A Toxicology Definition Perspective: Does Gastric Reflux Affect the Breath Alcohol Test Results?

Booker, J.L., and Renfroe, K., “The Effects of Gastroesophageal Reflux Diseas on Forensic Breath Alcohol Testing”, Journal of Forensic Sciences, 60(6): 1516-1522, 2015

Fifteen subjects, of which 10 were diagnosed with GERD, (5 male, 5 female ages 27 to 50 years) consumed a large dose of alcohol (1.7 g/kg for males and 1.5 g/kg for females) within 30 minutes. The alcohol was consumed after a standard meal of rice, beans, corn chips and spiced salsa. The subjects were tested under identical dosing conditions at least 3 weeks later to determine the reproducibility of the results, a key principle in scientific toxicology definition and analysis.

Blood samples were collected via a catheter every 20 minutes and BACs were measured by headspace GC. Breath tests were conducted at the same time as blood sampling in duplicate, using an Intoxilyzer model 5000. The rates of alcohol elimination ranged between 0.0103 and 0.0197 g/100mL/h which is consistent with previous studies. The mean rates of elimination were 0.0147 and 0.0159 g/100mL/h for the GERD and non-GERD subjects respectively.

The following graph shows the BAC and BrAC curves of 6 GERD subjects (G-1 to G-6). The bottom curve shows when the BrAC is greater than the BAC, which in this experiment only occurred in GERD subjects shortly after drinking ceased, when there was a high alcohol concentration in the stomach.

Only 3 of the 10 GERD subjects produced elevated BrAC results that could be attributed to GERD and only 1 subject produced elevated BrACs on both drinking occasions. The authors conclude that GERD is not a factor to be considered when the subject is post-absorptive and only occurs when alcohol is present in the stomach at a very high concentration.

They also conclude: GERD-related alcohol leakage from the stomach into a breath sample is therefore an essentially irrelevant source of potential error in forensic breath testing. This conclusion is vital for legal professionals relying on an accurate toxicology definition of testing limitations.

• Incidence is Rare:Only 30% of GERD subjects in the study showed any effect, and it was not reproducible in most.
• Timing is Crucial:Effects occur only during the initial absorptive phase when alcohol is still in the stomach.
• Forensic Protocols are Effective:The standard observation period required before an evidential breath test, duplicate breath tests with good agreement, and the sloped detectors effectively eliminate this already rare issue.
• Post-Absorptive Phase is Secure:Once alcohol is fully absorbed into the bloodstream, GERD does not cause elevated breath test readings.

For other studies on GERD and the mouth alcohol effect check out my book – “Wigmore on Alcohol, Courtroom Alcohol Toxicology for the Medicolegal Professional”, Chapter 3.05 Mouth Alcohol, Irwin Law, 2011. This resource, penned by a recognised toxicology expert, provides an expanded toxicology definition of interference factors and is an essential tool for any medicolegal library.

The application of this science is where the theoretical toxicology definition meets practical legal defence. Forensic toxicology experts, such as those at Wigmore on Alcohol, interpret these complex studies for the courtroom. With extensive experience testifying in hundreds of cases, an expert can clarify that the Booker and Renfroe study confirms the reliability of breath alcohol testing in individuals with GERD, provided testing is conducted according to established forensic protocols.

This expert analysis ensures that courts can have confidence in the scientific evidence presented, understanding both its strengths and its validated limitations. The core toxicology definition of the testing process remains sound, and conditions like GERD, while a common concern, are shown by science to be a negligible factor in producing erroneous results.

Contact us for a free forensic evaluation now!