Saliva Alcohol Research Articles

Preferences of Sjögren’s syndrome patients regarding potential new saliva substitutes

ObjectivesSjögren’s syndrome (SS) patients should be involved in the development of new saliva substitutes at an early stage. The purpose of the current study was to explore the preferences of these patients regarding various product characteristics of potential new saliva substitutes.Material and methodA questionnaire was distributed among SS patients. They could anonymously indicate their preferences for saliva substitute characteristics using 5-point Likert scales.ResultsFifty-nine SS patients filled in the questionnaire. According to their opinion, the most ideal saliva substitute has a thin-watery consistency with a neutral flavour that should be applied as a spray. Patients demand a prolonged alleviation of dry mouth complaints and neutralization of harmful bacteria. The patients mainly object against the presence of artificial sweeteners and alcohol in saliva substitutes, but have limited objections against the presence of vegetable-based ingredients and natural enzymes. Major objections were against the potential side effects “bitter taste” and “discoloration of teeth”. Age and severity of xerostomia affected desire of flavours. Younger patients preferred menthol flavour, while respondents with severe xerostomia preferred the use of “neutral flavours” significantly more.ConclusionThe most ideal saliva substitute has thin-watery consistency in spray form with a neutral flavour and providing long alleviation of dry mouth complaints. Besides, it should not contain artificial sweeteners or alcohol, and should not have a bitter taste or cause discoloration of the teeth.Clinical relevanceInvestigating the opinion of SS patients provides tailoured insights into their preference, which may contribute to the development of more effective saliva substitutes.

Cost-Effective Foam-Based Colorimetric Sensor for Roadside Testing of Alcohol in Undiluted Saliva

A novel foam-based colorimetric alcohol sensor was developed for the detection of alcohol in saliva. Detection was based on the color change of a potassium dichromate-sulfuric acid solution absorbed by melamine foam. In the presence of alcohol, the orange colorimetric sensor changed color to brown, green and, ultimately, blue, depending on the concentration of alcohol in the sample. The response of the proposed sensor toward alcohol was linear from 0.10 to 2.5% v/v. The limit of detection was 0.03% v/v. Alcohol concentration could be determined using the naked eye in the range of 0.00 to 10% v/v. The developed alcohol sensor presented good operational accuracy (RSD = 0.30–1.90%, n = 8) and good stability for 21 days when stored at 25 °C and 75 days when stored at 4 °C. The results of alcohol detection with the developed sensor showed no significant difference from the results of spectrophotometric detection at a 95% confidence level (p > 0.05). The sensor was easy to use, small, inexpensive and portable, enabling drivers to accurately measure their own blood alcohol level and providing convenient speed in forensic applications.

Novel tools for assessment of drunken driving: are they legal within the Sri Lankan jurisdiction?

Digital breathalyzer and the saliva alcohol test have become modern tools to detect drunken driving and widely used by forensic physicians in teaching and general hospitals in Sri Lanka. This paper appraises the legal validity of the digital breathalyzer and the saliva alcohol test within the Sri Lankan Jurisdiction. Saliva alcohol test is noninvasive, on the spot screen test, which gives quantitative results in fewer than five minutes using a saliva sample. Digital breathalyzer is also a reliable tool to detect high, moderate and low alcohol intake. Both these tests have been approved and certified by worldwide organizations and have received international recognition. Their usage has been validated in many other jurisdictions. However. according to the Motor Traffic Act of Sri Lanka, the breath test for alcohol shall be carried out by a police officer. Therefore, opinions framed by forensic physicians for the cases of drunken driving by means of the digital breathalyzer, is contrary with the current law of the country. Neither the binding judgement of Nalinda Kumara Vs Officer-In-Charge of Police, Kandy nor the Motor Traffic Act of Sri Lanka speak about an assessment of blood alcohol level using saliva. Therefore, using saliva alcohol test and framing opinions on it has no legality and could be challenged in a court of law. Considering the importance of these novel tools for a fair administration of justice, its validation should be done by amending the Motor Traffic Act of Sri Lanka and related regulations, without any delay.

