The concurrent assessment of methanol, ethanol, and formic acid is imperative for accurate clinical toxicology diagnosis in cases of methanol poisoning. Here, we reported a very simple and reliable headspace gas chromatography coupled with mass spectrometry (HSGC-MS) method for simultaneous quantitative determination of methanol, ethanol and formic acid in blood samples. The derivatization variables for formic acid were optimized. The method exhibits high sensitivity, good selectivity and effective separation factor for methanol (6.51 min), ethanol (8.29 min), and formic acid (11.41 min). The method demonstrates excellent reproducibility and accuracy. The limit of detection (LOD) and the limit of quantification (LOQ) were determined to be 3.14–5.83 μg/mL and 10.47–19.34 μg/mL, respectively. Finally, this method was successfully used for measuring the levels of methanol, ethanol, and formic acid in the serum of patients involved in actual methanol poisoning incidents.
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