A new Yale study found that breath alcohol detection — commonly referred to as breath alcohol content — may be more influenced by hygiene techniques than previously thought.

Researchers at the Yale Department of Pediatrics found that alcohol-based hygiene solutions including Purell or other soaps, routinely used by emergency department workers, can lead to elevated levels of breath alcohol content. The finding indicates that health workers may have to rethink commonplace hygiene techniques in certain testing circumstances. The study was published in the American Journal of Infection Control on Sept. 7.

“Basically, if a doctor used hand sanitizer before testing a patient, it could impact alcohol levels for up to three minutes after [when testing that patient’s BAC],” summed up co-author Travis Whitfill, a statistician with the Yale Department of Pediatrics and Emergency Medicine.

While previous studies have explored the possible connection between ABHS and false alcohol readings, this study expanded by testing different types of sanitizer application and using timing as a crucial experimental variable. For instance, the researchers looked at different results produced by both gel and foam alcohol solutions, in addition to varying the use of gloves by experimenters.

Surprisingly, across the board, alcohol registered in the Breathalyzer in every experimental group, even the ones in which alcohol originated from sanitizer.

“We designed a study to replicate the care we provide in the clinical arena,” explained study co-author Beth Emerson, professor of pediatrics and emergency medicine. “We found that there was a detectable amount of alcohol by breath detection in each one of the experimental condition groups.”

The study was initially conducted after a curious correlation between Purell use and alcohol levels, first noticed by one of Emerson’s colleagues. Emerson said her motivation behind authoring the study was to provide more accurate and safe care for emergency room patients.

The clinical standard of hygiene in most cases is washing hands with soap and water and, often times, using ABHS between patients according to the World Health Organization. The ubiquity of these alcohol sanitizers in emergency rooms can potentially influence breath alcohol content and register false positives. Such a case can even result in false incrimination and legal action.

Emerson recommends replacing the standard ABHS with the stand-by of simple hand washing before administering breath alcohol tests. While she does not currently plan on pursuing this research further, Emerson believes there is room for improvement in the clinical arena.

“Being able to publish this interesting finding was a first step in being able to disseminate this critical information,” Emerson explained.

Alcohol-based hygiene solutions will certainly persist in future medical practices. Relatively few patients are tested for BAC in the emergency room and the effectiveness and prevalence of ABHS overshadows the small subset of patients being tested. Additionally, the procedure for field sobriety tests used by law enforcement does not include the use of ABHS, said professor of medicine and pediatrics Richard Martinello, who was not affiliated with this study. Additionally, the procedure for field sobriety tests used by law enforcement does not include the use of ABHS.

“The subset of patients who they were interested in study, these are people who are coming in whose blood alcohol content is being measured for legal reasons,” Martinello said. “That is a relatively small portion of patients of our overall population, but this is still important.”

Emerson and her team simply plan to use this information in their own medical practice.

“Our unit will be using this information to help improve our practice and provide accurate care for our patients.”

The National Institute of Drug Abuse estimates that 14.3 percent of drug-related emergency visits are alcohol-related.