What We Know Now About Ethanol, Vapes, and Drug Testing

Electronic cigarette liquids (e-liquids) can contain a variety of chemicals to impart flavors, smells, and pharmacological effects. Surveillance studies have identified hundreds of chemicals used in e-liquids which have known health and safety implications. Ethanol is a common solvent in e-liquids, reported to be as high as 30% in some e-liquids. Other solvents such as ethyl acetate have also been identified. Literature describes the hydrolysis of ethyl acetate to ethanol in vivo as rapid. Animal studies have demonstrated inhaled concentrations of ethyl acetate >2000 mg/L can lead to accumulation of ethanol in the blood greater than 1000 mg/L, or 0.10%. The Preliminary Breath Tests (PBT) and Evidentiary Breath Tests (EBT) are conducted to measure ethanol in exhaled breath, after a 15-20 minute wait period. An e-liquid was submitted to the Laboratory for Forensic Toxicology Research for analysis after an individual working in a safety-sensitive position submitted to a random workplace drug test, which resulted in the detection of ethanol by preliminary breath testing at a concentration of 0.019%. Results of untargeted analysis were unremarkable, and volatiles analysis did not detect acetone, ethanol, isopropanol, or methanol. Ethyl acetate was identified, confirmed, and quantitated by headspace gas chromatography flame ionization detection coupled with mass spectrometry at a concentration of 1488±6 mg/L. Based on the reported literature describing the accumulation of ethanol in the blood from ingestion of ethyl acetate, the ethyl acetate in the e-liquid used prior to the PBT could explain the detection of ethanol in a breath sample. The identification of ethyl acetate in e-liquids demonstrates poor regulatory oversight. Inhalation of ethyl acetate can lead to serious health and safety concerns for the consumer. Product labelling on e-liquids remains a significant regulatory gap in the United States.