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      Can all healthy adults use the current evidential breath alcohol analysers? An investigation using a large spirometry database

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          Abstract

          People failing to give a specimen of breath at a police station are assumed to be deliberately obstructive and are charged with Failure to Provide under the Road Traffic Act 1988. However, spirometry records of 281,210 healthy individuals from UK BioBank showed that a significant minority cannot use existing evidential breath analysis machines. Women were three times more likely to be unable to use them than men (1.64% vs 0.54%) with the risk rising with age six-fold from those in their 40s (0.43%) to 2.7% in their 70s, with women more affected (0.65% to 3.8%). Short stature was a further risk factor: 2.6% of men and 3.8% of women below the 2 nd percentile of height could not use the current machines, with almost one in ten elderly, short women unable to do so, while smokers aged 50+ were twice as likely as non-smokers of the same age to be unable to provide breath specimens.

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          A study to investigate the ability of subjects with chronic lung diseases to provide evidential breath samples using the Lion Intoxilyzer 6000 UK breath alcohol testing device.

          D Honeybourne, A.J. Moore, A.K. BUTTERFIELD … (2000)
          The Lion Intoximeter 3000 has been used for evidential breath testing in the U.K. for some years. Some individuals with lung diseases have difficulty in providing evidential breath samples using the device. This study describes an investigation that we have carried out on a newer instrument--the Lion Intoxilyzer 6000UK--which is now in use in the U.K. The study was designed to investigate the ability of subjects with a variety of lung diseases to provide evidential breath samples using this device. The 40 adult subjects investigated comprized 10 normal controls, 10 with asthma, 10 with chronic obstructive pulmonary disease (COPD) and 10 with restrictive lung disease. After baseline spirometry, subjects were given alcohol to drink, the quantity based upon body weight. After a gap of at least 20 min, subjects were asked to provide evidential breath samples in accordance with.the test procedure built into the Lion Intoxilyzer 6000UK. The results showed that two asthmatic subjects, four with COPD and three with restrictive lung disease failed to provide evidential breath samples even after four attempts. Despite the device requiring a minimum sample volume of 1.2 l, eight of the nine subjects who failed had a forced vital capacity (FVC) of more than 1.5 l. Seven of these nine subjects had a forced expiratory volume in 1 sec (FEV1) of less than 1.0 l. In conclusion, this study has shown that some subjects with lung diseases may have difficulty in providing evidential breath samples using the Lion Intoxilyzer 6000 UK.
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            Study into the ability of patients with impaired lung function to use breath alcohol testing devices.

            P J Gomm, M D Osselton, C G Broster … (1991)
            A subject who fails to provide an adequate breath sample for a breath alcohol measuring device under the provisions of Road Traffic Act 1988 may be charged with refusing to supply a sample unless the police officer believes the person is genuinely unable to do so. Subjects who are confronted with this situation may approach their general practitioner or chest physician for advice on whether they are medically able to provide adequate breath samples to satisfy the breath testing devices. There is currently no guidance available for medical practitioners concerning respiratory performance or lung function which will impair the use of such breath testing devices. This paper describes experiments with human volunteers suffering from respiratory illnesses and their ability to provide adequate breath samples to satisfy the requirements of the breath alcohol testing devices used in Great Britain. It was found that the most suitable parameters for determining whether a subject was capable of using a breath alcohol testing device were spirometry measurements of Forced Expired Volume in one second (FEV1) and Forced Vital Capacity (FVC). In this study subjects with a FEV1 less than 2.0 litres and a FVC less than 2.6 litres were generally unable to use all the devices.
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              Study into the ability of healthy people of small stature to satisfy the sampling requirements of breath alcohol testing instruments.

              P J Gomm, C G Broster, N M Johnson … (1993)
              In a previous study (Gomm et al., 1991) people with a variety of respiratory diseases were tested and criteria defined for assessing their ability to provide samples for Breath Alcohol Testing Instruments. This study investigated the possible problems which may be encountered by healthy people of small stature--5ft 5in (166cm) or less--who do not suffer from a respiratory disease. This study followed the same pattern as the earlier work in that lung function (Forced Expiration Volume in One Second (FEV1) and Forced Vital Capacity (FVC)) was measured by spirometry, and Peak Expiration Flow Rate (PEFR) was measured using a Wright peak flow meter. Following the lung function measurements the subjects were requested to provide samples for Breath Alcohol Testing Instruments used by the Police in Great Britain. As with the previously reported work (Gomm et al., 1991), this study found that the FEV1 and FVC gave the most reliable indication of a person's capability of satisfying the sampling requirements of Breath Alcohol Testing Instruments, but on this occasion the PEFR also provided a good confirmatory indication. Because there were no subjects with interstitial lung diseases the values determined by this study on 48 healthy adults indicate that a healthy person of small stature should be capable of supplying a suitable breath sample if their FEV1, FVC and PEFR are greater than 2.31, 2.61 and 330 l/min respectively.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Leg J
                Journal ID (iso-abbrev): Med Leg J
                Journal ID (publisher-id): MLJ
                Journal ID (hwp): spmlj
                Title: The Medico-Legal Journal
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0025-8172
                ISSN (Electronic): 2042-1834
                Publication date (Electronic): 13 June 2023
                Publication date (Print): December 2023
                Volume: 91
                Issue: 4
                Pages: 180-185
                Affiliations
                [1-00258172231178419]Information School, University of Sheffield, UK
                Author notes
                [*]Galen Ives, The University of Sheffield, The Wave, 2 Whitham Road, Sheffield, S10 2AH, UK. Email: g.ives@ 123456sheffield.ac.uk
                Article
                Publisher ID: 10.1177_00258172231178419
                DOI: 10.1177/00258172231178419
                PMC ID: 10704883
                PubMed ID: 37309804
                SO-VID: 5748aae8-7c33-4df1-8d4f-631b45705297
                Copyright © © The Author(s) 2023
                License:

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: Carter Brown Associates;
                Award ID: No number
                Categories
                Subject: Original Articles
                Custom metadata
                typesetter ts2

                Keywords: breath alcohol,breathalyser,failure to provide,intoxilyzer,spirometry
                Data availability:
                Keywords: breath alcohol, breathalyser, failure to provide, intoxilyzer, spirometry

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