Table 1.
Summary of Literature Review of Inhaled Alcohol
| Article | Type of alcohol | Source of alcohol | Method of exposure | Study design | Biomarkers for alcohol exposure | Main finding |
|---|---|---|---|---|---|---|
| Ahmed-Lecheheb and colleagues (2012) | 70% EtOH | Hand-sanitizing gel | Sanitizer: 3 ml several times over 4-hour shift | Naturalistic | BrAC; urine and plasma levels of EtOH, acetaldehyde, and acetate | ↑ BrAC in 33% of participants |
| Ali and colleagues (2013) | 62% EtOH | Hand-sanitizing gel | Sanitizer: 3 groups with varying amounts and drying procedures | Between subjects; 3 conditions: 1.5 ml with hand rubbing, 1.5 ml no rubbing, 3.0 ml no rubbing | BrAC | ↑ BrAC (median, dose dependent) |
| Arndt and colleagues (2012) | 30% propan-1-ol; 45% 2-propanol | Hand-sanitizing gel | Sanitizer: 5 individuals applying every 15 minutes for 8 hours | Within subjects; 2 conditions: 2 individuals present in room but did not apply sanitizer (inhaled only) | EtG | ↑ EtG in 6 of 7 including both participants in inhaled only condition |
| Arndt and colleagues (2014) | 96% EtOH | Hand-sanitizing gel | Sanitizer: 3 ml 4 times per hour for 8 hours | Between subjects; dermal and inhalation versus inhalation only | EtG | ↑ EtG 6 hours after exposure |
| Below and colleagues (2012) | 70% propan-1-ol; 63.14% propan-2-ol; 45% propan-2-ol with 30% propan-1-ol | Hand-sanitizing gel | Sanitizer: 10 surgical hand rubs (4 ml repeated 5 times) over 80 minutes | Between subjects; dermal and inhalation of 3 sanitizers | Plasma propanol levels | ↑ In median propanol from dermal and inhalation |
| Brown and colleagues (2007) | 70% EtOH or 70% isopropanol | Hand-sanitizing gel | Sanitizer: 1 squirt (1.2 to 1.5 ml) every 2 minutes | Naturalistic | BrAC, serum | ↑ BrAC in 30% of participants within 2 minutes of exposure |
| Brugnone and colleagues (1983) | Occupational exposure to isopropanol | Isopropanol concentration in air | Air sample before shift, 30 minutes later, and hourly for next 7 hours | Naturalistic | Isopropanol in alveolar air, BAC, and urine | ↑ Alveolar concentration that correlated with environmental air; not detected in blood or urine |
| Campbell and Wilson (1986) | 1,000 ppm of EtOH air concentration | Inhaled alcohol | Inhaled alcohol for 3 hours | Case study, time series; blood assessed throughout 3 hours | BAC | No increases in EtOH blood content |
| Dumas-Campagna and colleagues (2014) | 125 to 1,000 ppm of EtOH air concentration | Inhaled alcohol | Inhaled alcohol for 4 hours in each condition | Within subjects; exposed to 5 concentrations over 6 days (excluding exercise condition) | BAC | Detectable BAC in all conditions with highest in 1,000 ppm after 4 hours (0.30 mg/dl) |
| Ernstgard and colleagues (2003) | 142 ppm of 2-propanol air concentration | Inhaled alcohol | Inhaled alcohol over 2 hours during light physical exercise | Within subjects; propanol and clean air exposures | BAC, urine, BrAC | ↑ 2-Propanol in BAC, urine, and blood up to 6 hours after exposure |
| Ernstgard and colleagues (2005) | 0,100,200 ppm of methanol | Inhaled alcohol | Inhaled alcohol over 2 hours in each condition with light physical exercise | Within subjects; exposed to 3 concentrations | BAC, urine, BrAC | Dose-dependent increase in methanol in BAC, urine, and BrAC |
| Hautemaniere and colleagues (2013a) | 70% EtOH | Hand-sanitizing gel | Sanitizer: used ad libitum over the course of a 4-hour shift | Naturalistic | BrAC, urine, and plasma levels of EtOH, acetaldehyde, and acetate | ↑ BrAC within 2 minutes of exposure |
| Jones and colleagues (2006) | 62% EtOH | Hand-sanitizing gel | Sanitizer: 0.5 g once per hour for 8 hours | Time series; urine assessed throughout 8 hours and next morning (18 hours) | EtG, EtS | ↑ EtG and EtS |
| Kramer and colleagues (2007) | 95, 85, and 55% EtOH | Hand-sanitizing gel | Sanitizer: 4 ml applied for 10 seconds repeated 20 times or 20 ml for 3 minutes repeated 10 times | Within subjects; 3 conditions: 55, 85, and 95% EtOH with 2 exposure durations | Blood levels of EtOH and acetaldehyde | Dose-dependent increase in median blood EtOH concentration |
| Miller and colleagues (2006) | 62% EtOH | Hand-sanitizing gel | Sanitizer: 5 ml applied 50 times over 4 hours | Within subjects; pre–post, repeated application | Plasma levels of EtOH | No increases in plasma EtOH levels |
| Nadeau and colleagues (2003) | 0 to 1,000 ppm of EtOH air concentration | Inhaled EtOH | Inhaled EtOH for 6 hours at each level | Within subjects; exposed to 4 concentrations (in ppm) over 4 days | Plasma levels of EtOH | Increases in plasma EtOH to 0.443 mg/dl at highest concentration (1,000 ppm) |
| Reisfield and colleagues (2011) | 62% EtOH | Hand-sanitizing gel | Sanitizer: 1 pump (~1 ml) every 5 minutes for 10 hours | Repeated measures; sanitizer procedure repeated for 3 days | EtG, EtS | ↑ EtG in all but 1 participant |
| Rohrig and colleagues (2006) | 62% EtOH | Hand-sanitizing gel | Sanitizer: applied 15 minutes for 4 hours | Between groups; sanitizer applied at various frequencies | EtG | ↑ EtG in 1 participant in the most frequent application group |
| Rosano and Lin (2008) | 61% EtOH | Hand-sanitizing gel | Sanitizer: 1 ml applied 20 times during 8 to 12 hours | Within subjects; comparing EtG after hand sanitizer and oral EtOH challenge | EtG | ↑ EtG in next day urine in 90% of sample |
| Skipper and colleagues (2009) | 62% EtOH | Hand-sanitizing gel | EthGel applied 2 squirts on hands every 4 minutes for 1 hour | Between groups; 4 conditions: control, skin exposure, vapor exposure or both | BrAC, EtG | ↑EtG with gel exposure, especially vapor |
| Valentine and colleagues (2016) | 23.5% EtOH | Electronic cigarette “liquid” | E-cigarette: Two 20-minute ad lib smoking sessions | Within subjects; pre–post smoking e-cigarette in high and low EtOH content | BrAC, EtG, EtS | No elevated BrAC, 38% of participants positive for EtG after high EtOH exposure |
BrAC, breath alcohol content; BAC, blood alcohol content; EtG, ethyl glucuronide; EtS, ethyl sulfate; EtOH, ethanol; ppm, parts per million.