Rom J Leg Med [25] 293-296 [2017]

DOI: 10.4323/rjlm.2017.293
FORENSIC TOXICOLOGY
© 2017 Romanian Society of Legal Medicine 

An unusual case of highly false-positive breath-alcohol test in a motor vehicle

driver

Ľubomír Straka1,*, František Novomeský1, Mária Marcinková1, Jozef Krajčovič1

_________________________________________________________________________________________
Abstract: Breath-alcohol measuring is considered to be the most common and most widely used procedure during
police driven road-side traffic stops of suspected drunk drivers. In spite of significant advances in technology and legal structure,
significant challenges still remain to be solved. Positive breath alcohol concentrations despite abstinence while driving have been
reported after exposure to a variety of alcohol-containing substances or endogenous breath volatile. The article describes an
unusual case of highly false-positive breath alcohol test in a motor vehicle driver caused by environmental exposure of the subject
to alcohol vapour. After police investigation, it was concluded that the driver was carrying refined spirit in the vehicle the day
before the road-side control and some part of spirit was spilled in the car while loading the spirit-containing barrels. This case
reaffirms, that in order to exclude possible false-positive breath-alcohol analysis due environmental alcohol inhalation, blank
sample of air in the motor vehicle (or any confined space) should be obligatory prior to any breath-alcohol analysis. In addition,
current literature on the possibilities of false-positive results is reviewed.
Key Words: breath-alcohol analysis, alcohol vapours, false-positive results, environment, contamination.

INTRODUCTION non-invasive sample collection, e./ analytical reliability,

Analysis of the expired air is an indirect way
how to monitor the concentration of volatile substances
in the pulmonary blood. This approach has found very
interesting and particularly important applications even
in forensic practice. The main application is breath-alcohol
analysis, widely used across the world. This method is
based on the principle that a diffusion-powered transfer
of alcohol from arterial blood to inhaled air takes places
in the alveoli [1]. This method is widely used for testing
drivers ability in traffic law enforcement, for workplace
alcohol testing, in the field of public safety, in the field
of research, but also in emergency medicine to estimate
the alcohol load in the body [2]. Reasons for widespread
forensic application in checking the breath alcohol
include a./ easy to use handy analytical instruments, b./
immediate results, c./ computerized instrumentation, d./
and f./ worldwide legal acceptability [3]. Because of
these reasons, breath alcohol analysis has emerged as the
predominant method for field testing of “driving under
influence” in law-enforcement authorities in US, Europe,
and Australia [3].
Most of current breath-testing instruments
have the ability to measure the concentration of
alcohol in exhaled air flow by following mechanisms:
(1) electrochemical fuel-cell sensors that oxidize
ethanol while free electrons – created electric current
is measured, being in proportional ratio to consumed
ethanol (2) absorption of infrared energy at wavelengths
corresponding to vibrational stretch in the ethanol
molecules. Sophisticated units for evidential testing are
equipped also with microprocessor, controlling entire
breath-test sequence (volume of breath, the temperature
of breath, concentration-time profile etc.). These units

1) Comenius University, Jessenius Faculty of Medicine in Martin, Slovakia

* Corresponding author: Comenius University, Jessenius Faculty of Medicine, University Hospital in Martin, Institute of
Forensic Medicine and Medicolegal Expertises, Kollárova 2, 03601 Martin, Slovak Republic, Tel.: +421 43 4132770, Fax:
+421 43 4132770, E-mail: straka@jfmed.uniba.sk

