Could elevated ketone levels produce inaccurate Breathalyzer results?

From our video partners

Herpes
What is Herpes? Learn the signs and symptoms.

False postive on breathalyzer

The short answer is yes. Ketoacidosis (elevated ketone levels) have been identified with false positive tests with blood alcohol measurements:


One reference to J Forensic Sci. 1995 Jul;40(4):686-7.

states:

We report the identification of acetone (0.45 mg/mL) and isopropanol (0.17 mg/mL) but without the presence of ethanol in a blood sample from a man suspected of driving under the influence of alcohol. A preliminary breath screening test with an electrochemical instrument (Alcolmeter S-L2) was positive and an evidential breath-test with a dual wavelength infrared analyzer (Intoxilyzer 5000), recognized the presence of an interferant in the subject's breath. The man admitted drinking moderate amounts of alcohol (vodka) the previous evening and was being treated by his doctor for hyperglycemia by special dietary control. This case scenario provides a good example of severe metabolic ketoacidosis in an ostensibly healthy man driving on the highway. Biotransformation of the abnormally high concentration of blood-acetone to isopropanol occurs through the alcohol dehydrogenase pathway.

PMID: 7595310 [PubMed - indexed for MEDLINE]



Another reference (more recent) is even more interesting as it relates to to a person on a low carb high fat diet (like Atkins).

Int J Obes (Lond). 2007 Mar;31(3):559-61. Epub 2006 Aug 8

A 59-year-old man undergoing weight loss with very low calorie diets (VLCD) attempted to drive a car, which was fitted with an alcohol ignition interlock device, but the vehicle failed to start. Because the man was a teetotaller, he was surprised and upset by this result. VLCD treatment leads to ketonemia with high concentrations of acetone, acetoacetate and beta-hydroxybutyrate in the blood. The interlock device determines alcohol (ethanol) in breath by electrochemical oxidation, but acetone does not undergo oxidation with this detector. However, under certain circumstances acetone is reduced in the body to isopropanol by hepatic alcohol dehydrogenase (ADH). The ignition interlock device responds to other alcohols (e.g. methanol, n-propanol and isopropanol), which therefore explains the false-positive result. This 'side effect' of ketogenic diets needs further discussion by authorities when people engaged in safety-sensitive work (e.g. bus drivers and airline pilots) submit to random breath-alcohol tests.

PMID: 16894360 [PubMed - indexed for MEDLINE]

First answer by Ilantoren. Last edit by Ilantoren. Contributor trust: 177 [recommend contributor]. Question popularity: 30 [recommend question]