breath ratio

Ethanol biomarkers