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Straka L. et al. An unusual case of highly false-positive breath-alcohol test in a motor vehicle driver
are capable of providing credible results when operated
even in a non-laboratory environment by people without
any scientific training as far as they require only minimal
cooperation of the testing subject.
The key aspects of breath sampling for alcohol
analysis that relate to instrumental and procedural
design include a./ gaining of last portion of a prolonged
breath expiration, because only this amount of air
exhaled reflects the alcohol concentration in arterial
blood to which the brain as the main target organ for
ethanol is being exposed; b./ avoiding the residual mouth
alcohol (recent ingestion, regurgitation or eructation) by
measuring concentration-time profile, and c./ preventing
of breath condensation in evidential instruments, which
are cooler than exhaled breath, because it might cause a
reduced breath alcohol numeric result [4].
In common practice, the possibility of
environmental contamination of breath sampling is
not always considered as an important complication of
evidential breath testing, although many forensic experts
perceive the problem as significant. Based on the own
experience, the authors report an unusual case of false-
positive evidential breath testing due to exposure of the
subject tested to an environment containing alcohol
vapours. As far as the possibility of the testing failure in
such conditions is rather underestimated in the medico-
legal literature, the case report should perhaps bring
some useful information to avoid a possible mistake in
the breath-alcohol testing and evaluation.
CASE REPORT
A man, 53 years of age, without any significant
medical history was driving a small delivery truck
used in pharmacy supply. The subject was randomly
controlled by traffic police patrol in a preventive action.
Within the ordinary control the subject was asked to
perform breath-alcohol check by use of breath alcohol
analyzer (AlcoQuant 6020 plus, Envitec Wismar GmbH,
Germany). Because of winter weather conditions, the
subject was allowed to perform the breath analysis within
the enclosed vehicle interior. Results of first analysis was
very annoying for driver – 0.59 mg/L of exhaled air. Driver
insisted on non-alcohol drinking period minimally 2 days
before drive. The second analysis was performed outside
the car, 12 minutes after the first analysis. The result was
also disqualifying for the driver – 0.18 mg/L. He declared
strictly his soberness, thus he insisted on blood sampling.
Police, aware of the great decline of alcohol curve after
consulting with prosecutor, took the driver to nearest
hospital for blood sample taking. By this act – 60 minutes
after the first analysis – driver´s breath analysis had been
performed for a third time, now surprisingly with the
result of 0.00 mg alcohol per liter of exhaled air.
In that moment the driver mentioned that he
carried a refined spirit in his car the day before, when
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some amount of the spirit had splashed out in the car
while loading the barrels. Having this information, the
police carried out an inspection of the mentioned car.
It was found that a small delivery truck involved in the
story (Fiat Ducato) had a rear load space separated to
the crew cabin by the solid metal barrier with wide open
window. The real load space of the car was covered by
soft felt layer. The large spots, still wet and of alcohol
smell, were found on the felt. The driver mentioned that
he didn’t clean the load space the day before because of
cold weather, nor he didn’t ventilate the car while driving
because of the same reason. The driver also declared the
documentation of legal transport of the spirit in total
amount of 300 litters in 6 barrels. Laboratory analysis of
the refined spirit sample proved 96% ethanol, 3% water,
1% other substances (aldehydes, esters, acids and other
alcohols). The driver´s blood sample had been analysed
by gas chromatography with unsurprisingly negative
results.
DISCUSSION
Breath alcohol analysis has been widely employed
as a primary means of determining alcohol involvement
in violations of rules of safe road traffic, and will hold this
position definitely - at least in the near future. In many
countries, the numeric outcomes of breath analysers
have the legal power for accusation and conviction of
the suspect in case of driving and drinking. However,
the validity of breath alcohol results is often questioned,
especially at the court [5]. For this reason, requirements
for evidential breath testing have to be very strictly
defined. It is very important that the analysis must be
conducted in conformance to all applicable rules and
regulations.
For forensic experts, the requirements for
evidential breath testing are clear and understandable.
The most important aspects of breath testing were
summarized by Caplan [6]:
At least 15 minutes long pretest alcohol
deprivation period with observing of possible emesis,
regurgitation or alcohol ingestion;
Analysis of a room air blank sample prior to
any subject or control test to establish the absence of
environmental contamination;
Analysis of control specimen to demonstrate
proper calibration and maintenance of the breath alcohol
analyzer;
Documentation of conduction all steps of
prescribed testing protocol;
Documentation of instrument maintenance and
calibration.
As recommended aspects is to report the results
as “breath alcohol concentration”, not as “blood alcohol
concentration” and taking of two separate samples to ten
minutes apart to avoid mouth alcohol contamination.
Romanian Journal of Legal Medicine Vol. XXV, No 3(2017)

