Blood alcohol concentration

The blood alcohol concentration ( BAC ) is a measure of the amount of alcohol in the blood and is usually given in parts by weight as g / kg ( per mille ). It is used to derive statements about the restriction of concentration and mental health caused by alcohol. The BAC can be measured in a blood sample or estimated from the result of a breath alcohol test or the amount of alcohol consumed. The taking of a blood sample can be enforced by a judge (not enforceable in Austria - but the legal consequences are the same as if you had been heavily drunk). To determine the BAK on cadavers, the blood may only be taken from the inguinal vein. Alternatively, aqueous humor can be used.

In German laboratories, the ethanol value of the sample is usually given in g / l and is often not determined in whole blood, but in serum or plasma. For the conversion to per mille or g / kg whole blood, two factors must therefore be taken into account: the density of whole blood (1.057 g / ml) and serum or plasma (1.026 g / ml) and the distribution coefficient serum or plasma / whole blood (1st , 2). The conversion formulas obtained are:

BAK (‰) = ethanol in whole blood (g / l) / 1.057

BAK (‰) = ethanol in serum or plasma (g / l) / (1.026 * 1.2) = ethanol in serum or plasma (g / l) / 1.2312

The values ​​given are average values that assume a normal relative proportion of blood cells in the blood volume ( hematocrit ). However, this is already lower in women than in men and can be even more reduced in the case of anemia .

Factors influencing the BAK

admission

Although alcohols can also be inhaled, absorbed through the skin, administered intravenously or taken with food, in practice the oral intake of alcoholic beverages plays a major role. The uptake of the ethanol takes place via the mucous membranes of the digestive tract, about 2% directly through the oral mucosa and esophagus. Ethanol is mainly absorbed in the upper small intestine , depending on the length of time it remains in the stomach , up to around 10 to 20% . The direct absorption through the oral mucosa leads to a rapid onset of action, the first (degrading) liver passage is omitted.

Dismantling

Ethanol is mainly broken down in the liver via alcohol dehydrogenase (ADH). This enzyme , which is composed of several isoenzymes of different activity, is also found in small amounts in other tissues such as the mucous membranes of the lungs or the gastrointestinal area. The breakdown rate in adults used to alcohol above a BAK of 0.1 ‰ is 0.1 ‰ to 0.2 ‰, i.e. H. on average 0.15 g / kg, per hour. Gender-specific differences, as in the case of the volume of distribution, have not been confirmed for alcohol breakdown. With blood alcohol levels above 2 ‰, the ethanol elimination can take place more quickly, since the MEOS is then also involved in the breakdown of alcohol. At an ethanol level of around 0.1 g / kg, there is no longer enough ethanol in the body to completely saturate the ADH system. The course of the blood alcohol curve as a function of time is no longer linear below these BAK values. In addition to degradation, small amounts of ethanol are also excreted unchanged. The lungs make up about 3% of the excretion, the kidneys about 1 to 2%.

Drinking behavior, biodegradation

The drinking behavior, the type of drink and the stomach filling significantly determine the length of time the alcohol stays in the stomach. Sweet, carbonated, and warm drinks pass the stomach faster than cold and bitter drinks. A full stomach increases the length of time you stay with alcoholic beverages. This is especially true after high-fat meals. Since the gastric mucosa is a larger diffusion barrier for ethanol than the mucous membranes of the small intestine, a longer stay in the stomach leads to a flatter course of the BAK curve. It is possible that some of the alcohol is already broken down by the enzymes in the gastric mucosa, so that it cannot contribute to the BAC. Since the uptake of ethanol is a diffusion process, the concentration of the drink ingested and its dilution by the stomach contents also play a role, since it influences the diffusion gradient .

Other individual factors

The level of BAK after consuming alcoholic beverages is determined by a number of individual factors such as body weight, height, gender and the composition of the isoenzymes of alcohol dehydrogenase. Since ethanol is hydrophilic and lipophobic, it is mainly distributed in body water after ingestion, while the fatty tissue only absorbs small amounts of alcohol. When calculating the BAK, the individually different water content must be taken into account, e.g. B. the body mass index or by age- and gender-specific factors. Since women have a higher body fat percentage on average than men, this is reflected, for example, in a smaller widmark factor. If an individual deviates significantly from his reference group due to overweight or underweight, this may lead to an incorrect calculation of the BAK.

