Alcohol use disorders (AUDs), and alcohol dependence (AD) in particular, are prevalent and associated with a large burden of disability and mortality. The aim of this study was to estimate prevalence of AD in the European Union (EU), Iceland, Norway, and Switzerland for the year 2010, and to investigate potential influencing factors. The 1-year prevalence of AD in the EU was estimated at 3.4% among people 18-64 years of age in Europe (women 1.7%, men 5.2%), resulting in close to 11 million affected people. Taking into account all people of all ages, AD, abuse and harmful use resulted in an estimate of 23 million affected people. Prevalence of AD varied widely between European countries, and was significantly impacted by drinking cultures and social norms. Correlations with level of drinking and other drinking variables and with major known outcomes of heavy drinking, such as liver cirrhosis or injury, were moderate. These results suggest a need to rethink the definition of AUDs.

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Balkan endemic nephropathy (BEN) is a kidney disease that has been reported in only certain rural villages in Serbia, Bulgaria, Romania, Croatia and Bosnia. The cause of BEN remains a mystery, but researchers seem to agree that exposure to one or more environmental agents is at least partially responsible. The Pliocene lignite hypothesis suggests the disease is due to long-term exposure to polycyclic aromatic hydrocarbons (PAHs) or other toxic organic compounds that have leached into drinking water supplies from low-rank coals. Although this hypothesis has been promoted by some researchers, efforts to substantiate it have been inconclusive due to limitations in sample size and methodology. The present study was designed to further examine this hypothesis by analyzing PAHs, which were implicated in the original hypothesis, in a larger number of water samples from endemic and nonendemic villages in Bulgaria and for other chemical differences between the villages. Results show that levels of all PAHs were low, with none exceeding the drinking water standard for benzo-[a]-pyrene, the most toxic PAH, and the only one for which a maximum contaminant level (MCL) has been set for drinking water. Comparison of additional unidentified chromatographic peaks from high-pressure liquid chromatography (HPLC) technique designed to detect dissolved organic compounds (DOCs) that leach from coal failed to show higher levels in BEN villages. This study finds no basis to connect PAHs or other unknown DOCs to the etiology of BEN, and suggests that the evidence in support of the Pliocene lignite hypothesis is limited to the spatial association originally proposed.

Objectives To assess the validity of Food and Agriculture Organization (FAO) data on availability of fish and vegetable oils as an indicator of national n-3 fatty acid intake, and to estimate the worldwide population living in countries with low n-3 fatty acid intake. Design Essential n-3 fatty acids (FAs) alpha-linolenic acid (ALA) and docosahexaenoic acid (DHA) measured by gas chromatography in adipose tissue from participants in this study, and those published from 11 other countries, were used to validate ALA and fish availability estimated from the FAO food balance sheets. Based on the validated FAO data for ALA and fish availability, we estimated the global prevalence of low n-3 FA availability. Setting Rural and urban areas of Bulgaria Subjects 50 men and 58 women Results Adipose tissue ALA and DHA in Bulgaria (0.34% and 0.11%) were lower than the 11 other countries with available data. A strong positive correlation was found between adipose tissue DHA and fish availability (r=0.88) and between adipose tissue ALA and ALA availability (r=0.92). Approximately half the world population lived in middle and low-income countries with limited access to n-3 FAs (fish < 400 g/wk and ALA < 4% of total vegetable oils), with the largest proportion being in Southeast Asia (53.6%), followed by Africa (27.1%) and Eastern Europe (8.5%). Of these, 33% lived in countries like Bulgaria where n-3 FAs were almost unavailable (fish < 200 g/wk and ALA < 2% of total vegetable oils). Conclusion Very low availability of n-3 FAs is extensive worldwide.

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