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Lee JY, Kim M, Kim J, Im H, Kim YS. Monitoring, exposure and risk assessment of formaldehyde in alcoholic beverages in Korea. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2024; 41:237-248. [PMID: 38315754 DOI: 10.1080/19440049.2024.2306540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024]
Abstract
Formaldehyde occurs naturally in food and alcoholic beverages. Formaldehyde and alcoholic beverages can cause various health problems, including irritation of the eyes, nose, and throat, respiratory problems, and skin rashes. Alcoholic beverage samples (N = 236) were collected and analyzed for formaldehyde by liquid chromatography-tandem mass spectrometry. The highest average concentrations were detected in fruit wines (1.71 µg/g), followed by wines (1.15 µg/g), cheongju (0.95 µg/g), soju (0.85 µg/g), takju (0.64 µg/g) and beers (0.61 µg/g). We assessed the exposure and risk assessment to formaldehyde from alcoholic beverages based on the monitoring data for the general population and consumers in Korea using various schemes for point estimation. The daily intakes of formaldehyde for the general population and consumers were estimated to be 83 µg and 1202 µg, respectively. The mean hazard indexes (HI) for the general population and consumers in Korea were 0.009 and 0.132, respectively. On the other hand, the mean hazard indexes (HI) for the general population and consumers in Korea were 0.009 and 0.132, respectively. The exposure to formaldehyde in these alcoholic beverages for the Korean population was shown to be of low concern, but it is necessary to monitor the level of formaldehyde in alcoholic beverages and continuously conduct exposure assessment for consumers.
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Affiliation(s)
- Ji-Yoon Lee
- Department of Food Science and Biotechnology, Ewha Womans University, Seoul, Republic of Korea
| | - Meehye Kim
- Department of Food Science and Biotechnology, Ewha Womans University, Seoul, Republic of Korea
| | - Jongdae Kim
- PeakmanSP CO., LTD, Hanam, Gyeonggi-do, Republic of Korea
| | - Hobin Im
- PeakmanSP CO., LTD, Hanam, Gyeonggi-do, Republic of Korea
| | - Young-Suk Kim
- Department of Food Science and Biotechnology, Ewha Womans University, Seoul, Republic of Korea
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2
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Liao H, Asif H, Huang X, Luo Y, Xia X. Mitigation of microbial nitrogen-derived metabolic hazards as a driver for safer alcoholic beverage choices: An evidence-based review and future perspectives. Compr Rev Food Sci Food Saf 2023; 22:5020-5062. [PMID: 37823801 DOI: 10.1111/1541-4337.13253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
Alcoholic beverages have been enjoyed worldwide as hedonistic commodities for thousands of years. The unique quality and flavor are attributed to the rich microbiota and nutritional materials involved in fermentation. However, the metabolism of these microbiota can also introduce toxic compounds into foods. Nitrogen-derived metabolic hazards (NMH) are toxic metabolic hazards produced by microorganisms metabolizing nitrogen sources that can contaminate alcoholic beverages during fermentation and processing. NMH contamination poses a risk to dietary safety and human health without effective preventive strategies. Existing literature has primarily focused on investigating the causes of NMH formation, detection methods, and abatement techniques for NMH in fermentation end-products. Devising effective process regulation strategies represents a major challenge for the alcoholic beverage industry considering our current lack of understanding regarding the processes whereby NMH are generated, real-time and online detection, and the high degradation rate after NMH formation. This review summarizes the types and mechanisms of nitrogenous hazard contamination, the potential risk points, and the analytical techniques to detect NMH contamination. We discussed the changing patterns of NMH contamination and effective strategies to prevent contamination at different stages in the production of alcoholic beverages. Moreover, we also discussed the advanced technologies and methods to control NMH contamination in alcoholic beverages based on intelligent monitoring, synthetic ecology, and computational assistance. Overall, this review highlights the risks of NMH contamination during alcoholic beverage production and proposes promising strategies that could be adopted to eliminate the risk of NMH contamination.