Absorption deficit

The expected values ​​calculated from the amount of alcohol consumed are usually higher than the measured blood levels. This deficit is also known as the absorption deficit. On an empty stomach, this deficit can amount to up to 10% of the amount of alcohol consumed, but it can be considerably higher with simultaneous food consumption or a full stomach and large amounts of drink.

Calculation of the BAK

The concentration of alcohol in the blood depends on:

• the amount of alcohol consumed
• the rate of absorption of alcohol in the body
• the amount of body water in which the alcohol is dispersed
• the rate of breakdown of alcohol in the blood.

Widmark formula

The Swedish chemist Erik M. P. Widmark has developed the following formula to determine the theoretical maximum BAC:

${\displaystyle w={\frac {A}{m\cdot r}}}$

With

• ${\displaystyle w}$ the mass fraction of alcohol in the body in ‰
• ${\displaystyle A}$ the absorbed mass of alcohol in grams (g)
• ${\displaystyle m}$ the mass of the person in kilograms (kg)
• ${\displaystyle r}$ the reduction or distribution factor in the body:
  • Men: 0.68-0.7
  • Women / adolescents: 0.55-0.60
  • Infants / young children: 0.75-0.80

In order to find out the mass of alcohol in a drink , the volume of the drink (measured in milliliters, so that the result is available in grams) with the alcohol volume percentage (to be found on the beverage container, e.g. beer: 0.05) and the density of alcohol ( to be multiplied) . For example, if a liter (i.e. 1000 ml) of beer has a volume fraction of 0.05 (i.e. 5%) alcohol, the 50 ml alcohol corresponds to a weight of 40 g. ${\displaystyle A}$ ${\displaystyle V}$ ${\displaystyle e}$ ${\displaystyle \rho \approx 0{,}8\,\mathrm {kg/l} =0{,}8\,\mathrm {g/ml} }$ ${\displaystyle A=V\cdot e\cdot \rho }$

An example: If a man weighing approx. 80 kg ( ) drinks a 0.5 l bottle of beer ( alcohol), this results in the following BAK inserted into the Widmark formula: ${\displaystyle m=80\,\mathrm {kg} }$ ${\displaystyle r\approx 0{,}7}$ ${\displaystyle A=20\,\mathrm {g} }$

${\displaystyle \mathrm {BAK} _{\mathit {Bsp.}}=\mathrm {c} _{\mathit {Bsp.}}=\mathrm {{\frac {20\,g}{80\,kg\cdot 0{,}7}}={\frac {20}{56}}{\frac {g}{kg}}\approx 0{,}3571{\frac {g}{kg}}\approx 0{,}36} \,{}^{0\!}\!/\!_{00}}$.

Between 10% and 30% must be deducted from the calculated blood concentration, since the alcohol is not completely absorbed. A value between 0.1 ‰ and 0.2 ‰ can be assumed as the hourly degradation value. The forensic literature also assumes a degradation rate of approx. 0.15 ‰.

The reduction factor reflects the proportion of the body in which the alcohol is distributed. In addition to Widmark's historically first formula, which is still in use today, further calculation methods are described below that take into account body weight and gender as well as body length and age.

Calculation according to Seidl

According to Seidl, the reduction factors for women (RW) and men (RM) are based on body weight in kg and body length in cm:

RW = 0.31233 - 0.006446 body weight + 0.004466 body length,

RM = 0.31608 - 0.004821 * body weight + 0.004432 * body length.

Calculation according to Ulrich

Ulrich suggested the following relationship for men (RU):

RU = 0.715 - 0.00462 * body weight + 0.0022 * body length

Watson's formula

Watson provided another formula. He empirically determined the dependence of the distribution factor on gender, body mass  (kg), body height  (cm) and age (in years). ${\displaystyle r}$ ${\displaystyle m}$ ${\displaystyle h}$ ${\displaystyle t}$

The distribution factor can be determined more precisely by estimating the water contained in the body (total body water GKW [liters])  : ${\displaystyle r}$

${\displaystyle GKW_{\mathrm {m{\ddot {a}}nnlich} }=2{,}447-0{,}09516\cdot {\frac {t}{\mathrm {Jahre} }}+0{,}1074\cdot {\frac {h}{\mathrm {cm} }}+0{,}3362\cdot {\frac {m}{\mathrm {kg} }}}$,

${\displaystyle GKW_{\mathrm {weiblich} }=-2{,}097+0{,}1069\cdot {\frac {h}{\mathrm {cm} }}+0{,}2466\cdot {\frac {m}{\mathrm {kg} }}}$.

