How Improper Blood Storage Techniques Employed By Utah Law Enforcement May Lead To Increased Levels Of Alcohol In Sample

Dave’s Plain Language Summary: Blood draws are unquestionably the most accurate way to measure ethanol (alcohol) concentrations in humans and mammals, however, because the majority of samples are not refrigerated immediately to the proper temperature, and mailed via U.S. Postal Service to the forensic lab, those samples with the yeast Candida Albicans (present in about 20-30% of the adult population) or other bacterium eliminating ethanol as a waste product, will yield increased ethanol levels when finally tested forensically. Ethanol levels can increase as much as double the initial drawn level when samples are kept at room temperature and storage tubes containing less than 2% sodium fluoride (SF) are used (Utah law enforcement routinely use vacutainers using a 1% solution because officers are not trained in what the colored stoppers mean in terms of SF concentrations.

 (J.C. Garriott, 4th ed. 2003), Anderson, Collection and Storage of Specimens for Alcohol Analysis, Medical-Legal Aspects of Alcohol 237,

Dave’s Plain Language Summary: Author summarized studies saying refrigeration and 2% Sodium Fluoride is required instead of 1%. Study falsely blames an automatic pipetting device for the anti law enforcement results. In other words, the results show increased levels of ethanol due to yeast produced ethanol levels

Blackmore; The Bacterial Production of Ethyl Alcohol, 8 Forensic Science Society Journal (1968),

The production of ethyl alcohol by a variety of bacteria from laboratory media and human tissue homogenates has been studied. Most bacteria commonly found at post-mortem can produce a significant amount of ethyl alcohol form glucose, sucrose, mannite or lactose. The same bacteria produced less than 20mg/100ml from ornithine, lysine, arginine and urea. Ethyl alcohol production can occur from tissue with gllucose concentrations of less than 20mg/ml. No ethyl alcohol was produced from carbohydrate and protein-fee urine. Sodium fluoride at a concentration of not less than 1% was needed to maintain sterility of stored blood. An analytical sequence is suggested for the determination of ethyl alcohol in samples taken at post-mortem in the effect of bacterial contamination is to be minimised.

Dave’s Plain Language Summary: Sodium Fluoride at not less than 1% is required to maintain sterility of stored blood and avoid production of ethanol as a waste by-product of yeast and bacteria reproduction.

The Effect of Microbial Contamination of the Blood Sample on the Determination of Ethanol Levels in Serum, 60 Am. J. Clin. Path. 700, 701 (Nov. 1973), Blume & Lakatura.

Dave’s Plain Language Summary: Sodium Fluoride is ineffective at inhibiting ethanol production by yeast and bacteria unless its use is combined with proper refrigeration techniques.

The Effect of Temperature on the Formation of Ethanol by Candida Albicans in Blood, 34(1) Journal of Forensic Sciences, 105-109(1989), Chang and Kollman.

The effect of temperature on microbial fermentation in blood was studied.  Fermentation was found to be highly temperature dependent, with refrigeration proving to be most effective at inhibiting ethanol formation.

Dave’s Plain Language Summary: Sodium Fluoride of less than 2% volume is ineffective against the most common and dangerous pathogen of humans; Candida Albicans, without refrigeration of the sample below 5 degrees centigrade. Mailing blood results to the lab is thus unacceptable because a constant refrigerated temperature cannot be maintained.