A Comparison of Standard Inhalers for Asthma With and Without Alcohol as the Propellant on the Measurement of Alcohol in Breath

Because most bronchodilator inhalers contain propellant gases or a small amount of ethanol as a co-solvent, the potential for these products to generate false readings on a evidential breath alcohol instrument was evaluated in 69 volunteers with clinically stable asthma. All subjects underwent a breath test on an infrared breath alcohol analyzer (Alcotest 7110, Dräger, Lübeck, Germany) before the use of the asthma inhaler and 1 and 5 min after inhalation. The effects of antiasthmatic medications delivered by metered dose inhalers (MDIs) with alcohol as a vehicle, alcohol-free MDIs, and dry powder inhalers were assessed in homogeneous groups of four to five patients. All subjects were alcohol-free on the preliminary breath test. One minute after inhalation, negative readings were only observed in 25 (36.2%) of subjects. In 62.3% of patients, apparent alcohol results were considered interferences or unstable readings by the breath-test instrument. One subject showed a final positive breath alcohol level (0.07 mg/L). After the use of dry powder inhalers, valid results without interferences were obtained. However, 89.6% of patients in which bronchodilators were delivered by MDIs (with propellant gases in the aerosol) showed altered partial readings and labeled the final output as "invalid," but tests perfomed 5 min after the use of inhalers were valid and correct in all cases. MDIs with propellants as a vehicle may cause false positive breath alcohol readings in some patients. These effects are transient and may be prevented by a 5–10-min interval between the use of MDIs and breath alcohol testing.