Breath/Blood Alcohol Concentration as an Indicator of Alcohol Use Problems

INTRODUCTION: The Federal Aviation Administration Office of Aerospace Medicine (AAM) is required by law to identify pilots who have driving under the influence (DUI) convictions. It is the responsibility of AAM to determine, based on the DUI, if the pilot has a drinking problem and needs follow-up treatment. Pilots with alcohol problems are at risk to themselves and the public and need to have treatment to reduce the extent of the risk. It has been suggested by some that a blood alcohol concentration (BAC) of 0.15 g · dL⁻¹ is evidence of tolerance and the pilot should be placed in an alcohol treatment program.

METHOD: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) Clinician’s Guide considers a person at risk for a drinking problem when a man drinks 5 or more drinks or a woman drinks 4 or more drinks in a day and reaches a 0.08 g · dL⁻¹ of ethanol in the blood. It is possible to estimate from a BAC or breath alcohol concentration (BrAC) the number of drinks consumed using the volume of distribution for ethanol and the weight of the individual. A spread sheet tool was developed to estimate the number of drinks consumed.

RESULTS: It was determined that DUI/DWI concentrations could be used to determine the minimum number of drinks consumed. Overweight people reach binge drinking levels and higher Hingson levels at lower DUI/DWI concentrations than people with an average weight or lower.

DISCUSSION: Using this tool there is a high probability (99.7%) of identifying a true binge drinker.

Canfield DV, Forster EM, Cheong Z-I, Cowan JM. Breath/blood alcohol concentration as an indicator of alcohol use problems. Aerosp Med Hum Perform. 2019; 90(5):488–491.