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Other causes of failed PEth test for alcohol abuse?

Mental Health | Last Active: 4 days ago | Replies (447)

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@kkb44

Just wondering if anyone has had any successes or found any new info since this thread has been going for a couple of years.
My husband is under a Wellness contract and has urine tested about every 10 days to 2 weeks. He also got a liver transplant about 18 months ago and has labwork done about once a month as a follow up from that. Every urine test has been clear, and while the doctor's labs don't specifically test for alcohol, biomarkers that could indicate alcohol use (GGT and MCV) have also always been in range. In October he got a low positive peTH (32) and he was retested by the same lab and got another low positive (60). He has been totally abstinent. He went to a different lab to have a voluntary hair test, and had his hospital do their own peTH and we're waiting on results. We're wracking our brains for a cause of this. Two ideas have emerged - 1. is that he's in healthcare and sanitizes his hands, using a liquid that mists, about 3 times per HOUR. When COVID started and there was a run on sanitizer his office switched suppliers and we realize now that the new one is ethanol based. It was on his skin and in the air constantly. Second thought is that I see now that his finger shouldn't touch the card. In both the test and retest he said the lab tech had him touch his finger to the card rather than let the blood drop.
I have done HOURS and HOURS of research on this topic. It's ridiculous that we could have 20+ tests that prove abstinence and one questionable test can turn lives upside down.

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Replies to "Just wondering if anyone has had any successes or found any new info since this thread..."

Hello @kkb44, Welcome to Mayo Clinic Connect. I think you are correct about the ethanol based hand sanitizers affecting the PEth test results. @toolsd and other members in the discussion I'm sure will be able to offer suggestions. Here is some information I found from January 2020 and one from 2019 that talk about the test.

Specificity of Phosphatidylethanol as a Marker for Alcoholic Beverage Consumption: https://www.centerforprofessionalrecovery.com/specificity-of-phosphatidylethanol-as-a-marker-for-alcoholic-beverage-consumption/

“Doctor, I do not understand the results of the test, because I swear I am not drinking alcohol.” Truth or lie?: https://www.sciencedirect.com/science/article/pii/S235200781930099X
Excerpt from the above article - "Conclusion - An abnormal elevation of PEth concentration in blood was observed after using ethanolic solution for hand cleaning. Thus, ethyl alcohol disinfection have to be avoid before blood sampling for DBS. If not, a rapid formation of PEth could happen during blood sampling, involving a risk of erroneous interpretation concerning alcohol consumption."