Breath alcohol analysers are not operated by forensic
experts but by qualified persons mostly from law
enforcement authorities. In author´s opinion and
experience, training of such persons includes basically
thorough operational knowledge of the given breath
alcohol analyser, taken mainly from the user´s manual.
The authors studied the detailed instructions for use of
breath analyser used in the presented case. The user´s
guide was approved by police. Throughout the whole
text of the user´s manual, a simple mention on possible
influence of environmental vapours of ethanol or other
alcohols on breath alcohol analysis was not found.
Keeping such user´s manual seriously, it is practically
impossible for police authorities to take into account and
deal with a case as being described.
There are also other specific situations which can
cause a false positivity of breath alcohol analysis and which
the investigator should have in mind while performing
the test. Probably the most frequent is the question of
residual mouth alcohol. Alcohol remaining in the oral
cavity can alter the results of a single Breathalyser test [7-
10]. The investigator should carefully ask for peroral use
of any substances containing alcohol, which may distort
the results of breath analysis to some extent, sometimes
very seriously. Such substances are many: mouthwashes,
inhalers, mouth-sprays, or even homeopathic tinctures,
to name a few [11-12]. On the other side, using of food,
beverages, breath freshening tablets, gastroesophageal
reflux disease, and blood in the mouth were excluded as a
potential source of affection of Breathalyser test [13-18],
although, according to our experience, this still requires
further research. It has been also proved by some studies
that dentures, dental adhesives and use of oral jewellery
have no effect on breath alcohol results [19-20]. However,
the pretest observation period in length minimally 15
minutes should reliably exclude the influence of breath
analysis by above mentioned chemical substances.
Similar contamination of exhaled breath by
alcohol can occur if vapours of anti-freeze alcohol-
based washer fluids from windshield washer permeates
the automobile's cabin [21]. Another ways, how the
environmental alcohol vapours can affect breath analysis,
are false-positive results after using an alcohol-based
hand disinfectant lotion prior the test [22-23]. All these
cases signalise the “alcohol air-pollution” nearby the
subject being tested, directly influencing the results.
Solution of these problems can be find in recommended
analysis of air blank sample prior to any control test to
establish the absence of environmental contamination
[4] or the mentioned pretest observation of the subject in
length of at least 15 minutes.
Rather rare problem in breath alcohol analysis
interpretation means the serious dieting of the subject.
Low caloric diets can lead to ketonaemia with elevated
blood concentrations of acetone, acetoacetate, and
ẞ-hydroxybutyrate. Under certain circumstances the
acetone reduces to isopropanol by hepatic alcohol
dehydrogenase (ADH). In such cases, isopropanol can
cause the false-positive results of breath alcohol analysis
[24]. The isopropanol impact to the breath analysis
results can´t be avoided even by strict adherence to
common requirements for evidential breath testing, thus
the mentioned problem needs further discussion.
Breath alcohol analysis is firmly established
as an important tool facilitating the apprehension and
prosecution of driving under influence of alcohol [25]. In
spite of significant advancements in technology and legal
structure, many challenges still remain to be solved. One
of them – the possibility of environmental influence to
the analysis is well known but – in author´s opinion - it
is still not properly applied in practice. As is it was shown
in the case presented - in order to exclude possible false
positivity of breath alcohol analysis by environmental
alcohol vapours, blank sampling of air should be
obligatory prior to any test made in enclosed space (cars,
rooms and others). The above mentioned possibility of
“alcohol air-pollution” should be also seriously stated
in the user manuals of breath analysers and the police
authorities should be trained how to deal with such a
possibility.
Conflict of interest. The authors declare that
there is no conflict of interest.

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