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Affiliation(s)
- Hui Liao
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, P. R. China
| | - Hussain Asif
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, P. R. China
| | - Xinlei Huang
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, P. R. China
| | - Yi Luo
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, P. R. China
| | - Xiaole Xia
- The Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Wuxi, P. R. China
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3
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Xue S, Dong N, Xiong K, Guo H, Dai Y, Liang H, Chen Y, Lin X, Zhu B, Zhang S. The Screening and Isolation of Ethyl-Carbamate-Degrading Strains from Fermented Grains and Their Application in the Degradation of Ethyl Carbamate in Chinese Baijiu. Foods 2023; 12:2843. [PMID: 37569112 PMCID: PMC10416978 DOI: 10.3390/foods12152843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Ethyl carbamate (EC), a 2A carcinogen produced during the fermentation of foods and beverages, primarily occurs in distilled spirits. Currently, most studies focus on strategies for EC mitigation. In the present research, we aimed to screen strains that can degrade EC directly. Here, we report two Candida ethanolica strains (J1 and J116), isolated from fermented grains, which can reduce EC concentrations directly. These two yeasts were grown using EC as the sole carbon source, and they grew well on different carbon sources. Notably, after immobilization with chitosan, the two strains degraded EC in Chinese Baijiu by 42.27% and 27.91% in 24 h (from 253.03 ± 9.89 to 146.07 ± 1.67 and 182.42 ± 5.05 μg/L, respectively), which was better than the performance of the non-immobilized strains. Furthermore, the volatile organic compound content, investigated using gas chromatography-mass spectrometry, did not affect the main flavor substances in Chinese Baijiu. Thus, the yeasts J1 and J116 may be potentially used for the treatment and commercialization of Chinese Baijiu.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Sufang Zhang
- SKL of Marine Food Processing & Safety Control, National Engineering Research Center of Seafood, School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China; (S.X.); (N.D.); (K.X.); (H.G.); (Y.D.); (H.L.); (Y.C.); (X.L.)
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Abt E, Incorvati V, Robin LP, Redan BW. Occurrence of Ethyl Carbamate in Foods and Beverages: Review of the Formation Mechanisms, Advances in Analytical Methods, and Mitigation Strategies. J Food Prot 2021; 84:2195-2212. [PMID: 34347857 PMCID: PMC9092314 DOI: 10.4315/jfp-21-219] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/02/2021] [Indexed: 11/11/2022]
Abstract
ABSTRACT Ethyl carbamate (EC) is a process contaminant that can be formed as a by-product during fermentation and processing of foods and beverages. Elevated EC concentrations are primarily associated with distilled spirits, but this compound has also been found at lower concentrations in foods and beverages, including breads, soy sauce, and wine. Evidence from animal studies suggests that EC is a probable human carcinogen. Consequently, several governmental institutions have established allowable limits for EC in the food supply. This review includes EC formation mechanisms, occurrence of EC in the food supply, and EC dietary exposure assessments. Current analytical methods used to detect EC will be covered, in addition to emerging technologies, such as nanosensors and surface-enhanced Raman spectroscopy. Various mitigation methods have been used to maintain EC concentrations below allowable limits, including distillation, enzymatic treatments, and genetic engineering of yeast. More research in this field is needed to refine mitigation strategies and develop methods to rapidly detect EC in the food supply. HIGHLIGHTS
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Manning L, Kowalska A. Illicit Alcohol: Public Health Risk of Methanol Poisoning and Policy Mitigation Strategies. Foods 2021; 10:1625. [PMID: 34359495 PMCID: PMC8303512 DOI: 10.3390/foods10071625] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 12/16/2022] Open
Abstract
Illicit (unrecorded) alcohol is a critical global public health issue because it is produced without regulatory and market oversight with increased risk of safety, quality and adulteration issues. Undertaking iterative research to draw together academic, contemporary and historic evidence, this paper reviews one specific toxicological issue, methanol, in order to identify the policy mitigation strategies of interest. A typology of illicit alcohol products, including legal products, illegal products and surrogate products, is created. A policy landscape matrix is produced that synthesizes the drivers of illicit alcohol production, distribution, sale and consumption, policy measures and activity related signals in order to inform policy development. The matrix illustrates the interaction between capabilities, motivations and opportunities and factors such as access, culture, community norms and behavior, economic drivers and knowledge and information and gives insight into mitigation strategies against illicit alcohol sale and consumption, which may prove of value for policymakers in various parts of the world.
