Table 1. Specificity and sensitivity of alcohol biomarkers in relation to the reported amount drunk.

Parameter	Sensitivity	Specificity	Amount drunk	References
MeOH	70%	98%	> 0.5 ‰ for several hours	(8)
CDT	46–90%	70–100%	Chronic excessive drinking	(15) (e2) (14)
GGT	37–95%	18–93%	Chronic excessive drinking	(15)
AST	25–60%	47–68%	Chronic excessive drinking	(15)
ALT	15–40%	50–57%	Chronic excessive drinking	(15)
MCV	40–50%	80–90%	Chronic excessive drinking	(15)
CDT. MCV and GGT in combination	88%	95%	Chronic excessive drinking	(9)
EtG in urine	100%	NS	1.2 g/L BAK after 24 h (Cut-off 100 ng/mL)	(20)
	50 and. 100%. resp.	NS	0.2 g/L BAK after 24 h / 12 h (cut-off 100 ng/mL)	(20)
	89%	99%	Abstinence monitoring	(9)
EtG in hair	75%	96%	Chronic excessive drinking (cut-off 30 pg/mg)	(36)
FAEE in hair	90–97%	75–90%	Chronic excessive drinking (dependent on cut-off)	(33) (34)
PEth	88–100%	48–89%	see eTable	see eTable

ALT. alanine aminotransferase; AST. aspartate aminotransferase; BAC. blood alcohol concentration;

CDT. carbohydrate-deficient transferrin; EtG: ethyl glucuronide; FAEE: fatty acid ethyl ester;

GGT. gamma-glutamyl transferase; MCV. mean corpuscular volume; MeOH: methanol; NS. not stated; PEth. phosphatidylethanol.

The limits between low-risk and harmful alcohol consumption are 24 g and 12 g of pure alcohol per day for adult men and women. respectively (e3). The World Health Organization (WHO) defines chronic excessive drinking as an average daily consumption of at least 60 g ethanol per day over several months.