Methanol related deaths in Edirne

Determination of water content in dimethyl sulfoxide/N,N-dimethyl formamide and methanol content in ethanol by solvatochromism of azo dye, 2-(tert-butyl)-4-methoxy-6-(naphthalen-1-yldiazenyl) phenol

A novel 2-(tert-butyl)-4-methoxy-6-(naphthalen-1-yldiazenyl)phenol (NAP) was synthesized by coupling reaction of 2-tert-butyl-4-methoxyphenol with diazotized naphthylamine as diazo component. The azo dye was characterized by NMR, FT-IR and UV-vis spectroscopic techniques. The visible spectrum of NAP was recorded in different solvents and at different pHs. NAP exhibited a large wavelength shift with increasing solvent polarity, showing significant color change over a wide range in different solvents. The determination of water content in organic solvents miscible with water such as dimethyl sulfoxide (DMSO)/N,N-dimethyl formamide (DMF) and methanol content in ethanol, which is also a common mixture were investigated with NAP which is azo dye. The present reported solvatochromic compound for the determination of water content in DMSO/DMF and methanol content in ethanol showed a fairly wide linear range compared to some previously reported solvatochromic compounds in the literature. In addition, the solvatochromism of NAP allows the determination of methanol content in ethanol, which has caused many deaths, with a fast, cheap and easy method.

Methanol poisoning in Turkey: Two outbreaks, a single center experience

OBJECTIVES

Methanol poisoning is still one of the major causes of mortality due to intoxication because of the challenging diagnosis and late hospital admissions. We aimed to evaluate epidemiological data, clinical characteristics, laboratory findings, treatment protocols, and prognosis of patients in a tertiary hospital in two different methanol outbreaks occurring in a three-year interval.

METHODS

The study was planned as a single-center and retrospective observational case series study. Patients ≥18 years of age who were admitted to the hospital between 1 September 2016 and 1 September 2019 and diagnosed with methanol poisoning were included in the study.

RESULTS

Sixty-seven patients whose data were sufficient and accessible were included in the study. Thirty-five (52.2%) patients were discharged without sequelae, 14 (20.9%) patients were discharged with sequelae (both central nervous system sequelae and visual sequelae in 3 patients, only visual sequelae in 11 patients) and 18 (26.9%) patients died. High anion gap (AG) metabolic acidosis (pH < 7.07, AG > 26.7), low Glasgow Coma Score, and increased lactate (lactate > 2.55 mmol/L) levels were found to be associated with poor outcome. Folate use in treatment did not have a statistically significant effect (p = 0.087) on the prevention of visual sequelae development, but it had a statistically significant effect on mortality (p = 0.041).

CONCLUSIONS

State of consciousness and the severity of metabolic acidosis were significant parameters associated with mortality. In addition to antidote and elimination therapies, given the benefit on mortality and low risk of adverse events, folate therapy should be considered for all patients with significant toxic methanol exposures.

Scotch Tape Optical Vapor Sensor for Ethanol-Methanol Mixtures

A simple optical vapor sensor based on conventional Scotch adhesive tape, for analyzing ethanol-methanol mixtures, is proposed and demonstrated. The sensing signal relies on the variation of optical power transmitted through the tape, resulting from the response of the adhesive material to vapor sorption. The optical sensor exhibits high selectivity for ethanol vapor over methanol vapor. When exposed to vapors from ethanol-methanol liquid mixtures, the sensor shows a linear detection range of 0-100 vol%, and detection limits of 8.8 vol% ethanol and 17.6 vol% methanol. Repeatability, reproducibility, reversibility, and sensitivity to other volatile organic compounds are also studied.

"It can't happen to me": Alcohol drinkers on the 2012 outbreak of methanol poisonings and the subsequent prohibition in the Czech Republic

Background

In September 2012, a series of methanol poisonings occurred in the Czech Republic as a result of an influx of illicit alcohol into (predominantly) cheap alcoholic beverages on the retail market. The public authorities decided to prevent public health risks by prohibiting sales of liquors that contained more than 20% alcohol (> 20% liquor). The "partial" prohibition lasted for almost two weeks, but the poisonings still continued. This article assesses the impact of the methanol poisoning risks and the (partial) prohibition on alcohol drinking patterns, and describes the understanding of risks and their mitigation in vulnerable groups.

