In response to the issue of alcohol use in patients presenting to emergency departments (ED) in Queensland, Jamieson Trauma Institute (JTI) have identified a need for valid and reliable surveillance of the prevalence of alcohol use in patients. By collecting accurate data, the team hope to provide a more complete picture of the risk factors and inform targeted public health interventions.  

In collaboration with Pathology Queensland, the JTI has piloted a new surveillance approach comparing acute and medium-term alcohol use in patients, through two markers of alcohol consumption, the well-known blood ethanol and the new phosphatidylethanol (PEth).  

The project, led by JTI Principal Research Fellow Professor Cate Cameron and Pathology Queensland’s Dr Jacobus Ungerer, involved secondary testing of blood samples collected during routine clinical care of ED patients presenting to RBWH for a 10-day period, which included the Australia Day long weekend. 

Blood ethanol, the most frequently used biomarker of alcohol use, may not always accurately reflect the patient’s ethanol exposure. Due to its relatively short half-life in blood, it is only a snapshot of the blood alcohol level at that moment in time. As a marker of medium-term and long-term alcohol use, PEth levels can indicate a person’s ‘average’ alcohol consumption during the previous two to four weeks. As such, the PEth test could be the tool required to quantify medium to long-term alcohol exposure and its impact on hospital presentations. 

The pilot findings were alarming – blood ethanol was found in nearly 10 per cent of patients and PEth was found in over 30 per cent. Interestingly, 25 per cent of the patients tested negative for blood ethanol had PEth concentrations which indicated significant to heavy medium-term alcohol consumption. 

This new approach showed that simply using blood ethanol tests in isolation may miss medium-term alcohol consumption in ED presentations. Performing periodic measurement of both acute and medium-term alcohol consumption in ED presentations would be valuable for informing targeted public health prevention and control strategies. 

Professor Cate Cameron said the research is necessary to ensure education and resources for alcohol misuse can be targeted appropriately. 

“The impact of alcohol misuse in Australia is immense, both from acute intoxication such as injury risk and violence, as well as a myriad of chronic health issues,” Professor Cameron said.  

“Since the study was developed, the pandemic hit worldwide leading to an unprecedented job losses, lockdowns, isolation, work from home and increasing domestic violence.  

“Evidence from other studies suggests increases in alcohol sales and consumption in this time.”