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Affiliation(s)
- Louise Manning
- School of Agriculture, Food and the Environment, Royal Agricultural University, Stroud Road, Cirencester GL7 6JS, UK
| | - Aleksandra Kowalska
- Institute of Economics and Finance, Maria Curie-Skłodowska University, pl. Marii Curie-Skłodowskiej 5, 20-031 Lublin, Poland;
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6
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Wang Y, Liu Y, Huang X, Xiao Z, Yang Y, Yu Q, Chen S, He L, Liu A, Liu S, Zou L, Yang Y. A Review on Mechanistic Overview on the Formation of Toxic Substances during the Traditional Fermented Food Processing. FOOD REVIEWS INTERNATIONAL 2021. [DOI: 10.1080/87559129.2021.1933021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Yilun Wang
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Yuxuan Liu
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Xiaohong Huang
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Zihan Xiao
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Yifang Yang
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Qinxin Yu
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Shujuan Chen
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Li He
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Aiping Liu
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Shuliang Liu
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
| | - Likou Zou
- College of Resource, Sichuan Agricultural University, Chengdu PR China
| | - Yong Yang
- College of Food Science, Sichuan Agricultural University, Ya’an PR China
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7
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Jayakody LN, Jin YS. In-depth understanding of molecular mechanisms of aldehyde toxicity to engineer robust Saccharomyces cerevisiae. Appl Microbiol Biotechnol 2021; 105:2675-2692. [PMID: 33743026 DOI: 10.1007/s00253-021-11213-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/17/2021] [Accepted: 02/28/2021] [Indexed: 11/25/2022]
Abstract
Aldehydes are ubiquitous electrophilic compounds that ferment microorganisms including Saccharomyces cerevisiae encounter during the fermentation processes to produce food, fuels, chemicals, and pharmaceuticals. Aldehydes pose severe toxicity to the growth and metabolism of the S. cerevisiae through a variety of toxic molecular mechanisms, predominantly via damaging macromolecules and hampering the production of targeted compounds. Compounds with aldehyde functional groups are far more toxic to S. cerevisiae than all other functional classes, and toxic potency depends on physicochemical characteristics of aldehydes. The yeast synthetic biology community established a design-build-test-learn framework to develop S. cerevisiae cell factories to valorize the sustainable and renewable biomass, including the lignin-derived substrates. However, thermochemically pretreated biomass-derived substrate streams contain diverse aldehydes (e.g., glycolaldehyde and furfural), and biological conversions routes of lignocellulosic compounds consist of toxic aldehyde intermediates (e.g., formaldehyde and methylglyoxal), and some of the high-value targeted products have aldehyde functional group (e.g., vanillin and benzaldehyde). Numerous studies comprehensively characterized both single and additive effects of aldehyde toxicity via systems biology investigations, and novel molecular approaches have been discovered to overcome the aldehyde toxicity. Based on those novel approaches, researchers successfully developed synthetic yeast cell factories to convert lignocellulosic substrates to valuable products, including aldehyde compounds. In this mini-review, we highlight the salient relationship of physicochemical characteristics and molecular toxicity of aldehydes, the molecular detoxification and macromolecules protection mechanisms of aldehydes, and the advances of engineering robust S. cerevisiae against complex mixtures of aldehyde inhibitors. KEY POINTS: • We reviewed structure-activity relationships of aldehyde toxicity on S. cerevisiae. • Two-tier protection mechanisms to alleviate aldehyde toxicity are presented. • We highlighted the strategies to overcome the synergistic toxicity of aldehydes.
