TCAS provides alcohol-related toxicological assessment services.(a)
For more than 34 years, TCAS has regularly provided consultative and professional
services involving alcohol toxicology . One of the world's most commonly abused
drugs, ethanol (ethyl alcohol) is a leading contributor to morbidity across cultures.
Although low to moderate alcohol consumption has some recognized health benefits
(in particular with respect to cardiovascular issues), excessive alcohol
consumption represents a "Top-10" risk which continues to contribute to the worldwide
burden of disease.1
From a toxicological perspective, excessive consumption of alcoholic beverages has
the potential to result in numerous, well-documented toxicological endpoints. Alcohol
can cause inflammation of the liver with eventual scarring and cirrhosis. Excessive
alcoholic beverage consumption is also associated with an increased risk for malignancies
at different sites.2 Additionally, ethyl carbamate
and acetaldehyde (commonly associated with alcoholic beverage fermentation) have
been formally classified by the International Agency for Research on Cancer (IARC)
as "Group 1 Human Carcinogens."3,4
Blood-Alcohol Assessments
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Establishing blood-alcohol concentration (BAC) on a toxicological basis involves
compiling relevant factors relating to the manner in which the body processes and
eliminates alcohol. These include (but are not limited to) subject's age, body weight,
recent consumption rates and medical history, review of circumstances, evidence
supporting or refuting subject statements, timeline of events, absorption time,
subject's observed behavior and/or judgment defects, review of field sobriety test(s)
and/or impairment assessments, blood or breath tests (if any) and calculation of
ethanol loss due to metabolic elimination factors based on generally-accepted metabolic
rates.5
TCAS has produced numerous reports with respect to alcohol intoxication
and validation of blood-alcohol content for both plaintiffs and defendants as well
as postmortem forensic evaluations with respect to blood-alcohol content, drug interaction
effects and toxicity. Please
contact our office for additional information.
Impairment and Field Sobriety Assessments
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Impairment and field sobriety tests are most frequently performed by law enforcement
personnel, often under less than ideal circumstances. Whereas many tests produce
accurate results, some do not for a variety of reasons. In an accident or DWI case, the expert toxicologist must assess
the objective blood ethanol results and retrograde levels at the time of the accident
as well as various judgmental and behavioral facts potentially pertaining to alcoholic
intoxication. Additional factors include assessment of the laboratory results, scientific
validity of the analysis methodology and interpretation of results. These include the
respective degrees of (a) loss of critical judgment, (b) decreased sensory response,
(c) emotional instability, (d) decreased inhibitions, (e) impaired memory and comprehension,
(f) increased reaction time and (g) muscular incoordination as well as applicability
of local, state, and federal statutes.
TCAS has performed numerous impairment and field sobriety validation assessments
for both plaintiffs and defendants in both criminal and civil matters. Please
contact our office for additional information.
Retrograde Extrapolation
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A toxicological retrograde extrapolation for alcohol provides a BAC estimate from
blood or breath sample(s), typically obtained at a different time than
that of collection. Factors governing the accuracy of the extrapolation can
include (but are not limited to) the time of event, time of test(s), type and quantity
of beverages consumed, food consumed,6 age, gender,
weight, medical history, elimination factors, metabolic rate and supporting circumstantial evidence.
The quality of extrapolated results will only be as good as the information provided
to the toxicologist who must apply scientifically credible methods to develop a
timeline consistent with the prevailing body of toxicological literature. All causative
and contributing factors are applied in developing the extrapolation including
relevant deposition transcripts, medical records, police reports and (in some cases)
review or inspection of an accident scene. The resulting timeline, based on weight-of-evidence
(WOE), estimates the changes in BAC concentration over specific time periods and
is supported by an objective written report (or affidavit) detailing the methodology
and results of the toxicological assessment. Please contact our
office for additional information.
Dram Shop
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The term "dram shop" relates to laws governing liquor establishments serving
alcoholic beverages. Most states hold licensed premises responsible for injuries
and property damage caused by visibly-intoxicated patrons. The expert toxicologist
must assess many factors including quantity of alcohol consumed, measured blood-alcohol
concentration, age, physical condition, medical history, behavior, sequence of events,
metabolism, elimination, etc. Other factors include actions of the liquor establishment,
compliance with local regulations, actions by patrons and personnel and circumstances
of the incident(s). Dram shop laws vary widely by state in the U.S. Compliance with
local regulations is essential for any scientifically credible toxicological assessment
to be admissible in court.7
TCAS has performed numerous dram shop assessments and has provided toxicologial
guidance and expert testimony on behalf of both defendants and plaintiffs in both
criminal and civil matters. Please
contact our office for additional information.
Endogenous Alcohol
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Endogenous alcohol is a phenomenon documented within the toxicological literature
in which severely-burned bodies produce postmortem alcohol from microflora deposits
on the open tissues which cause rapid alcoholic fermentation to occur.
This rapid-fermentation phenomenon has been studied and published in articles by
the Federal Aviation Administration (FAA) following the autopsies of hundreds of
plane crash victims known not to have consumed alcohol. It was also observed in
USS Iowa turret gunnery disaster victims in 1989 and other severe burn cases.
TCAS has considerable forensic experience in this area with respect to
both defendants and plaintiffs. A recent case involving endogenous alcohol
illustrates how correct interpretation of postmortem urine and vitreous alcohol
concentrations can have a significant impact on litigation. Please
contact our office for additional information.
Notes and References
- Ezzati et al., "Comparative Quantification of
Health Risks," Vol. 1, 2004
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Alcohol
consumption and ethyl carbamate. "IARC Monographs on the Evaluation
of Carcinogenic Risks in Humans," 2010;96:3-1383.
- IARC, "Monographs on the Evaluation of Carcinogenic Risks to Humans,"
Agents Classified by the IARC Monographs,
Volumes 1-135 (2024)
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, "Personal
habits and indoor combustions," Volume 100 E, A review of human carcinogens.
IARC Monographs on the Evaluation of Carcinogenic Risks in Humans 2012;100(Pt
E):373-472.
- Goldfrank et al., "Goldfrank's Toxicological Emergencies," Fifth Meditation,
1994, Appleton & Lange, Norwalk, CT, pg. 814.
- Jones et al., "Food-Induced Lowering of Blood-Ethanol Profiles and
Increased Rate of Elimination Immediately After a Meal," Journal of Forensic
Sciences, JFSCA, Vol. 39, No.4, July 1994, pg. 1088.
- National District Attorneys Association, "Alcohol
Toxicology for Prosecutors: Targeting Hardcore Impaired Drivers," 2015
Images
- TCAS report demonstrative (redacted), image courtesy freepik.com
- TCAS report demonstrative (redacted), © Copyright 2017 TCAS
- Breathalyzer photo adapted from National Institute on Drug Abuse
- TCAS report demonstrative (redacted), © Copyright 2017 TCAS
- Liquor store photo by Amy Hennen, Aurora, SD
- Photo adapted from National Park Service, Firefighter Training Class, "Structural Fire Management Program"