After heart disease and cancer, alcohol misuse is now the third largest health problem in the UK.

Moderate alcohol use is normal, but alcohol abuse or dependence is a serious problem. Too much alcohol affects the central nervous system and how the brain functions. It affects perception, thinking, and coordination. It impairs judgment, reduces inhibitions, and increases aggression. Those who abuse alcohol are more likely than others to engage in high risk, thoughtless, or violent behaviors.

The most frequently encountered workplace indicators of alcohol problems include absences, especially on Mondays. Reduction in quality, timeliness, and quantity of work relative to previous levels, as well as irritability and incidents of emotional disagreement with co-workers and supervisors, are also noted. Occasionally, an employee's use of alcohol is apparent in the length of the lunch break and changes in mood observed in the afternoon.

Background

There is a fairly close correlation between the impairing effects of alcohol and blood alcohol concentration. This is why most countries specify a legal limit in blood, above which it is an offence to drive a motor vehicle. In the UK the legal limit for driving is defined as 80 mg in 100 ml blood (mg%). Alcohol is eliminated from the body at a predictable rate. It is also eliminated faster than most other drugs – indeed all alcohol is likely to have been eliminated during a 12 hour period.

The measurement of alcohol concentration in blood is therefore a successful means of determining impairment. However because of the problems associated with taking blood samples, this type of measurement is not ideal for non-forensic circumstances. Fortunately, because of its properties, it is possible to measure alcohol in breath, oral fluid (saliva) and urine.

Alcohol Distribution – Breath, Oral Fluid (Saliva) and Urine

There is good correlation between blood alcohol concentration (BAC) and breath, oral fluid and urine. Because of this, accurate determination of alcohol in these media can be used to determine impairment levels.