A modification in women by Axel Eicker is age-dependent. Here, however, a parameter only has three digits, which leads to a loss of accuracy:

${\displaystyle GKW_{\mathrm {weiblich} }=0{,}203-0{,}07\cdot {\frac {t}{\mathrm {Jahre} }}+0{,}1069\cdot {\frac {h}{\mathrm {cm} }}+0{,}2466\cdot {\frac {m}{\mathrm {kg} }}}$.

${\displaystyle r}$results as follows ( = density of blood, average ): ${\displaystyle \rho _{\mathrm {Blut} }}$ ${\displaystyle 1{,}055\,{\tfrac {\mathrm {g} }{\mathrm {cm} ^{3}}}}$

${\displaystyle r={\frac {\rho _{\mathrm {Blut} }\cdot GKW}{0{,}8\cdot m}}}$.

The factor 0.8 indicates the proportion of water in the blood. If you plug this into the Widmark formula, you get

${\displaystyle c={\frac {0{,}8\cdot A}{\rho _{\mathrm {Blut} }\cdot GKW}}}$.

Measurement of the BAK

The BAK can be determined using different methods. Common methods are the ADH method and gas chromatographic determination. Both procedures are usually not applied to whole blood, but to serum. For this purpose, the solid blood components are separated from the blood serum by centrifugation . Efforts have been made since the late 1990s to calculate the BAC from the breath alcohol concentration (AAC).

Taking blood while disinfecting the puncture site with ethanol has no falsifying influence on the measurement of the blood alcohol concentration.

For legal purposes, the BAK in Germany must be carried out using two different procedures in duplicate. The four individual values must not deviate from the mean value by more than 10% .

ADH method

In a buffer solution , the enzyme alcohol dehydrogenase (ADH) oxidizes ethanol to acetaldehyde . The aldehyde is bound by semicarbazide . The released hydrogen is bound to NAD . The NAD-H formed differs from NAD in that it has a clear absorption band in the ultraviolet range of 340 nm. This allows conclusions to be drawn about the ethanol content of a sample on appropriately calibrated devices by measuring the extinction .

Gas chromatographic determination

One method for gas chromatographic determination of ethanol in serum is the method with an internal standard . For this purpose, the diluted serum sample is tert with a defined amount . -Butanol mixed. The ratio of the peak heights or peak areas of the internal standard and the ethanol peak of the sample can be used to calculate the ethanol content of the sample.

Breath alcohol concentration

There are a number of methods for determining breath alcohol . The measuring method developed for police practice originally used a test tube filled with deep yellow potassium dichromate . When breathing air containing alcohol (1 liter blowing volume) is passed through, the tube is colored green due to the formation of Cr (III) ; the length of the green colored zone is a measure of the alcohol content. The police have been using electronic devices with an electrochemical sensor since 1995, which shows the measured breath alcohol concentration (AAC) in mg / l on a digital display. Usually, the Dräger Alcotest 7410 device is used by the police on site for controls and for accident reports.

The two procedures mentioned are not admissible as evidence in court. They therefore only serve as a preliminary test. Basic tests of electronic breath alcohol test procedures were published in 1981 by the then Institute for Social Medicine and Epidemiology of the Federal Health Office . Depending on the test result, either a blood sample is ordered or a conclusively reliable AAK measurement is carried out. For this purpose, the Dräger Alcotest 7110 Evidential MK III has been available since the late 1990s, a much more complex measuring device that fulfills the legal requirements by using two different measuring methods ( fuel cell and infrared sensor) in duplicate. The comparability of AAK and BAK is discussed, however.

According to § 24a Abs. 1 StVG , 0.5 ‰ blood alcohol concentration corresponds to 0.25 mg / l breath alcohol concentration.

Legal meaning

In criminal and regulatory offense law, the BAK of the perpetrator plays a role primarily in assessing his or her culpability . In addition, certain criminal offenses presuppose that the perpetrator or victim is alcoholized. Under civil law, alcohol consumption can lead to the nullity of declarations of intent ( Section 105 BGB ).