Photochromic polyoxometalate–based enzyme-free reusable sensors for real-time colorimetric detection of alcohol in sweat and saliva

This study describes a new strategy for real-time detection of alcohol in saliva and sweat. Phosphotungstic acid (PTA) is a colorless, photoelectrochromic heteropoly acid that can be reduced by ethanol under ultraviolet (UV) radiation to produce an intense blue color. This system has useful properties in the development of a new alcohol sensor: (1) the blue color can be detected by the naked eye or mobile camera, even at low ethanol concentrations; (2) color intensity is proportional to ethanol concentration; and (3) once exposed to air, reduced PTA is subsequently oxidized and returns to its colorless state offering sensor reusability. Based on these properties, we developed a simple device consisting of a PTA-impregnated non-woven material and a low-cost UV lamp that can be used to evaluate the alcohol concentration in saliva and sweat. We further enhanced the practical applicability of this sensor by demonstrating the integration of digital image analysis, multivariate analysis, and mobile camera technology with this sensor. This device can be potentially used in vehicles as a convenient, reusable alcohol sensor for drivers.

Hue‐shifting for accurate and precise quantification of biochemical substances using diagnostic test strips

AbstractSome test strips have high feasibility for the quick and approximate quantification of the biochemical substances in samples. Recently, test strips became more precise and accurate by involving the quantitative observation of coloration and regression modelling. Their accuracy and precision can be significantly improved by hue‐shifting the colours of the original sample and those of the standards. The standard colour images included in the instructions of test strips for the detection of four urinary and two salivary biochemical substances were used. Images of glucose‐loaded test strips for urinary glucose detection were also prepared. Using the red‐green‐blue (RGB) colour image, the author prepared 11 hue‐shifted colour images by changing the hue of the original RGB colour image at intervals of 30°. From each of the 12 colour images, 10 greyscale images indicating values of the intensity of RGB, cyan, magenta, yellow, key black, L*, a* and b* were prepared. In regression modelling, the additional 110 greyscale images improved the values of the coefficient of determination and normalised mean absolute error in the quantification of protein, specific gravity, urobilinogen and glucose in urine, as well as of alcohol and nitric oxide in saliva. Further analyses showed that the hue‐shifting technique yielded new greyscale images that were more significantly related to the values of the biochemical variables in question than any previous greyscale images. This improvement was realised by the most significant linear measures for the description of concentrations of biochemical substances, and synergetic effects between significant greyscale images.

Colorimetric analysis of saliva–alcohol test strips by smartphone-based instruments using machine-learning algorithms

We report a smartphone-based colorimetric analysis of saliva–alcohol concentrations, utilizing optimal color space and machine-learning algorithms. Commercial saliva–alcohol kits are used as a model experiment, utilizing a custom-built optical attachment for the smartphone to obtain consistent imaging of the alcohol strips. The color of the strips varies with the alcohol concentration, and the smartphone camera captures the color produced on the test strip. To make a suitable library for each alcohol concentration, statistical methods were tested to maximize between-scatter and minimize within-scatter for each concentration. Results of three different classification methods (LDA, SVM, and ANN) and four-color spaces (RGB, HSV, YUV, and Lab) were evaluated with various machine-learning data sets and five different smartphone models. Cross-validation results were used to assess the statistical performance, such as positive (PPV) and negative (NPV) predictive values. An Android app developed and provided average classification rates of 100% and 80% for the standard and enhanced concentrations, respectively.

Frequency of Alcohol Use Among Injured Adult Patients Presenting to a Ghanaian Emergency Department

