{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:51:34Z","timestamp":1791287494906,"version":"4.1.0"},"reference-count":18,"publisher":"Croatian Society for Medical Biochemistry and Laboratory Medicine","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biochem. med. (Online)"],"published-print":{"date-parts":[[2026,10,15]]},"abstract":"<jats:p>Introduction: Drink-driving remains a leading global cause of road traffic fatalities. In Italy, the determination of blood alcohol concentration (BAC) in injured drivers relies on coordination between law enforcement and emergency departments (ED) to ensure legally admissible evidence. Because ethanol undergoes continuous metabolic decay, any delay in blood sampling can lead to underestimated values or \u201cpharmacokinetic false negatives\u201d.\nMaterials and methods: A retrospective study was conducted throughout 2025 on 115 drivers admitted to a major university hospital following road accidents. Preanalytical turnaround time (TAT), categorized into intra-ED and extra-ED intervals, was assessed against variables like clinical severity (triage code), temporal patterns (duty shifts\/weekends), and licensure status. Serum alcohol concentration (SAC) that is used to screen BAC was measured with the enzymatic methods.\nResults: The population was predominantly male (77.4%) with a median age of 36 years. While the median intra-ED TAT was 139 minutes and remained stable across various clinical and temporal factors, the overall preanalytical TAT (from accident to sampling) reached a median of 204 minutes. The only statistically significant association concerned SAC at ED admission with ED duty shift (P = 0.045), and with day of the week (P = 0.035).\nConclusions: The observed TAT appears insensitive to environmental stressors, potentially indicating a \u201cdegraded\u201d baseline performance. This study emphasizes that objective quality goals for TAT cannot rely solely on administrative averages. Instead, they must be grounded in a quantitative relationship between sampling delay and metabolic decay using pharmacokinetic models to mitigate the risk of forensic evidence loss.<\/jats:p>","DOI":"10.11613\/bm.2026.030703","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:09:44Z","timestamp":1786691384000},"page":"512-520","source":"Crossref","is-referenced-by-count":1,"title":["Forensic integrity of blood alcohol sampling in the emergency department, Part I: Epidemiology and factors affecting turnaround time"],"prefix":"10.11613","volume":"36","author":[{"given":"Maria","family":"Sapio","sequence":"first","affiliation":[{"name":"Department of Clinical Pathology, University Hospital Policlinico Umberto I, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Criniti","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Giglio","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, University Hospital Policlinico Umberto I, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"Galardo","sequence":"additional","affiliation":[{"name":"Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orietta","family":"Gandini","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Angeloni","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Ialongo","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, University Hospital Policlinico Umberto I, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4885","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"key20260814070935_r1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/0001-4575(94)90026-4","article-title":"The grand rapids dip revisited.","volume":"26","author":"Hurst","year":"1994","journal-title":"Accid Anal Prev"},{"key":"key20260814070935_r2","doi-asserted-by":"crossref","first-page":"387","DOI":"10.15288\/jsa.2000.61.387","article-title":"Alcohol-related relative risk of driver fatalities and driver involvement in fatal crashes in relation to driver age and gender: an update using 1996 data.","volume":"61","author":"Zador","year":"2000","journal-title":"J Stud Alcohol"},{"key":"key20260814070935_r3","unstructured":"World Health Organization (WHO), International Federation of Red Cross and Red Crescent Societies (IFRC), Global Road Safety Partnership (GRSP). Drink-driving: A road safety manual for decision-makers and practitioners. 2nd ed. Geneva: WHO; 2022. Available from: https:\/\/cdn.who.int\/media\/docs\/default-source\/documents\/health-topics\/road-traffic-injuries\/ifrc-drink-driving-2022-final.pdf. Accessed Feb 27th 2026."},{"key":"key20260814070935_r4","doi-asserted-by":"crossref","first-page":"758","DOI":"10.3390\/healthcare11050758","article-title":"Worldwide prevalence of alcohol use in non-fatally injured motor vehicle divers: a systematic review and meta-analysis.","volume":"11","author":"Kassym","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"key20260814070935_r5","unstructured":"European Commission (EC). Alcohol and drugs: Road safety thematic report. Brussels: European Road Safety Observatory (ERSO), Directorate General for Transport; 2023. Available from: https:\/\/road-safety.transport.ec.europa.eu\/system\/files\/2023-10\/ERSO-TR-alcohol_drugs_2023.pdf. Accessed Feb 27th 2026."