Calculation of the blood alcohol content at the time of the crime based on the amount of drink

If a blood sample was not taken, the blood alcohol concentration at the time of the offense must usually be calculated based on the amount of drinking. Based on the amount consumed, body weight and body structure, the blood alcohol concentration that would theoretically have been reached if the entire amount of alcohol had entered the body at once is determined with the help of tables that also provide information about the alcohol content of many beverages (theoretical concentration ). Based on this value, the following calculation must be made:

Highest possible blood alcohol concentration

Theoretical concentration

minus absorption deficit 10%

Degradation per hour 0.1 ‰

Lowest possible blood alcohol concentration

Theoretical concentration

minus absorption deficit 30%

Degradation per hour 0.2 ‰

One-time safety deposit 0.2 ‰

The absorption of alcohol, including the per mille content, in the body depends on body weight:

Calculation of the blood alcohol content at the time of the crime based on a blood sample taken later

If a blood sample was taken, according to the established case law of the Federal Court of Justice, principles apply that are based on scientific knowledge, are generally valid and do justice to the principle of doubt (case law does not recognize individual degradation values). Even an expert may not disregard these principles. According to these principles, the blood alcohol concentration at the time of the offense is calculated as follows after the blood sample:

Highest possible blood alcohol concentration

In favor of the defendant, it can be assumed that resorption has been completed. Degradation per hour 0.2 ‰; One-time safety surcharge of 0.2 ‰ from the first hour.

Lowest possible blood alcohol concentration

Degradation per hour 0.1 ‰ after resorption is complete . This can take up to two hours. Therefore, two hours after drinking are not taken into account for the back calculation .

If only " Alcotest handheld measuring device" test results are available on the breathing air concentration, these may not be used to the detriment of the accused because of the still existing measurement inaccuracies . However, nothing stands in the way of utilization in favor of the accused. The measured values ​​are then to be recalculated as well as blood sample results.

The longer in the past the offense, the more problematic the BAK's recalculation at the time of the offense becomes, in particular because of the so-called late drink. If the perpetrator drinks large amounts of alcohol in a short time after the crime - for example when the police arrive or while driving to the station - the subsequent determination of the BAK at the time of the offense is based on the flood value in the case of an unknown amount and in an unknown concentration alcohol in the blood usually no longer be possible. Under certain circumstances, the accompanying alcohol analysis can help to rule out a night drink .

This can also be calculated approximately with the extended Widmark formula:

${\displaystyle c(x)={\frac {A}{m\cdot r}}-a\cdot x}$

With

${\displaystyle a=0{,}1\dots 0{,}2\approx 0{,}15}$,

${\displaystyle x={\text{Zeit}}\ \mathrm {[h]} }$,

(further variables as in section Widmark formula ).

Limit values

The following table gives a selected overview of the limit values ​​in Europe. For professional drivers and motorized two-wheelers as well as novice drivers, lower limit values ​​often apply. Further information can be found in the article Drinking alcohol limits in road traffic in Europe .

Comparison of the limit values ​​in Europe

country	allowed maximum limit	Fine	Driving license withdrawal	Retraining	prison sentence	Vehicle withdrawal	Remarks
Germany	0.0 ‰ - 0.5 ‰	from 250 €	from 0.5 ‰	from 0.5 ‰	No	No	MPU for motorized vehicle drivers from 1.1 ‰, for cyclists from 1.6 ‰, in the event of repetition, an MPU can also be arranged for lower values.
Italy	0.0 ‰ - 0.5 ‰	€ 500 - € 6,000	from 0.5 ‰	No	from 1.5 ‰	from 1.5 ‰
Norway	0.2 ‰						Sentence not known.
Poland	0.2 ‰	> 145 €	from 0.2 ‰ driving ban	No	possible	No	Only applies to drivers of a motor vehicle.
Austria	0.1 ‰ - 0.5 ‰	€ 300 - € 5,900	from 0.5 ‰	from 0.5 ‰	No	No	Retraining and / or driving license revocation in the event of repetition from 0.5 ‰. Mandatory from 0.8 ‰.
Sweden	0.2 ‰						Sentence not known.

