Illicit Alcohol: Public Health Risk of Methanol Poisoning and Policy Mitigation Strategies

Drivers of illicit alcohol consumption among at-risk populations aged 15-29 years old in Zambia: a qualitative perspective

Background

Illicit alcohol consumption is a major public health problem in Zambia and many other countries in Sub-Saharan Africa. This study aimed to determine drivers of illicit alcohol consumption among at-risk populations, such as youths, in selected urban areas in Zambia, using the social-ecological model as a lens to understand these drivers.

Methods

Through a qualitative approach, we conducted semi-structured interviews with 12 key stakeholders from the Ministry of Health, Zambia Revenue Authority, local council public health departments, and rehabilitation centers. We also interviewed 30 alcohol consumers who frequent alcohol retail settings such as bars or liquor stores. Participants were purposively selected based on their knowledge of illicit alcohol consumption.

Results

Social demographic factors such as age and sex were identified as key drivers. Adolescents as young as 10 years old initiated illicit consumption, with males constituting the majority of consumers. Limited job opportunities and recreational facilities in communities encouraged young people to consume illicit alcohol; this is worsened by the availability of alcohol in their social circles. Peer influence was also found to be a major driver of illicit alcohol consumption, as cultural norms normalized alcohol use. Lack of productive activities and economic disparities were also found to drive consumption among this group. Low-income individuals sought cheaper alternatives, such as home-distilled spirits or fermented alcohol, due to their affordability and availability in disadvantaged neighbourhoods. Social norms, such as the consumption of homemade alcoholic beverages during social gatherings such as weddings, were also significant drivers.

Conclusion

Despite policies and state agencies banning illicit alcohol sale and production, the sale of alcoholic beverages to young people and weak enforcement of regulations across the country, especially in urban areas increases young people's risk of consuming illicit alcohol. Applying the social-ecological model emphasizes the need for multi-level interventions. These interventions should target individuals, communities, and policy levels. Specifically, they should aim to regulate alcohol consumption, disrupt the social environments that promote illicit alcohol consumption, and ultimately facilitate positive behavior change among young people.

Methanol Induced Optic Neuropathy: Molecular Mysteries, Public Health Perspective, Clinical Insights and Treatment Strategies

Methanol-induced optic neuropathy (MION) represents a critical public health issue, particularly prevalent in lower socioeconomic populations and regions with restricted alcohol access. MION, characterized by irreversible visual impairment, arises from the toxic metabolization of methanol into formaldehyde and formic acid, leading to mitochondrial oxidative phosphorylation inhibition, oxidative stress, and subsequent neurotoxicity. The pathogenesis involves axonal and glial cell degeneration within the optic nerve and potential retinal damage. Despite advancements in therapeutic interventions, a significant proportion of affected individuals endure persistent visual sequelae. The study comprehensively investigates the pathophysiology of MION, encompassing the absorption and metabolism of methanol, subsequent systemic effects, and ocular impacts. Histopathological changes, including alterations in retinal layers and proteins, Müller cell dysfunction, and visual symptoms, are meticulously examined to provide insights into the disease mechanism. Furthermore, preventive measures and public health perspectives are discussed to highlight the importance of awareness and intervention strategies. Therapeutic approaches, such as decontamination procedures, ethanol and fomepizole administration, hemodialysis, intravenous fluids, electrolyte balance management, nutritional therapy, corticosteroid therapy, and erythropoietin (EPO) treatment, are evaluated for their efficacy in managing MION. This comprehensive review underscores the need for increased awareness, improved diagnostic strategies, and more effective treatments to mitigate the impact of MION on global health.

Age- and sex-standardized prevalence of alcohol consumption and its determinants in the western region of Iran, Ilam: a cross-sectional study

BACKGROUND AND OBJECTIVE

In recent years, alcohol consumption in different parts of Iran has increased. However, this growth was dramatic in deprived regions. The percent study aimed to determine the age-sex standardized prevalence of alcohol consumption and related factors in the general population of Ilam city during 2021-2022.

METHOD

This population-based cross-sectional study was conducted in the general population of Ilam city located in western Iran. A total of 1,431 individuals over the age of 15 were included in the study using multi-stage cluster sampling. Alcohol consumption was assessed using a Persian version of high-risk behavior questionnaire (Cronbach's alpha > 73%). Analysis was done by Stata version 11 and R Software. Logistic regression analysis was used for data analysis and calculating odds ratio (OR), and a significance level of 0.05 was considered.

RESULTS

In total 1,431 individuals completed the questionnaire. The mean ± standard deviation (SD) age of the study participants was 43.40 ± 15.51 years. The age-sex standardized prevalence with 95% confidence interval (CI) of alcohol consumption was 4.05% (95% CI: 3.09 to 5.20). Based on multiple logistic model, having a bachelor's degree (OR: 7.13; 95% CI: 1.89 to 26.76), cigarette smoking (OR: 6.92; 95% CI: 2.94 to 16.29), hookah smoking (OR: 7.34; 95% CI: 3.09 to 17.47) and drug abuse (OR: 2.88; 95% CI: 1.38 to 5.99) had a positive association with alcohol consumption. Furthermore, having a high economic status 0.62 (OR: 0.62; 95% CI: 0.26 to 1.48) had a negative association with alcohol consumption. The most powerful determinants (according to standardized coefficient) for alcohol consumption were hookah smoking (standardized coefficient: 0.588) and high education level (0.743).

