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

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.

Comparative risk assessment of carcinogens in alcoholic beverages using the margin of exposure approach

“…Less data on unrecorded alcohol is generally available. 28 The data were, therefore, taken from an own survey recently conducted in the European Union. 11 Generally, the contamination of alcoholic beverages with the selected compounds is subject to a wide variation depending on product category, raw material or diligence during manufacturing.…”

“…28 At least for one of the compounds, ethyl carbamate, mitigative risk management approaches are ongoing but only on a ''recommendation'' basis. 9 Inorganic compounds such as lead or arsenic could be relevant for future research.…”

Composition of Unrecorded Distilled Alcohol (bai jiu) Produced in Small Rural Factories in Central China

“…The industry has been joined by many in the public health community in suggesting concern about the safety of unrecorded alcohol, mainly pointing to the potential for adulteration or contamination in the unsupervised production and distribution system (Lachenmeier et al, 2009b(Lachenmeier et al, , 2011. When adulteration or contamination does occur, there is typically a great deal of media attention that gives an impression of widespread risk.…”

High Ethanol Contents of Spirit Drinks in Kibera Slums, Kenya: Implications for Public Health

“…However, artisanally and naturally produced spirits from grains and sugars and even commercially rectified spirits always contain some amount of higher alcohols. Therefore, all the chang'aa samples analysed did not comply with Kenyan limit but are still judged as of no concern to public health [28].…”