Methods

The rapid assessment and response method (RAR) was used during the (partial) alcohol prohibition. Semi-structured interviews were conducted with respondents recruited for the study in alcohol-intake settings (e.g., bars and restaurants, street alcohol outlets) in six regions. In total, 107 alcohol users were interviewed, mostly with risky drinking patterns (69% scored ≥ 1 on the CAGE scale), and 53 alcohol retailers/staff members serving alcohol.

Results

About one third of the alcohol users in the study (35%) drank > 20% liquors during the prohibition; a higher score on the CAGE scale was associated with a lower probability of drinking > 20% liquors during the period of the prohibition, probably because of the perception of being at high risk of poisoning. There was some increase in drinking liquors with an alcohol content less than 20%. Those who continued drinking > 20% liquors typically did so in the belief that some sources of these were safe.

Conclusions

Public policies aimed at reducing the risk of methanol poisonings in emergency situations should adopt broader measures than those focusing on market control. These measures include increased access to brief interventions, addressing the strategies that alcohol consumers adopt to prevent risk, and, in general, helping consumers make informed choices to prevent further fatalities.

Analysis of methanol and its derivatives in illegally produced alcoholic beverages

INTRODUCTION

Illegal alcohol production remains as a common issue worldwide. Methanol poisoning mostly occurs because of the methanol used in production of counterfeit alcohol instead of ethyl alcohol due to its low price or by drinking the liquids containing methyl alcohol. Pectolytic enzymes results in an increase of methanol levels in many fermentation products such as ciders or wines. Methanol poisonings are infrequently encountered in forensic medicine practice. However, sporadic cases due to methanol intoxication as well as epidemic cases have been reported. In this study, we aimed to identify existence of methanol and its metabolites in illegally produced alcoholic beverages used in Antakya region.

MATERIAL AND METHODS

Twelve legally produced alcohol samples and Fifty-six different illegally produced alcohol samples were collected from the markets and local producers. Existence of methanol, formic acid, methyl amine, methyl formate and trioxan were determined using GC-MS method in these samples.

RESULTS

Fifty-six different illegal alcohol samples were analyzed in this study and methanol was detected in 39 (75%) of samples. Formic acid was detected in 3, formamide in 1, methyl amine in 6, methyl formate in 10 and trioxan in 2 samples.

CONCLUSION

Overwhelming majority of illegal alcoholic beverages was detected to contain methanol. Interestingly this study also revealed the presence of trioxane, which has not previously reported among toxic agents in illegal alcohol samples.

A systematic review of the epidemiology of unrecorded alcohol consumption and the chemical composition of unrecorded alcohol

BACKGROUND AND AIMS

Unrecorded alcohol constitutes about 30% of all alcohol consumed globally. The aims of this systematic review were to determine the epidemiology (occurrence, types, prevalence) of unrecorded alcohol consumption in different countries/regions, analyse the chemical composition of unrecorded alcohol and examine health outcomes caused by the consumption of unrecorded alcohol, based on either epidemiology or toxicology.

METHODS

A systematic search for, and qualitative analysis of, papers with empirical results on the different categories of unrecorded alcohol, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

Unrecorded alcohol was widespread in all regions of the world. Artisanal fermented beverages and spirits were the most common categories of unrecorded alcohol globally, and were available on all continents. In India, industrially produced spirits (country spirits) were most prevalent. In Russia and countries of the former Soviet Union, surrogate alcohols complemented artisanal spirits. Cross-border shopping was the most prevalent method of obtaining unrecorded alcohol in parts of Europe. Ethanol was the most harmful ingredient of unrecorded alcohol, and health consequences due to other ingredients found in unrecorded alcohol were scarce. However, as unrecorded alcohol is usually the least expensive form of alcohol available in many countries, it may contribute to higher rates of chronic and irregular heavy drinking.