Germany

Driving a motor vehicle on public roads, paths and places in an unfit condition is prohibited.

In 1953, the Federal Court of Justice set a binding blood alcohol level of 1.5 ‰ for the courts in the Federal Republic of Germany, above which every driver is deemed to be absolutely unfit to drive on the road. This value was reduced by the BGH in 1966 to 1.30 ‰ and in 1990 to 1.10 ‰. Since 1973, alcohol driving by drivers from 0.8 ‰, since 1998 from 0.5 ‰, has also been punished as an administrative offense.

For novice drivers up to the age of 21 and during the probationary period, the introduction of the new § 24c StVG in Germany from August 1, 2007 also includes an absolute ban on alcohol. An administrative offense is committed by anyone who, during the probationary period in accordance with Section 2a StVG or before the age of 21 as a driver of a motor vehicle, consumes alcoholic beverages or starts driving even though he is under the influence of such a beverage. The following values ​​are predominantly not set by law, but as a permanent case law, the result of years of judicial practice.

BAK in ‰	Legal meaning
0.0	Absolute alcohol ban for novice drivers during the probationary period or before the age of 21. The offense is classified as a serious administrative offense and not only punished with a fine of 250 €. In addition, you also receive 1  point in the register of fitness to drive in Flensburg, which, according to Section 2a (2) StVG, leads to the arrangement of participation in a special advanced seminar and the extension of the probationary period by 2 years.
0.3	" Relative inability to drive ": If there are typical failure symptoms, driving errors or specific hazards, this is punishable according to § 316 StGB ( drunkenness in traffic ) or even according to § 315c StGB ( endangerment of road traffic ) and is also usually a withdrawal of the driving license (according to § 69 StGB). The fitness to drive is no longer given.
0.5	The "0.5 per mille limit": unauthorized driving of a motor vehicle in road traffic, even without failure symptoms (usually due to corresponding habituation to alcohol). Administrative offense according to § 24a StVG (first violation: 1 month driving ban , 500 € fine, 2 points in the register of fitness to drive in Flensburg; second violation: 3 months driving ban, 1000 € fine, 2 points; further violations: 3 months driving ban, 1500 € fine, 2 points) . After the second discovered alcohol trip - regardless of the level of the BAK - a medical-psychological examination is usually required to check the fitness to drive .
1.1	“ Absolute inability to drive ” when driving a motor vehicle in traffic. Offense according to Section 316 StGB. Withdrawal of the driving license for about 9 months (differently regulated), penalty order with a fine of at least 40 to 60 daily salary rates or imprisonment for negligent cause of danger, 3 points in Flensburg, claims for damages by third parties.
1.3	“Absolute driving ineptitude” when driving a motor sports boat on Lake Constance
1.6	Arrangement of an MPU for “assessment of fitness to drive” and “absolute inability to drive” even when driving non-motorized vehicles in traffic (especially bicycles). The deadline for implementation is normally 2 months, if a positive report is not submitted, the driver's license will be withdrawn .
1.8	"Absolute driving ineptitude" when driving ships.
2.0	Reduced responsibility in accordance with Section 21  StGB is possible (except for homicides).
2.2	Reduced responsibility in accordance with Section 21 of the  Criminal Code for homicides is possible (lowering the inhibition threshold).
2.5	Reduced responsibility in accordance with Section 21 of the  Criminal Code is likely. Incapacity according to § 20  StGB (and thus also actio libera in causa ) is possible.
3.0	Incapacity according to Section 20 of the  Criminal Code is (very) likely (except in the case of murder). According to the latest case law of the BGH, a regular presence of culpability is no longer assumed (but the indicative effect remains). § 323a  StGB Full intoxication possible if § 20  StGB cannot be excluded.
3.3	Incapacity of the murderer is (very) likely ("safety margin", higher inhibition threshold)
3.5	The ability to interrogate ends here ( Section 136a StPO ). This is important for the usability of the statement and a possible criminal liability of the interrogator.
> 3.0	The value of the lethal dose is described in specialist literature as 3 ‰ to 4 ‰. However, cases with a survived BAC of 4 ‰ are not exceptional. Extreme cases are known that significantly exceed these values.

