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Alcohol is responsible for an ever-increasing number of deaths worldwide, and many road accidents are caused by irresponsible drinking and driving. The use of biomarkers that can support a diagnosis of alcohol abuse is a very important tool that can improve the prevention of many alcohol-related diseases and serious traffic accidents. The main aim of our study was the full validation of a rapid and simple method by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) to detect ethyl glucuronide in hair (hEtG). The method was successfully applied to n = 171 real hair samples collected from drivers convicted of driving while impaired by alcohol or drugs. A comparison of hEtG and serum Carbohydrate-Deficient Transferrin percentages (% CDT) was also performed to carefully evaluate the data in relation to the specific detection windows of the two different biomarkers. Most of the drivers with hEtG > 30 pg/mg were males in their thirties. None of the hEtG-positives had a serum % CDT above the cutoff (≥2%). Although some researchers suggest caution until solid data are available on the possible effects of interindividual variability that may influence EtG incorporation and metabolism, hEtG is a very useful biomarker of long-term alcohol exposure that shows greater reliability than traditional blood markers. [ABSTRACT FROM AUTHOR]

Background: Drugged driving is associated with an increased risk of road accidents worldwide. In Italy, driving under the influence (DUI) of alcohol and drugs is a reason for driving disqualification or revocation of the driving license. Drivers charged with driving under the influence of alcohol and drugs must attend a Local Medical Commission (LMC) to undergo mandatory examinations to regain the suspended license. Our study mainly aims to report on the analysis performed on hair samples collected from 7560 drivers who had their licenses suspended for drugged or drunk driving between January 2019 and June 2024. Methods: A rapid, sensitive, and selective method for the determination of ethyl glucuronide in hair by UPLC/MS-MS was developed and fully validated. Results: The most frequently detected substances were cocaine (ecgonine methyl ester, norcocaine, and benzoylecgonine) and cannabinoids (Δ9-tetrahydrocannabinol, cannabidiol, and cannabinol), followed by opiates (codeine, morphine, and 6-MAM), methadone (EDDP), and amphetamines (amphetamine, methamphetamine, MDA, MDMA, and MDEA). To perform a more in-depth analysis, we also compared hair color with the drug classes that tested positive. The results showed a significant prevalence of dark hair that tested positive for one or more substances, followed by gray/white hair and light hair. Conclusions: Our study provides an interesting and alarming insight into drug exposure in the general population with serious public health threats, discussing the main aspects of hair matrix analysis and focusing on its advantages and reliability in the interpretation of results. [ABSTRACT FROM AUTHOR]