Wrist-worn alcohol biosensors: Strengths, limitations, and future directions

Abstract

Wearable alcohol biosensors have emerged as a valuable tool for noninvasive, objective and continuous monitoring of alcohol consumption. However, to date their research and clinical applications have been limited by several factors including large size, high cost, and social stigma. In contrast, recently developed wrist-worn alcohol biosensors are smaller, less expensive, and may be more acceptable for daily use. However, these devices are at the prototype phase and have just begun to be tested for research applications. In this paper, we describe our experiences with two prototypes of these new wrist-worn alcohol biosensors (i.e., Quantac Tally and BACtrack Skyn) and their associated smartphone applications in both a controlled laboratory setting and the real-world environment. Our preliminary experiences with these devices highlight their advantages including comfort, high participant acceptability, and good compliance. However, there are various limitations that should be addressed prior to future research applications of these biosensors, including large interpersonal variations in transdermal alcohol readings, lack of immediately applicable data analysis/interpretation software, and poor battery life after a few months. More research is also needed to further validate the new biosensors, and investigate individual (e.g., skin thickness, gender differences) and environmental factors (e.g., humidity, temperature) contributing to the variations in transdermal alcohol readings measured by wrist-worn alcohol biosensors.

Assessment of Alcohol Use in the Natural Environment

“…Studies using WrisTAS in observational studies of young adults have reported device malfunction on approximately 18% of study days (Simons et al., ) and that only 38% of participants had a complete, interpretable data series over a 2‐week period (Luczak et al., ). Similar problems have been observed with newer sensor devices (Wang et al., ).…”

“…Both devices contain electrochemical sensors to determine alcohol concentration in insensible perspiration in an enclosed area above the skin and have additional sensors measuring skin temperature and contact to confirm the device is being worn. Smaller and more efficient devices are being developed, but currently have limited commercial availability and lack supporting data (Wang et al., ).…”

Research in the Time of Coronavirus: Continuing Ongoing Studies in the Midst of the COVID-19 Pandemic

“…Some labs provide infectious disease testing services which can examine 4th generation HIV antibody testing using dried blood spot and chlamydia and gonorrhea testing using mail-in swabs, as well as mail-in samples for Hepatitis B and C testing [31][32][33]. Alcohol use can be remotely monitored using Bluetooth-enabled breathalyzers that estimate breath alcohol concentration or wrist-worn alcohol biosensors that continuously measure transdermal alcohol content [34][35][36].…”

Wearable Enzymatic Alcohol Biosensor

“…Skin permeability to ethanol is known to fluctuate over time [39], and therefore a flux-type sensor placed directly on the skin will measure the product of blood alcohol concentration and skin permeability, resulting in signals that vary with time [16]. The introduction of a diffusion-limiting membrane with known permeability converts a flux-type sensor into a continuous concentration sensor [40][41][42].…”

“…Continuous alcohol sensors have received growing interest from the research community [5][6][7][8][9][10][11][12][13][14], but commercial realizations thus far have involved trade-offs in performance [15,16]. The only two commercialized platforms (SCRAM and WrisTAS) use platinum fuel cells.…”