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Affiliation(s)
- Lahiru N Jayakody
- School of Biological Sciences, Southern Illinois University Carbondale, Carbondale, IL, USA.
- Fermentation Science Institute, Southern Illinois University Carbondale, Carbondale, IL, USA.
| | - Yong-Su Jin
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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8
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Xu X, Niu C, Liu C, Li Q. Unraveling the Mechanisms for Low-Level Acetaldehyde Production during Alcoholic Fermentation in Saccharomyces pastorianus Lager Yeast. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:2020-2027. [PMID: 30666873 DOI: 10.1021/acs.jafc.8b06868] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Acetaldehyde is produced by yeast during alcoholic fermentation, and its modification greatly affects beer flavor and quality. In the current study, we analyzed two yeast strains with a low level of acetaldehyde to reveal the potential mechanism underpinning the desirable low acetaldehyde production by these strains. We demonstrated that high alcohol dehydrogenase (ADH) activity and high NADH availability were the dominant factors for the low level of acetaldehyde in the fermentation liquor at the end of fermentation. High ADH activity resulted in reduced accumulation of acetaldehyde during the cell growth phase by increasing the flux to ethanol, whereas high NADH availability (in the cytosol or mitochondria) enhanced acetaldehyde reduction at the later phase of main fermentation. Furthermore, NADH availability is a more useful target trait than ADH activity for constructing yeast strains with a low level of acetaldehyde for industrial applications in terms of flavor contribution and unaltered fermentation period.
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Affiliation(s)
- Xin Xu
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology , Jiangnan University , Wuxi , Jiangsu 214122 , People's Republic of China
- State Key Laboratory of Food Science and Technology , Jiangnan University , Wuxi , Jiangsu 214000 , People's Republic of China
- School of Biotechnology , Jiangnan University , 1800 Lihu Avenue , Wuxi , Jiangsu 214122 , People's Republic of China
| | - Chengtuo Niu
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology , Jiangnan University , Wuxi , Jiangsu 214122 , People's Republic of China
- State Key Laboratory of Food Science and Technology , Jiangnan University , Wuxi , Jiangsu 214000 , People's Republic of China
- School of Biotechnology , Jiangnan University , 1800 Lihu Avenue , Wuxi , Jiangsu 214122 , People's Republic of China
| | - Chunfeng Liu
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology , Jiangnan University , Wuxi , Jiangsu 214122 , People's Republic of China
- State Key Laboratory of Food Science and Technology , Jiangnan University , Wuxi , Jiangsu 214000 , People's Republic of China
- School of Biotechnology , Jiangnan University , 1800 Lihu Avenue , Wuxi , Jiangsu 214122 , People's Republic of China
| | - Qi Li
- Key Laboratory of Industrial Biotechnology, Ministry of Education, School of Biotechnology , Jiangnan University , Wuxi , Jiangsu 214122 , People's Republic of China
- State Key Laboratory of Food Science and Technology , Jiangnan University , Wuxi , Jiangsu 214000 , People's Republic of China
- School of Biotechnology , Jiangnan University , 1800 Lihu Avenue , Wuxi , Jiangsu 214122 , People's Republic of China
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9
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Dzialo MC, Park R, Steensels J, Lievens B, Verstrepen KJ. Physiology, ecology and industrial applications of aroma formation in yeast. FEMS Microbiol Rev 2017; 41:S95-S128. [PMID: 28830094 PMCID: PMC5916228 DOI: 10.1093/femsre/fux031] [Citation(s) in RCA: 206] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/06/2017] [Indexed: 01/05/2023] Open
Abstract
Yeast cells are often employed in industrial fermentation processes for their ability to efficiently convert relatively high concentrations of sugars into ethanol and carbon dioxide. Additionally, fermenting yeast cells produce a wide range of other compounds, including various higher alcohols, carbonyl compounds, phenolic compounds, fatty acid derivatives and sulfur compounds. Interestingly, many of these secondary metabolites are volatile and have pungent aromas that are often vital for product quality. In this review, we summarize the different biochemical pathways underlying aroma production in yeast as well as the relevance of these compounds for industrial applications and the factors that influence their production during fermentation. Additionally, we discuss the different physiological and ecological roles of aroma-active metabolites, including recent findings that point at their role as signaling molecules and attractants for insect vectors.