CONCLUSIONS

Very large amounts of alcohol are produced globally that go unrecorded. The primary harm from this kind of alcohol arises from the fact that it is typically much cheaper than licit alcohol.

Fatal methanol poisoning

Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected.

Fatal methanol poisoning: features of liver histopathology

Methanol poisoning has become a considerable problem in Iran. Liver can show some features of poisoning after methanol ingestion. Therefore, our concern was to examine liver tissue histopathology in fatal methanol poisoning cases in Iranian population. In this study, 44 cases of fatal methanol poisoning were identified in a year. The histological changes of the liver were reviewed. The most striking features of liver damage by light microscopy were micro-vesicular steatosis, macro-vesicular steatosis, focal hepatocyte necrosis, mild intra-hepatocyte bile stasis, feathery degeneration and hydropic degeneration. Blood and vitreous humor methanol concentrations were examined to confirm the proposed history of methanol poisoning. The majority of cases were men (86.36%). In conclusion, methanol poisoning can cause histological changes in liver tissues. Most importantly in cases with mean blood and vitreous humor methanol levels greater than 127 ± 38.9 mg/dL more than one pathologic features were detected.

Unrecorded consumption, quality of alcohol and health consequences

ISSUES

This contribution aims to examine systematically the evidence on the impact of the quality of unrecorded alcohol products on health consequences.

APPROACH

Systematic computer assisted review of the literature.

KEY FINDINGS

There are a number of pathways related to alcohol quality that may lead to acute or chronic health problems. The following constituents and contaminants of alcoholic beverages were identified as likely contributors to these problems: (i) toxic metals (e.g. lead) from contaminated water sources or unsuitable distillation equipment; (ii) volatile constituents, such as acetaldehyde or higher alcohols, which may be produced in significant amounts due to faults in production technology or microbiological spoilage; (iii) ethyl carbamate (urethane), a carcinogenic contaminant with major occurrence in certain fruit and sugarcane spirits; (iv) biologically active flavour compounds (e.g. coumarin in cosmetics used as non-beverage alcohol); (v) toxic compounds used to denature alcohol (e.g. methanol or diethyl phthalate). In addition, the often higher ethanol content may have detrimental health effects. These pathways should not be assumed as present for all subcategories of unrecorded alcohol, but are more relevant to certain types and geographic regions.

IMPLICATIONS

A health impact of unrecorded alcohol over and above the effect of ethanol cannot be excluded. More research is urgently needed, especially with respect to liver disease and alcohol poisoning as endpoints.

CONCLUSION

A feasible approach for new research on the effects of unrecorded alcohol could be based on a representative sample from low socioeconomic regions with high prevalence of unrecorded consumption.

Surrogate alcohol: what do we know and where do we go?

BACKGROUND

Consumption of surrogate alcohols (i.e., nonbeverage alcohols and illegally produced alcohols) was shown to impact on different causes of death, not only poisoning or liver disease, and appears to be a major public health problem in Russia and elsewhere.

METHODS

A computer-assisted literature review on chemical composition and health consequences of "surrogate alcohol" was conducted and more than 70 references were identified. A wider definition of the term "surrogate alcohol" was derived, including both nonbeverage alcohols and illegally produced alcohols that contain nonbeverage alcohols.

RESULTS

Surrogate alcohol may contain substances that cause severe health consequences including death. Known toxic constituents include lead, which may lead to chronic toxicity, and methanol, which leads to acute poisoning. On the other hand, the role of higher alcohols (e.g., propanol, isobutanol, and isoamyl alcohol) in the etiology of surrogate-associated diseases is currently unclear. Whether other constituents of surrogates have contributed to the high all-cause mortality over and above the effect of ethanol in recent studies also remains unclear.

CONCLUSIONS

Given the high public health importance associated with the consumption of surrogate alcohols, further knowledge on its chemical composition is required as well as research on its links to various disease endpoints should be undertaken with priority. Some interventions to reduce the harm resulting from surrogate alcohol could be undertaken already at this point. For example, the use of methanol or methanol-containing wood alcohol should be abolished in denatured alcohol. Other possible surrogates (e.g., automobile products) should be treated with bittering agents to avoid consumption.