Injuries are the cause of almost 6 million deaths annually worldwide, with 15% to 20% alcohol associated. The frequency of alcohol-associated injury varies among countries and is unknown in Ghana. We determined the frequency of positive alcohol test results among injured adults in a Ghanaian emergency department (ED). This is a cross-sectional chart review of consecutive injured patients aged 18 years or older presenting to the Komfo Anokye Teaching Hospital ED for care within 8 hours of injury. Patients were tested for presence of alcohol with a breathalyzer or a saliva alcohol test. Patients were excluded if they had minor injuries resulting in referral to a separate outpatient clinic, or death before admission. Alcohol test results, subject, and injury characteristics were collected. Proportions with 95% confidence intervals were calculated. Injured adult patients (2,488) presented to the ED from November 2014 to April 2015, with 1,085 subjects (43%) included in this study. Three hundred eighty-two subjects (35%; 95% confidence interval 32% to 38%) tested alcohol positive. Forty-two percent of men (320/756), 40% of subjects aged 25 to 44 years (253/626), 42% of drivers (66/156), 42% of pedestrians (85/204), 49% of assault victims (82/166), 40% of those seriously injured (124/311), and 53% of subjects who died in the ED (8/15) had positive results for presence of alcohol. The frequency of alcohol-associated injury was 35% among tested subjects in this Ghanaian tertiary care hospital ED. These findings have implications for health policy-, ED- and legislative-based interventions, and acute care.

Smartphone-based colorimetric analysis for detection of saliva alcohol concentration.

A simple device and associated analytical methods are reported. We provide objective and accurate determination of saliva alcohol concentrations using smartphone-based colorimetric imaging. The device utilizes any smartphone with a miniature attachment that positions the sample and provides constant illumination for sample imaging. Analyses of histograms based on channel imaging of red-green-blue (RGB) and hue-saturation-value (HSV) color space provide unambiguous determination of blood alcohol concentration from color changes on sample pads. A smartphone-based sample analysis by colorimetry was developed and tested with blind samples that matched with the training sets. This technology can be adapted to any smartphone and used to conduct color change assays.

Detection of alcohol in saliva for blood alcohol concentration using alcohol saliva strip test: A forensic aid

Context: Alcohol is a factor in many categories of injury. Alcohol intoxication is frequently associated with injuries from falls, fires, drowning, overdoses, physical and sexual abusements, occupational accidents, traffic accidents and domestic violence. In many instances, for forensic purpose, it may be necessary to establish whether the patients/subjects have consumed alcohol that would have been the reason for the injury/accidents. Combining rapidity and reliability, alcohol saliva strip test (AST) has been put forward for the detection of alcohol in saliva for blood alcohol concentration (BAC). In the present study, we have determined BAC by using AST. Aims and Objectives: The main objective of this study was to detect alcohol in saliva for BAC in alcoholics by using AST. Materials and Methods: Two socio-economic groups were selected for the present study where Group A consisted of 40 subjects from the local bar and Group B consisted of 40 subjects from an organized party. The subjects were selected randomly at the local bar and at the organized party who have consumed different forms of alcohol. ALCO-SCREEN 02 plastic strip with a reactive pad was used for the detection of presence of alcohol in saliva. Results: In the present study, 85% of subjects from Group A, i.e., at the local bar, demonstrated positive results of variable intensity with AST when compared to the subjects from Group B in the organized party which was only about 25%. Conclusion: The present study showed that AST, performed by using ALCO-SCREEN 02 plastic strip with a reactive pad, can detect the presence of 0.02% BAC or more that can be helpful for various purposes such as forensic, workplace, medical and research settings. The study also showed that amount, time period, concentration and quality of the alcohol intake can influence the BAC, which can be a contributory factor for many accidents, injuries and medical conditions.

Alcohol saliva strip test.

Alcohol is a factor in many categories of injury. Alcohol intoxication is frequently associated with injuries from falls, fires, drowning, overdoses, physical and sexual abusements, occupational accidents, traffic accidents and domestic violence. In many instances, for forensic purpose, it may be necessary to establish whether the patients have consumed alcohol that would have been the reason for the injury/accidents. Combining rapidity and reliability, alcohol saliva strip test (AST) has been put forward for the detection of alcohol in saliva for blood alcohol concentration (BAC).

