Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework Alan Wayne Jones Forensic Science International

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Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework Alan Wayne Jones Forensic Science International Volume 200, Issue 1, Pages 1-20 (July 2010) DOI: 10.1016/j.forsciint.2010.02.021 Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Human metabolism of ethanol illustrating oxidative and non-oxidative pathways and the relative amounts excreted unchanged. The CYP2E1 enzyme has a higher km for ethanol as substrate compared with ADH and becomes more important in metabolism when blood-alcohol concentration exceeds 60mg/100mL. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 Pharmacokinetic profile of ethanol showing a rising BAC (absorption) to reach a peak concentration (Cmax) at time tmax followed by a rectilinear declining phase (zero-order kinetics). Linear regression analysis gives the y-intercept (C0) and x-intercept (min0) allowing determination of the elimination rate from blood (β-slope) and distribution volume (rho factor) as shown. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 Food-induced lowering of blood-alcohol curves when healthy subjects (N=12) drank a moderate dose (0.8g ethanol/kg body weight) on an empty stomach or after eating a standardized breakfast. The insert graph shows the curves for a single subject [71]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Negative correlation between the elimination rate of alcohol from blood (β) and the distribution volume of ethanol (rho) in healthy men and women who consumed alcohol on an empty stomach. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 Inter-individual variations in shapes of the concentration–time profiles of ethanol in 48 healthy men after they drank 0.68g/kg body weight as neat whisky in the morning after an overnight fast [65]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 6 Intra-individual variations in concentration–time profiles of ethanol in 4 subjects after they drank a dose of 0.80g/kg body weight on an empty stomach on four separate occasions [112]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 7 No statistically significant differences in mean elimination rate of ethanol from blood between and within subjects according to one-way analysis of variance. Results are for 12 subjects who drank 0.80g ethanol per kg body weight on four separate occasions [112]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 8 Concentration–time profiles of ethanol during the post-absorptive portions of blood-alcohol curve in the same male subject (aged 24 years) who drank alcohol (0.5g/kg) on 10 separate occasions [113]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 9 Relative frequency distribution of blood-alcohol concentrations among apprehended drivers in Sweden. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 10 Relative frequency distribution of elimination rates of alcohol from blood in apprehended drivers derived from double blood samples taken ∼1h apart [16]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

Fig. 11 Concentration–time profiles of alcohol in blood in four alcoholics during detoxification showing how the elimination rate of ethanol from blood was determined by linear regression analysis [121]. Forensic Science International 2010 200, 1-20DOI: (10.1016/j.forsciint.2010.02.021) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions