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Dynamic Chiropractic – March 12, 2006, Vol. 24, Issue 06

Breath Alcohol Testing and Its Role in Chiropractic

By Leo M. Kenney, DC, FACO, DABFP, DABCC
Editor's note: This is part two of a three-part series on the value of incorporating occupational testing services into your chiropractic practice. Part one, "Chiropractic's Role in Occupational Drug Testing Programs," appeared in the Feb. 27 issue and is available online at

In fact, long before automobiles arrived, individuals drove teams of horses while they were drunk. As the automobile became more popular, increasing numbers of people drove intoxicated, and the number of accidents and fatalities increased. However, it wasn't until the 1940s that law enforcement used a tool to measure the driver's level of intoxication.

These first devices, introduced in the early 1940s, were inaccurate and crude. In the 1950s, a new, more accurate testing device called "The Breathalyzer" was patented by Robert Borkenstein of Indiana. Some states continued to use this device until the late 1990s.

Today's testing devices use one of three testing methodologies: fuel-cell-based testing, infrared spectrometry (IR) or gas chromatography (CG). All three methodologies, when performed correctly, are accepted by the National Highway Traffic Safety Administration (NHTSA) as evidential breath-testing methodologies and are referred to as evidential breath-testing devices (EBTs).

An EBT is a device that measures alcohol concentration in the breath. These devices have met the NHTSA'specifications for precision and accuracy. EBTs detect all low-molecular-weight alcohols and must be able to discriminate between acetone and alcohol. If they meet the NHTSA criteria, they are added to the its conforming products list for EBTs. They may then be used in federally mandated alcohol testing programs.1

Gas-chromatography- and infrared-spectrometry-based EBTs are large and, for the most part, not portable. The fuel-cell-based EBTs are portable and easily used. An example of this type of device is the Lifeloc® Phoenix EBT. Devices such as this are light, portable and easily used. Some devices, such as the Phoenix, even walk the user through all the required steps for a DOT breath alcohol test.

Individuals who are certified to perform breath alcohol testing for federally mandated programs are called breath alcohol technicians (BATs). To serve as a BAT, you must undergo specific training as defined by the DOT Office of Drug and Alcohol Policy and be certified as a BAT. The DOT does not certify BATs. Private companies certify individuals as BATs. These companies provide the specific required training and certify initial proficiency in the operation of the specific EBT that will be used. BATs must maintain their certification by recertifying every five years.

Anyone can operate as a BAT if they undergo the required training. Chiropractors and their staff can perform these necessary and mandated services for motor carriers and other mandated companies. But it is not only the federally mandated companies who are using breath alcohol testing.

In 1991, the Omnibus Transportation Employee Testing Act of 1991, administered by the U.S. Department of Transportation, began requiring alcohol testing of employees in "safety-sensitive" job positions. This means that today, approximately 12.1 million individuals are covered under these regulations.

Individuals in the trucking, airline, rail, transit, pipeline, and maritime industries are subject to random, post-accident, reasonable suspicion, follow-up, and in some instances pre-employment breath alcohol testing. In addition, the federal government requires testing of other employees as well.

In recent years, employers have recognized the need for alcohol testing to curb the level of on-the-job drinking. Employees who drink while at work, or who report to work after drinking, increase the risk of injury to themselves and others, and cost the company money. This increases the employer's liability, workers' compensation costs, and insurance premiums. Eventually, it also raises the costs of company goods or services and can have a significant impact on competitiveness.

In a study of workers in a large industrial plant, it was found that 24 percent of workers reported drinking during work at least once in the past year; that drinking during or just before work was associated with workplace problems; and that coming to work hungover was associated with workplace problems.2 In addition, consider the following: According to the Small Business Administration, substance abusers are 33 percent less productive and cost their employers $7,000 annually,3 the costs in lost productivity caused by alcohol use in 1995 were estimated at $119 billion nationally, and as many as 40 percent of workplace fatalities are attributed to alcohol use.4

As a result, more and more companies are implementing drug and alcohol policies in the workplace and utilizing breath alcohol testing. Often, their alcohol policies and testing programs mirror the federal programs that have been upheld in court. Some use saliva-based testing for the screening test, but those that may result in employee termination often opt for testing that has been upheld by the courts; namely, the use of an EBT device operated by a BAT.

Chiropractors who provide breath alcohol testing services are offering the employers in their area a service that more and more are looking for. These services are quick and easy to apply, and seldom present any difficulty in the daily operation of a chiropractic practice.

By acting as the BAT for a company's alcohol testing program, the chiropractor gains entry into the company's safety and human resources department. By developing trusted relationships, the chiropractor has the opportunity to explain the other services they can provide and show the employer how they can help the company's bottom line.

Most chiropractors are keenly aware of the health and financial benefits available to employers through the use of chiropractic services. Unfortunately, too often we are still battling the old enemies of ignorance and prejudice. By integrating this occupational service into your practice, you can gain access to important referral sources among your local industries and employers.


  1. 49 CFR Part 40: Procedures for Transportation Workplace Drug and Alcohol Testing Programs.
  2. Ames, Genevieve M, Joel W Grube, Roland S Moore. The relationship of drinking and hangovers to workplace problems: an empirical study. Journal of Studies on Alcohol 1997;58(1):37-47.
  3. Hoffman-LaRoche, Inc. Corporate Initiatives for a Drug Free Workplace, citing the U.S. Chamber of Commerce, 1990.
  4. Bureau of National Affairs. Alcohol and Other Drugs in the Workplace: Costs, Controls and Controversies, 1986, pg 7.
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