O194 Alcohol in saliva related to the anatomical site of oral carcinoma

Introduction: Alcohol is responsible for the development of cancer in the areas of the oral cavity that function as a salivary reservoir (floor of the mouth, retromolar area, tongue and mandibular gingiva). Methods: Thirty volunteers participated in evaluating salivary alcohol concentrations in the floor of the mouth (reservoir area), upper anterior vestibule and palate (non-reservoir areas) at determined minute intervals following consumption of 150 ml of whiskey. Salivary alcohol levels were evaluated using Q.E.D. Saliva Alcohol Test (Enzymatics, Inc.). Results: The highest concentration of alcohol was found in the floor of the mouth, i.e. the mouth reservoir. The duration of direct effect of alcohol following a single consumption is approximately 20 minutes, while the effect of saliva excreted alcohol in the floor of the mouth lasts approximately 7.7 hours. Discussion: The localisation of the higher concentrations of direct alcohol and alcohol excreted in saliva are in correlation with typical localisations of oral cavity cancer, therefore alcohol may be considered cancerogenic. The carcinogenic effect of alcohol on the oral cavity mucosa is a result of prolonged effect of alcohol excreted in saliva and not through the contact of high concentrations of alcohol following alcoholic beverage consumption.

Comparison of Ethanol Concentrations in Saliva and Blood

ABSTRACTAlcohol concentrations in blood and saliva were compared on the basis of 74 experiments, in which 38 volunteers took part. They received a dose of ethanol of 0.7 g/kg of body weight (men) and 0.6 g/kg of body weight (women). Duplicate venous blood samples and an unstimulated mixed saliva secretion were taken simultaneously at 15-minute intervals up to 5 hours. The study shows good agreement between alcohol concentrations in both specimens. In over 50% of the results, the difference did not exceed ± 0.05 g/L, and in over 75%, 0.1 g/L. The mean value of the difference did not differ statistically significantly from zero (mean = 0.020 ± 0.089 g/L, median = 0.00 g/L). The Pearson's correlation coefficient amounted to 0.94 (p<0.0001). The difference between the mean ethanol concentration in blood and saliva was relatively high only for the samples collected during the first hour after consumption. After that, the difference did not exceed 0.05 g/L. The shapes of time profiles of alcohol concentration in blood and saliva were different, because saliva alcohol concentration (SAC) is proportional to arterial blood alcohol concentration. The mean value of blood to saliva alcohol concentration ratio (BAC/SAC) amounted to 0.978 ± 0.174, and the median was 0.980. In the authors' opinion saliva analysis for alcohol can be helpful in the assessment of a driver's sobriety.

Intervención breve en accidentados con alcoholemia positiva desde un centro de traumatología

Objectives: Main research objective is to verify the effectiveness of brief intervention to reduce alcohol consumption in non-dependent adults injured in a traffic crash, presenting at the emergency department with a positive saliva alcohol test. The aim of the pilot study is to verify the feasibility of the project (staff training, screening and intervention at a trauma centre) and to roughly estimate the prevalence and profile of alcohol-attributable traffic casualties. Method: Training programme and support material are delivered. Saliva alcohol screening is performed by nurses in patients attending the emergency department because of a traffic crash. Positive patients are offered brief intervention. Staff’s opinion on training, esteemed self-efficacy and feasibility of the whole procedure (screening and intervention) is collected by opinion surveys. Prevalence and profile of patients with positive saliva is drawn up by comparative analysis of selected variables. Results: Trained staff considers (80%) training useful and matching objectives. Nurses consider that, despite the nonvalid results in case of mouth dryness, the saliva test is easy (89%), doesn’t pose major problems (55%), and is well accepted by the patient (53%). Trained staff have felt comfortable and self-effective (67%) in delivering the intervention. 261 out of 264 patients accepted screening and 28 (11%) had a positive result. Only 2 patients refused intervention, which was performed on 16. Patients with a positive test present more frequently in the weekends (p: 0.005) and are more hospitalised (p: 0.05) than those with a negative test. Conclusion: The programme is well designed, feasible and accepted by the patient. Main study will use urine alcohol test on patients with dry mouth, and will reinforce screening in the weekends and in sever injured patients.

Saliva alcohol concentrations in accident and emergency attendances

Objectives—Although alcohol is known to play a key part in accidents, no UK study has assessed alcohol concentrations in a comprehensive sample of accident and emergency (A&E) attenders. This study...