In shipping, a BAK limit value of 0.5 ‰ or an AAK limit value of 0.25 mg / l applies to the driver of a vehicle and personnel with other activities in bridge, deck or machine service in the area of ​​validity of the Maritime Traffic Regulations Breathing air ( Section 3 Paragraph 4 SeeSchStrO). Driving a ship under the influence of alcohol can be illegal according to Section 61 (1) No. 1a-c SeeSchStrO in conjunction with Section 15 of the Sea Tasks Act (SeeAufgG). For skippers, criminal liability according to § 315a StGB or § 316 StGB can also come into consideration.

Liability and insurance coverage

Exponential increase in accident risk with increasing blood alcohol concentration.

In legal proceedings after a road traffic accident, alcohol consumption regularly has a negative effect on the assessment of guilt between those involved in the accident. Even in relatively clear accident situations, it can lead to the fact that an intoxicated victim is (partly) responsible due to reduced ability to react to evasive maneuvers or braking maneuvers or that the other party involved in the accident is released from (partly) guilty. Different judgments are only made in exceptional cases.

At the same time, the drunkenness of the vehicle driver also has an impact on the usual insurance cover : “If alcohol is clearly responsible for the accident, the drunkenness clause applies in motor vehicle liability insurance. It releases the insurer from its obligation to provide benefits. (... Although) the motor vehicle liability insurance regulates the damage. However, it then takes recourse against the driver . She can get back a maximum of € 5,000 from the injuring party. "

In cases of doubt, the accused can take a second blood sample from the doctor involved and have it examined in an independent and quality-controlled forensic medical institute in order to provide evidence to the contrary. Only then can contradictions and, in particular, possible sample mix-ups during the analysis be clarified in a court-proof manner.

Basic reports and monographs

• PV Lundt, E. Jahn: Alcohol in traffic offenses. Report from the Federal Health Office . Ed. Federal Minister of Justice and Federal Minister of Transport. Kirschbaum Verlag, Bad Godesberg 1966, DNB 456442146 .
  • Supplementary statement on the previously submitted reports by the Federal Health Office. Kirschbaum Verlag, Bad Godesberg 1967, DNB 457472073 .
• Harald Schütz : Alcohol in the blood - detection and determination, conversion, calculation . Verlag Chemie, Weinheim 1983, ISBN 3-527-26094-3 .
• HJ Gibitz, H. Schütz (arr.): Determination of ethanol in serum - implementation and interpretation in the clinical-chemical laboratory . For the DFG . Communication XX of the Senate Commission for Clinical-Toxicological Analysis. VCH Verlagsgesellschaft, Weinheim 1993, ISBN 3-527-27555-X .

See also

Wiktionary: BAK  - explanations of meanings, word origins, synonyms, translations

Wiktionary: Blood alcohol concentration  - explanations of meanings, word origins, synonyms, translations

Web links

• Per mill calculator - with the possibility of comparing different BAK formulas
• § 24 c StVG draft law, adopted by the Bundestag on May 24, 2007, printed matter 16/5398 (PDF; 451 kB), dip.bundestag.de

