Ethyl glucuronide in hair as a marker of driving under the influence of alcohol: a year of laboratory experience applied to regaining a driver's license

BACKGROUND: In Italy, the Local Medical Legal Commission is responsible for evaluating the mental and physical capabilities of drivers whose licenses have been suspended by competent authorities. However, Italy lacks a standard procedure for conducting subsequent investigations after driver license suspensions due to driving under the influence of alcohol (DUIA) or drugs METHODS: This study focuses on data from the first year of implementing a protocol validated by the Forensic Toxicology Laboratory of the University of Perugia. The study analyzed ethyl glucuronide (EtG) in hair samples for license renewal after DUIA suspension. It involved 664 subjects, with 83.58% males and 16.42% females. Most subjects were between 26-55 years old, with over 65 years being the least represented age group. RESULTS: The mean concentration of EtG was statistically significant different between females (mean value 21.05 pg/mg) and males (mean value 25.01 pg/mg). The highest EtG concentration was detected in subjects between 35-45 years, reaching 121 pg/mg. Many subjects who underwent EtG analysis were moderate drinkers: 554 subjects (81.93%) tested negative with an EtG value below 30 pg/mg, while 120 subjects (18.07%) had an EtG concentration over 30 pg/mg. Additionally, 77 subjects tested positive for drugs, with benzodiazepines being the most frequently detected drugs (41.45%). CONCLUSIONS: This study provides important descriptive information about the characteristics of the examined population and revealed that the regional protocol in use in Umbria is effective and able to distinguish chronic users through the dosage of the EtG in the keratin matrix, in striving for a national protocol in the future.