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Affiliation(s)
- Maria C Dzialo
- Laboratory for Genetics and Genomics, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Gaston Geenslaan 1, B-3001 Leuven, Belgium
- Laboratory for Systems Biology, VIB Center for Microbiology, Bio-Incubator, Gaston Geenslaan 1, 3001 Leuven, Belgium
| | - Rahel Park
- Laboratory for Genetics and Genomics, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Gaston Geenslaan 1, B-3001 Leuven, Belgium
- Laboratory for Systems Biology, VIB Center for Microbiology, Bio-Incubator, Gaston Geenslaan 1, 3001 Leuven, Belgium
| | - Jan Steensels
- Laboratory for Genetics and Genomics, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Gaston Geenslaan 1, B-3001 Leuven, Belgium
- Laboratory for Systems Biology, VIB Center for Microbiology, Bio-Incubator, Gaston Geenslaan 1, 3001 Leuven, Belgium
| | - Bart Lievens
- Laboratory for Process Microbial Ecology and Bioinspirational Management (PME&BIM), Department of Microbial and Molecular Systems, KU Leuven, Campus De Nayer, Fortsesteenweg 30A B-2860 Sint-Katelijne Waver, Belgium
| | - Kevin J Verstrepen
- Laboratory for Genetics and Genomics, Centre of Microbial and Plant Genetics (CMPG), KU Leuven, Gaston Geenslaan 1, B-3001 Leuven, Belgium
- Laboratory for Systems Biology, VIB Center for Microbiology, Bio-Incubator, Gaston Geenslaan 1, 3001 Leuven, Belgium
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10
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Pflaum T, Hausler T, Baumung C, Ackermann S, Kuballa T, Rehm J, Lachenmeier DW. Carcinogenic compounds in alcoholic beverages: an update. Arch Toxicol 2016; 90:2349-67. [PMID: 27353523 DOI: 10.1007/s00204-016-1770-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 06/15/2016] [Indexed: 01/01/2023]
Abstract
The consumption of alcoholic beverages has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC) since 1988. More recently, in 2010, ethanol as the major constituent of alcoholic beverages and its metabolite acetaldehyde were also classified as carcinogenic to humans. Alcoholic beverages as multi-component mixtures may additionally contain further known or suspected human carcinogens as constituent or contaminant. This review will discuss the occurrence and toxicology of eighteen carcinogenic compounds (acetaldehyde, acrylamide, aflatoxins, arsenic, benzene, cadmium, ethanol, ethyl carbamate, formaldehyde, furan, glyphosate, lead, 3-MCPD, 4-methylimidazole, N-nitrosodimethylamine, pulegone, ochratoxin A, safrole) occurring in alcoholic beverages as identified based on monograph reviews by the IARC. For most of the compounds of alcoholic beverages, quantitative risk assessment provided evidence for only a very low risk (such as margins of exposure above 10,000). The highest risk was found for ethanol, which may reach exposures in ranges known to increase the cancer risk even at moderate drinking (margin of exposure around 1). Other constituents that could pose a risk to the drinker were inorganic lead, arsenic, acetaldehyde, cadmium and ethyl carbamate, for most of which mitigation by good manufacturing practices is possible. Nevertheless, due to the major effect of ethanol, the cancer burden due to alcohol consumption can only be reduced by reducing alcohol consumption in general or by lowering the alcoholic strength of beverages.
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Affiliation(s)
- Tabea Pflaum
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany
| | - Thomas Hausler
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany
| | - Claudia Baumung
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany
| | - Svenja Ackermann
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany
| | - Thomas Kuballa
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany
| | - Jürgen Rehm
- Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, M5S 2S1, Canada.,Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada.,Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Dirk W Lachenmeier
- Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, 76187, Karlsruhe, Germany. .,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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