Individual evidence

1. ↑ H. Greiling, AM Gressner: Textbook of Clinical Chemistry and Pathobiochemistry. 3. Edition. Schattauer, Stuttgart 1995, p. 1404.
2. ↑ Alcohol: absorption-distribution-degradation.
3. ↑ H. J. Mallach , H. P. Hartmann, V. Schmidt: Alcohol effects in humans. Thieme, Stuttgart / New York 1987, p. 62.
4. ↑ T. Ehrig, KM Bohren, B. Wermuth, JP von Wartburg: Degradation of aliphatic alcohols by human liver alcohol dehydrogenase: effect of ethanol and pharmacokinetic implications. In: Alcoholism, clinical and experimental research. 1988, pp. 789-794.
5. ^ W. Huckenbeck, W. Bonte: Alkohologie. In: B. Madea, B. Brinkmann: Manual forensic medicine . Springer, Berlin / Heidelberg / New York 2003, pp. 379–636.
6. ↑ CM Oneta, UA Simanowski, M. Martinez, A. Allali-Hassani, X. Parés, N. Homann, C. Conradt, R. Waldherr, W. Fiehn, C. Coutelle, HK Seitz: First pass metabolism of ethanol is strikingly influenced by the speed of the gastric emptying. In: Good. 43, 1998, pp. 612-619.
7. ↑ MS Mumenthaler, JL Taylor, JA Yesavage: Ethanol pharmacokinetics in white women: nonlinear model fitting versus zero-order elimination analyzes. In: Alcoholism, clinical and experimental research. 2000, pp. 1353-1362.
8. ↑ M. Wolf, N. Wiens: On the course of the blood alcohol curve in the low concentration range. In: Contributions to forensic medicine. 40, 1982, pp. 63-67.
9. ↑ R. Felberbaum: Experimental studies on the concentrations of accompanying alcohol in blood and urine after consumption of alcoholic beverages . Dissertation. University of Cologne 1989.
10. ↑ EMP Widmark: The theoretical basics and the practical usability of forensic and medical alcohol determination . Urban & Schwarzenberg, Berlin / Vienna 1932, DNB 365635693 .
11. ^ S. Seidl, U. Jensen, A. Alt: The calculation of blood ethanol concentrations in males and females. In: International Journal of Legal Medicine. Volume 114, 2000, pp. 71-77.
12. ↑ L. Ulrich, Y. Cramer, P. Zink: The consideration of individual parameters when calculating the blood alcohol content from the amount consumed. In: blood alcohol. 24, 1987, pp. 192-198.
13. ↑ PE Watson, R. Watson, RD Batt: Total body water volumes for adult males and females estimated from simple anthropometric measurements. In: The American Journal of Clinical Nutrition. 33, January 1980, pp. 27-39. PMID 6986753 .
14. ↑ G. Lippi, AM Simundic, G. Musile, E. Danese, G. Salvagno, F. Tagliaro: The alcohol used for cleansing the venipuncture site does not jeopardize blood and plasma alcohol measurement with head-space gas chromatography and an enzymatic assay . In: Biochem Med (Zagreb). 27 (2), Jun 15, 2017, pp. 398-403. PMID 28694729
15. ^ W. Schwerd (Ed.): Brief textbook of forensic medicine . 1976, p. 111 ff.
16. ↑ R. Iffland: To reduce the amount of serum for forensic blood alcohol determination. In: blood alcohol. 28, 1991, No. 6, pp. 371-376.
17. ↑ Günter Schoknecht with the collaboration of Hans-Ulrich Melchert and Wolfgang Thefeld: Testing of electronic breath alcohol test procedures - a statement from the Federal Health Office . D. Reimer Verlag, Berlin 1981, ISBN 3-496-02114-4 .
18. ↑ R. Iffland, H. Käferstein: Discussion remarks on Working Group III "Breath and blood alcohol measurement on the test bench". In: blood alcohol. 46, 2009, pp. 84-88.
19. ↑ BGHSt 37, 231 = NJW 1991, 852
20. ↑ BGHSt 25, 246, 250 = NJW 1974, 246. ( Archive link ( Memento from May 19, 2014 in the Internet Archive ))
21. ↑ BGH NStZ 1995, 96
22. ↑ BGH NStZ 1995, 96
23. ↑ G. Berghaus, H. Grass: Driving safety under the influence of alcohol. In: B. Madea, B. Brinkmann: Manual forensic medicine . Springer Verlag, Berlin / Heidelberg / New York 2003, pp. 885–925.
24. ↑ Young drivers: That's why they're particularly at risk! In: 123FAHRSCHULE. Retrieved October 8, 2019 . 
25. ^ Higher Regional Court of Karlsruhe as Higher Shipping Court, judgment of January 18, 2001 - Ns 1/00: No. 78.
26. ↑ Heribert Blum: Drunkenness in traffic (§§ 315 c I No. 1 a, 316 StGB, 24 a StVG). In: Road Traffic Law. (SVR) 173, 2011, 175
27. ↑ www.infrastructure.gov.au page 54, section 5.4.1. (PDF; 313 kB) Retrieved May 6, 2011 . 
28. ↑ According to an expert opinion, inevitability despite drunkenness ( memento of November 30, 2010 in the Internet Archive ): LG Landstuhl, judgment of June 4, 2007, file number 1 O 806/06
29. ↑ Complicity despite severe drunkenness of the opponent : OLG Stuttgart, judgment of October 26, 2006, file number 13 U 74/2006
30. ↑ The crowd does it ( Memento from August 26, 2014 in the Internet Archive ) HUK-Coburg, February 2, 2011.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !

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