Is contaminated unrecorded alcohol a health problem in the European Union? A review of existing and methodological outline for future studies

Authors

  • Dirk W. Lachenmeier,

    Corresponding author
    1. Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe, Germany
      Dirk W. Lachenmeier, Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, D-76187 Karlsruhe, Germany. E-mail: lachenmeier@web.de
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  • Kerstin Schoeberl,

    1. Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe, Germany
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  • Fotis Kanteres,

    1. Centre for Addiction and Mental Health (CAMH), Toronto, Canada
    2. Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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  • Thomas Kuballa,

    1. Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe, Germany
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  • Eva-Maria Sohnius,

    1. Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Karlsruhe, Germany
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  • Jürgen Rehm

    1. Centre for Addiction and Mental Health (CAMH), Toronto, Canada
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
    3. Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
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Dirk W. Lachenmeier, Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, D-76187 Karlsruhe, Germany. E-mail: lachenmeier@web.de

ABSTRACT

Aims  Some European countries with high levels of unrecorded alcohol consumption have anomalously high rates of death attributable to liver cirrhosis. Hepatotoxic compounds in illegally produced spirits may be partly responsible. Based on a review of the evidence on the chemical composition and potential harm from unrecorded alcohol, the Alcohol Measures for Public Health Research Alliance (AMPHORA) project's methodology for identifying, analysing and toxicologically evaluating such alcohols is provided.

Methods  A computer-assisted literature review concentrated on unrecorded alcohol. Additionally, we refer to our work in the capacity of governmental alcohol control authority and a number of pilot studies.

Results  The risk-oriented identification of substances resulted in the following compounds probably posing a public health risk in unrecorded alcohol: ethanol, methanol, acetaldehyde, higher alcohols, heavy metals, ethyl carbamate, biologically active flavourings (e.g. coumarin) and diethyl phthalate. Suggestions on a sampling strategy for identifying unrecorded alcohol that may be most prone to contamination include using probable distribution points such as local farmers and flea markets for selling surrogate alcohol (including denatured alcohol) to focusing on lower socio-economic status or alcohol-dependent individuals, and selecting home-produced fruit spirits prone to ethyl carbamate contamination.

Conclusions  Standardized guidelines for the chemical and toxicological evaluation of unrecorded alcohol that will be used in a European-wide sampling and are applicable globally are provided. These toxicological guidelines may also be used by alcohol control laboratories for recorded alcohol products, and form a scientific foundation for establishing legislative limits.

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