Monitoring Alcohol Consumption in Slovak Cities during the COVID-19 Lockdown by Wastewater-Based Epidemiology

Abstract

The consumption of alcohol in a population is usually monitored through individual questionnaires, forensics, and toxicological data. However, consumption estimates have some biases, mainly due to the accumulation of alcohol stocks. This study’s objective was to assess alcohol consumption in Slovakia during the COVID-19 pandemic-related lockdown using wastewater-based epidemiology (WBE). Samples of municipal wastewater were collected from three Slovak cities during the lockdown and during a successive period with lifted restrictions in 2020. The study included about 14% of the Slovak population. The urinary alcohol biomarker, ethyl sulfate (EtS), was analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). EtS concentrations were used to estimate the per capita alcohol consumption in each city. The average alcohol consumption in the selected cities in 2020 ranged between 2.1 and 327 L/day/1000 inhabitants and increased during days with weaker restrictions. WBE can provide timely information on alcohol consumption at the community level, complementing epidemiology-based monitoring techniques (e.g., population surveys and sales statistics).

Wastewater‐based Epidemiology to Investigate Spatio‐Temporal Trends in Alcohol Consumption in Aotearoa, New Zealand

“…Analysis of the overall alcohol consumption during each of the COVID Alert levels revealed that there was no evidence of a significant difference in mean alcohol consumption between the highest restriction (Level 4) and lowest restriction, Level 1 ( p ‐value=0.25) (Figure 4). Our observation of no increase in consumption under enforced social restrictions and lockdowns/stay‐at‐home orders is in line with that seen in studies in Australia, Austria, Belgium, Slovakia and Spain who report a stable or decrease in alcohol consumption in their WBE‐based studies, as well as subsequent increases in consumption once restrictions eased [33–38] …”

“…Our observation of no increase in consumption under enforced social restrictions and lockdowns/ stay-at-home orders is in line with that seen in studies in Australia, Austria, Belgium, Slovakia and Spain who report a stable or decrease in alcohol consumption in their WBE-based studies, as well as subsequent increases in consumption once restrictions eased. [33][34][35][36][37][38] The Impact of COVID-19 Report (2020) was a survey conducted by Te Whatu Ora j Health Promotion (formerly Te Hiringa Hauora j Health Promotion Agency j Te Hiringa Hauora) between the 7th and 13th of April 2020, i. e., during the first COVID-19 Alert Level 4 Lockdown (not during the time period covered in this study). In this survey, 34 % of respondents selfreported consuming less alcohol than usual, 19 % report consuming more alcohol than usual, and almost half (47 %) consumed their usual amount.…”

Pharmaceutical and Recreational Drug Usage Patterns during and Post COVID-19 Determined by Wastewater-Based Epidemiology

“…That indicates that the restrictions might have caused an increase in alcohol consumption. Other authors have observed an opposite relationship-due to the shutdown of the hospitality industry and cancellation of events, common places and occasions for social drinking of alcoholic beverages were not available; consequently, alcohol consumption in Innsbruck, Austria, dropped from 12.6 to 9.9 kg day −1 1000 inh −1 [3], and in selected Slovak cities during the lockdown, it was reported to decrease ca 20% compared to the period of milder restrictions [38]. However, it is important to note that the relationship between pandemic limitations and alcohol consumption is complex.…”