Adolescent injury in the emergency department: Opportunity for alcohol interventions?

Study objective: Alcohol, the most commonly used substance among adolescents, is frequently associated with injury. Little is known regarding the drinking characteristics of injured adolescents. Such data are critical for developing emergency department interventions to decrease alcohol-related injury among adolescents. We sought to describe the drinking characteristics of injured adolescents and to describe the relationship of injury severity and mechanisms with drinking characteristics. Methods: This study was a prospective cohort study performed in a university hospital (sampled May 1, 1995, to July 15, 1995) and a large urban teaching hospital (sampled May 1, 1996, to August 1, 1996). The participants were aged 12 to 20 years, presenting within 6 hours of an injury. We performed a saliva alcohol test and self-administered questionnaire. Age, sex, E-code, injury severity score (ISS), and ED disposition were recorded. An alcohol frequency/quantity index was calculated. Descriptive statistics and 95% confidence intervals were calculated. Results: Two hundred sixty-three patients with a mean age of 17 years and a mean ISS of 2.1 (SD 3.5) were recruited. One hundred fifty-two (50%) were males, and 33 (13%) were admitted. Ten (4%) patients had a positive saliva alcohol test response. On average, within the last year, these adolescents had 1.7 adverse alcohol consequences. Sixty percent drank in unsupervised settings, and 36% reported drinking 5 or more drinks in a row. Conclusion: Alcohol use/misuse is a substantial problem among injured adolescents regardless of severity or mechanism of injury. ED physicians should consider screening/intervention or primary prevention of alcohol problems for all injured adolescents. [Maio RF, Shope JT, Blow FC, Copeland LA, Gregor MA, Brockmann LM, Weber JE, Metrou ME. Adolescent injury in the emergency department: opportunity for alcohol interventions? Ann Emerg Med . March 2000;35:252-257.]

Detection of alcohol use in adolescent patients in the emergency department.

To examine 3 methods of detecting alcohol use among adolescent patients visiting a Level-1 regional trauma center. Part 1 was a retrospective review of laboratory records and (13- to 19-year-old) patient medical records over the 1-year period from August 1993 to July 1994. Part 2 was a review of ICD-9 discharge diagnoses for the same age range during the same 1-year period. Part 3 involved prospective saliva alcohol testing of injured patients aged 13-17 years old. Part 1: A total of 522 blood tests were conducted and 160 (30.6%) were positive for alcohol. More than one-third of the alcohol-positive sample had alcohol ingestion as the only reason for their visits, i.e., they were uninjured. The alcohol-positive group was more likely to be male and older. Part 2: A total of 99 alcohol-related discharge diagnoses were given to adolescent patients. Alcohol abuse was the most common diagnosis. With the 2 methods of detection combined, 186 patients were identified. Part 3: A total of 119 saliva alcohol tests were conducted. One patient tested positive but had been identified while in triage as having used alcohol. In this study population, approximately one-third of adolescent patients tested for alcohol as part of routine clinical care were alcohol-positive but were not necessarily given an alcohol-related diagnosis. Thus, studies determining rates of alcohol-positive adolescents treated in EDs should use multiple methods of detection. Universal testing does not appear to be warranted for all injured adolescent patients.

Emergency Department Detection and Referral Rates for Patients with Problem Drinking

Alcohol-related problems cause 100,000 deaths annually, costing society more than $150 billion/year. This study was designed to establish provider detection and referral rates in a large inner-city Emergency Department, using three established measurement tools: the Ever a Problem (EAP), the four-question CAGE screen, and the QED Saliva Alcohol TEST (SAT). Two hundred ten patients met sample criteria; 172 (81%) were enrolled. Among those who were enrolled, 40% were positive on at least one measure: 13% on the SAT, 19% on the EAP, and 31% on the CAGE. The provider detection rate was high for SAT+ (intoxicated) patients (69.5%), but less so for those who were EAP+ and/or CAGE+ without an elevated SAT (32.6%). On retrospective record review, only 23.5% of those patients who were SAT+ and either CAGE+ or EAP+ could be shown to have been referred for treatment. We conclude that (1) the prevalence of alcohol problems is high in our ED setting (2) detection is possible with minimal disruption of the usual ED processing of care, and (3) significant opportunities for referral are currently being missed.