},{"key":"key20260814070935_r6","unstructured":"European Commission (EC). Policy Orientations on road safety 2011\u20132020 (COM\/2010\/0389). Brussels: European Commission; 2010. Available from: https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/?uri=CELEX:52010DC0389. Accessed Feb 27th 2026."},{"key":"key20260814070935_r7","first-page":"91","article-title":"Pharmacokinetics of ethanol - Issues of forensic importance.","volume":"23","author":"Jones","year":"2011","journal-title":"Forensic Sci Rev"},{"key":"key20260814070935_r8","doi-asserted-by":"crossref","DOI":"10.11613\/BM.2025.030501","article-title":"The enzymatic analysis of alcohol (ethanol) in serum and plasma with the alcohol dehydrogenase reagent: focus on intra-analytical and post-analytical aspects.","volume":"35","author":"Ialongo","year":"2025","journal-title":"Biochem Med (Zagreb)"},{"key":"key20260814070935_r9","article-title":"Forensic integrity of blood alcohol sampling in the emergency department, Part II: Establishing quality goals of turnaround time with Monte Carlo simulation.","volume":"36","author":"Ialongo","year":"2026","journal-title":"Biochem Med (Zagreb)"},{"key":"key20260814070935_r10","unstructured":"Istituto Nazionale di Statistica (ISTAT). Incidenti stradali in Italia - Anno 2024. Roma: Istituto Nazionale di Statistica; 2025. Available from: https:\/\/www.istat.it\/wp-content\/uploads\/2025\/07\/REPORT_INCIDENTI_STRADALI_2024.pdf. Accessed Feb 27th 2026."},{"key":"key20260814070935_r11"},{"key":"key20260814070935_r12","doi-asserted-by":"crossref","DOI":"10.1016\/j.fsisyn.2022.100224","article-title":"Driving under the influence of drugs: correlation between blood psychoactive drug concentrations and cognitive impairment. A narrative review taking into account forensic issues.","volume":"4","author":"Blandino","year":"2022","journal-title":"Forensic Sci Int Synerg"},{"key":"key20260814070935_r13","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s00038-011-0259-3","article-title":"Times to drink: cross-cultural variations in drinking in the rhythm of the week.","volume":"57","author":"Room","year":"2012","journal-title":"Int J Public Health"},{"key":"key20260814070935_r14","first-page":"301","article-title":"Situated drinking: The association between eating and alcohol consumption in Great Britain.","volume":"40","author":"Warde","year":"2023","journal-title":"Nordisk Alkohol Nark."},{"key":"key20260814070935_r15","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugpo.2024.104414","article-title":"How is alcohol consumption and heavy episodic drinking spread across different types of drinking occasion in Great Britain: An event-level latent class analysis.","volume":"127","author":"Holmes","year":"2024","journal-title":"Int J Drug Policy"},{"key":"key20260814070935_r16","doi-asserted-by":"crossref","first-page":"240","DOI":"10.15441\/ceem.17.270","article-title":"Night shift preparation, performance, and perception: are there differences between emergency medicine nurses, residents, and faculty?","volume":"5","author":"Richards","year":"2018","journal-title":"Clin Exp Emerg Med"},{"key":"key20260814070935_r17","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1080\/15389588.2024.2333918","article-title":"Delays in blood collection and drug toxicology results among crash-involved drivers arrested for impaired driving.","volume":"25","author":"Price","year":"2024","journal-title":"Traffic Inj Prev"},{"key":"key20260814070935_r18","doi-asserted-by":"crossref","first-page":"607","DOI":"10.3390\/toxics13070607","article-title":"The crime of vehicular homicide in Italy: trends in alcohol and drug use in fatal road accidents in Lazio region from 2018 to 2024.","volume":"13","author":"Vernich","year":"2025","journal-title":"Toxics"}],"container-title":["Biochemia medica"],"original-title":[],"link":[{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/36\/3\/10.11613\/BM.2026.030703\/fullArticle","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:58:50Z","timestamp":1791284330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biochemia-medica.com\/en\/journal\/36\/3\/10.11613\/BM.2026.030703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":18,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,10,5]]},"published-print":{"date-parts":[[2026,10,15]]}},"URL":"https:\/\/doi.org\/10.11613\/bm.2026.030703","relation":{},"ISSN":["1846-7482","1330-0962"],"issn-type":[{"value":"1846-7482","type":"electronic"},{"value":"1330-0962","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,15]]}}}