Heavy metals in unrecorded Albanian rakia: A pilot study on a potential public health risk

Unrecorded alcohol has been linked to illness above and beyond that caused by ethanol alone because of the presence of toxic contaminants. While it can be found in all countries, consumption is high in Albania, where it is frequently consumed as a fruit brandy known as rakia. Among the contaminants identified previously in such products, metals including lead have been detected at levels posing a risk to health but there is little information on their presence in rakia. To fill this gap, we measured the level of ethanol and 24 elements among them toxic metals in 30 Albanian rakia samples. We found that 63.3% of rakia samples had ethanol concentration above 40% v/v. We also showed that there was a significant difference between the measured [mean: 46.7% v/v, interquartile range (IQR): 43.4-52.1% v/v] and reported (mean: 18.9% v/v, IQR: 17.0-20.0% v/v) concentrations of ethanol in rakia. Among the metals detected, aluminium, copper, iron, manganese, lead, and zinc were present in rakia samples at concentrations ranging between 0.013 and 0.866 mg/l of pure alcohol (pa), 0.025-31.629 mg/l of pa, 0.004-1.173 mg/l of pa, 0.185-45.244 mg/l of pa, 0.044-1.337 mg/l of pa, and 0.004-10.156 mg/l of pa, respectively. Copper and lead were found to be the greatest concern posing a potential public health risk. Although the estimated daily intake of these heavy metals from unrecorded rakia was below their toxicological threshold, the concentrations of lead and copper exceeded their limit value of 0.2 and 2.0 mg/l of pa specified for spirits in 33% and 90% of samples, respectively. Therefore, the possibility of adverse health effects cannot be excluded completely. Our findings highlight the need for action by policymakers against the risks posed by these products in Albania.

Health and economic gain attributable to the introduction of the World Health Organization's drinking water standard on arsenic level in Hungary: A nationwide retrospective study on cancer occurrence and ischemic heart disease mortality

The World Health Organization (WHO) estimates that 140 million individuals are at risk from consumption of drinking water containing arsenic at concentrations above the WHO guideline value of 10 μg/l. Arsenic mitigation is considered to be the most effective way to prevent arsenic related diseases. After joining the European Union, Hungary implemented a Drinking Water Quality Improvement Programme (DWQIP) to reduce levels of arsenic in drinking water below the WHO guideline value. But what impact did this have on health? We estimated the change in lifetime excess skin, lung, and bladder cancer risks and mortality from ischaemic heart disease (IHD) associated with chronic arsenic intake among those exposed before (2004-2007) and after (2014-2017) the implementation of DWQIP. A population-based risk assessment approach was used to assess lifetime excess cancer risk applying two scenarios for lung and bladder cancers. The economic benefits of the DWQIP were estimated by the combination of cost of illness and value per statistical life methods. Compared to the period before the DWQIP, its implementation was associated with a significant reduction in arsenic in drinking water [median: 3.0 μg/l interquartile range (IQR): 1.5-12.0 μg/l to median: 2.15 μg/l IQR: 1.0-5.79 μg/l]. The two scenarios were estimated to be associated with 225.2 and 35.9 fewer cancer cases each year. The number of annually prevented IHD deaths was estimated to be 88.9. It was estimated that the benefits of the DWQIP will outweigh its costs. We conclude that reducing arsenic levels in drinking water to 10.0 μg/l resulted in significant health and economic benefits. Our study goes beyond the existing research, offering both new insights into the impact of arsenic mitigation and providing a methodological template for similar studies in the many parts of the world that have yet to reduce arsenic exposure.

Methanol in unrecorded fruit spirits. Does it pose a health risk to consumers in the European Union? A probabilistic toxicological approach

Methanol is present at high concentrations in unrecorded fruit spirits, placing consumers of these beverages at risk of exposure at high levels. When assessing any health risk it is necessary to consider blood methanol levels (BMLs), reference dose (RfD), and maximum tolerable blood methanol level (MTBML). The aim of our study was to estimate daily methanol intake and related BMLs attributable to drinking unrecorded fruit spirits in the European population using a probabilistic Monte Carlo simulation. Data on the concentration of methanol in unrecorded fruit spirits in European Union member states were collected and the health risk posed by consumption of unrecorded fruit spirits was estimated. We found that drinking unrecorded fruit spirits containing methanol at a concentration higher than 8598.1 mg/litre of pure alcohol (p.a.) or 6382.1 mg/litre of p.a. and also at least 10 g ethanol can result in a methanol intake above the RfD by men and women, respectively. We confirmed that consumption of unrecorded fruit spirits containing methanol does not result in BMLs higher than the MTBML. Further studies are required to assess whether there is any health risk from chronic exposure to methanol above the RfD from unrecorded fruit spirits.

Heavy metal contamination in recorded and unrecorded spirits. Should we worry?

Heavy metals can be released into all alcoholic beverages during production and storage. However, there is at least a theoretical risk that they could be present in higher, and potentially toxic, concentrations in those produced in the household and small-scale stills common in Central and Eastern Europe, which lack quality control and whose products are unrecorded by authorities. Yet, so far, few studies comparing concentrations of heavy metals in recorded and unrecorded spirits have been published. In this study we ask whether there is any difference between heavy metal concentrations in recorded and unrecorded spirits and, thus, the related health risk. The levels of heavy metals were determined in recorded (n = 97) and unrecorded (n = 100) spirits using inductively coupled plasma optical emission spectrometric analysis and applied to population-based risk assessments, considering average, regular and chronic heavy drinkers. Concentrations of Cu, Zn, and Sn were significantly higher in unrecorded spirits than those in their recorded counterparts and recorded spirits contained significantly higher levels of Fe, Mn, and Ni than unrecorded spirits. Combined exposure to heavy metals posed a potential health risk in chronic heavy drinkers consuming recorded spirits. However, when compared to the health risk arising from drinking large volumes of ethanol, the risk is negligible. Consequently, there are no grounds to worry about the adverse effects of heavy metals from spirits.