Identification of Hazardous/Harmful Drinking among Subcritically Injured Patients

To examine the relationship between a saliva alcohol test (SAT) and hazardous/harmful drinking, as measured by the Alcohol Use Disorders Identification Test (AUDIT), among a sample of subcritically injured patients. Patients (n = 78) seeking treatment for a subcritical injury were saliva-tested for alcohol and interviewed regarding their drinking behaviors and related difficulties. Associations of SAT values with AUDIT results were determined. SAT results and hazardous/harmful drinking were not independent events (p < 0.001). Estimates of sensitivity and specificity (using a dichotomous SAT result [> or = 4 mmol/L] to identify positive AUDIT patients) were 65.2% and 83.6%, respectively. SAT-positive people had significantly higher AUDIT scores than did SAT-negative individuals (p < 0.0001). Patients experiencing assault-type injuries were much more likely to be SAT-positive than were patients incurring other types of injury. Discriminant function analysis suggests that AUDIT scores can successfully identify SAT-positive and SAT-negative patients; the analysis accounted for 42.5% of the variance and correctly classified 84.6% of the sample. The use of an easy-to-administer, noninvasive, routine SAT, among patients presenting for a subcritical injury in a hospital ED, provides a mechanism for the identification of individuals with a history of hazardous/harmful drinking. However, since discrimination of hazardous/harmful drinking is imperfect, some caution is warranted when conducting such screening activities.

Injury as a Motivator to Reduce Drinking

To identify predictors of readiness to change drinking behavior by minor-injury patients who had positive saliva alcohol tests (SATs) in the ED. To develop and test a model intended to be prognostic of readiness to change, which included predispositional and injury-event-related variables. An on-site survey was conducted of minor-injury ED patients sampled consecutively during predesignated periods. Patients were identified as SAT-positive during their screening evaluations. After giving their consent, they were administered a self-report battery that assessed predispositional and injury-event-related variables as well as readiness to change their drinking. Predictors of readiness to change drinking were tested with regression analyses. Twenty-four SAT-positive patients participated; there were 18 men and six women (average age 34 years). Preinjury predispositional variables were by themselves unrelated to the patient's readiness to change while in the ED. Aversiveness of the injury and perception of degree of alcohol involvement were injury-event-related variables predictive of readiness to change (p < 0.008). Negative consequences attributed to drinking prior to the injury event strengthened the association of injury aversiveness and alcohol involvement with readiness to change (p < 0.0075). Interventions to decrease drinking in this population should focus on increasing patient awareness of the association between drinking, injuries, and other alcohol-related negative consequences.

Alcohol Use among Subcritically Injured Emergency Department Patients

To determine the incidence of alcohol use in subcritically injured patients presenting to the ED, by using a saliva alcohol test (SAT) at ED triage during the ED initial assessment; to compare the incidence of alcohol use revealed by the SAT with documentation of alcohol use by ED nurses and emergency physicians (EPs) blinded to the SAT results; and to describe the demographics of the SAT-positive, subcritically injured population. A blinded, prospective, observational evaluation of ED patients presenting with subcritical injuries was performed. The patients were tested for alcohol use with an SAT, and a subsequent record review was conducted for extraction of demographic data and evidence of documentation of alcohol use by ED nurses and EPs blinded to the SAT results. During the study, 791 subcritically injured patients had SATs performed. Twenty-one percent of these patients were found to be alcohol-positive by SAT. Either the ED nurse or the EP documented a clinical impression of alcohol use for 52% of the SAT-positive patients. There were higher SAT-positive rates among men (24%), victims of assault (47%), and patients arriving at night (41%). While the SAT identified 21% of the subcritically injured patient population as alcohol-positive, ED nurse and EP documentation did not identify half of these alcohol-positive patients. Many of these patients may be at risk for additional injuries related to their drinking behavior.