CONCLUSION

Considering the prevalence of alcohol consumption in the population over 15 years old, it is necessary to take preventive and intervention measures, with more attention from health policymakers and other sectors.

Outcome assessment of acute methanol poisoning: A risk-prediction nomogram approach for in-hospital mortality

Acute methanol poisoning could be associated with high morbidities and fatalities. Stratifying high-risk patients is crucial in improving their prognosis. Hence, this study aimed to identify patients with methanol poisoning at high risk of in-hospital mortality. Also, the risk factors for blindness were assessed. The study included 180 acutely methanol-poisoned patients who received standard medical care. Out of 180 patients, 52 (28.9 %) patients presented with blindness, and 43 (23.9 %) patients died. The predictive model was based on four significant variables, including blindness, mean arterial pressure, serum bicarbonate, and serum creatinine. The presence of blindness and elevated serum creatinine significantly increased the likelihood of mortality by 14.274 and 5.670 times, respectively. Likewise, decreases in mean arterial pressure and serum bicarbonate significantly increased mortality risk by 0.908 and 0.407 times, respectively. The proposed nomogram exhibited excellent discriminatory power (area under the curve (AUC)=0.978, accuracy=93.3 %), which outperforms the AUCs of individual predictors. The provided nomogram is easily applicable with outstanding discrimination, making it clinically helpful in predicting in-hospital mortality in acutely methanol-poisoned patients. Regarding the risk factors for blindness, multivariable regression analysis revealed that delayed time for admission (OR=1.039; 95 % CI=1.010-1.069; p= 0.009) and elevated anion gap (OR=1.053; 95 % CI=1.007-1.101; p= 0.023) were significant risk factors. The current study assists physicians in identifying methanol-poisoned patients with a high probability of mortality or blindness on admission. Future studies are recommended for external validation of the created nomogram, in addition to follow-up for patients with visual impairment.

Navigating Food Fraud: A Survey of Nigerian Consumer Knowledge and Attitudes

Food fraud presents a growing threat globally, impacting consumer health; food safety; and brand credibility. The key motivation for food fraud is usually an economic or financial advantage. Economically motivated food fraud (EMA) is the illegal deception, deliberate and intentional substitution or addition of a substance in a food product, which may pose a possible health risk to unsuspecting consumers. This study aims to assess the awareness and attitudes of Nigerian consumers towards food authenticity and the regulatory measures in place to combat food adulteration. The study comprised 2160 respondents who were asked about their knowledge of high-profile food fraud incidents, frequently adulterated products, and their opinions of the effects of food fraud and preventative measures. The findings of this study revealed that more than a third of respondents were unfamiliar with the term "food fraud". However, they were aware of local high-profile cases, such as "plastic rice" and counterfeit dairy products. Most participants relied on point-of-sale information for assessing food authenticity, with street vendors being viewed as potential sources of food adulteration. The study also found that more than half of the respondents were concerned about food fraud regardless of whether it involved local or imported products. A wide variety of food items were identified as prone to adulteration or fraudulent activity. These included alcoholic drinks, dairy products, honey, rice, and tomato paste, amongst others. These findings highlight the need for improved consumer awareness, regulatory effectiveness, and remediation efforts to combat food fraud in Nigeria.

Optimisation and characterisation of KOH-activated carbon obtained from Baijiu spent grains for the mitigation of risk factors in alcoholic beverages

This study aims to repurpose waste grain from the Baijiu brewing process into activated carbon for mitigating risk factors in alcoholic beverages, enhancing quality and ensuring safety. For attaining the most effective activated carbon, tailored carbon synthesis conditions were identified for diverse alcoholic beverages, optimising strategies. For beverages with low flavour compound content, optimal conditions include 900 °C calcination, 16-hour activation and a 1:2 activation ratio. In contrast, for those with abundant flavour compounds, 800 °C calcination, 16-hour activation and a 1:1 activation ratio are recommended. Post-synthesis analyses, employing nitrogen physisorption-desorption isotherms, FT-IR and SEM, validated a significant BET surface area of 244.871 m2/g for the KOH-activated carbon. Critical to adsorption efficiency, calcination temperature showcased noteworthy micro-porosity (0.8-1 nm), selectively adsorbing higher alcohols (C3-C6) and acetaldehyde while minimising acid and ester adsorption. Sensory evaluations refined optimal parameters, ensuring efficient spent grain management and heightened beverage safety without compromising aroma.

Assessing Vodka Authenticity and Origin in Vietnam's Market: An Analytical Approach Using FTIR and ICP-MS with Multivariate Statistics

Vodka constitutes a significant sector of Vietnam's alcohol industry, including both domestic and imported varieties. However, this diversity faces challenges from illegal imports and adulterated products, threatening consumer health and brand integrity. This study employs Fourier transform infrared spectroscopy (FTIR) and inductively coupled plasma mass spectrometry (ICP-MS) to analyze 300 vodka samples from five brands collected across Hanoi. Significant variations were found in elemental compositions, with sodium concentrations ranging from 205.67 μg/L to 1269.24 μg/L and magnesium levels from 65.57 μg/L to 1453.34 μg/L. Principal Component Analysis (PCA) of the FTIR and ICP-MS data effectively differentiated the samples, with the first two principal components explaining 84.78% and 73.02% of the total variance, respectively. The PCA plots revealed distinct chemical profiles, notably isolating Rocket Vodka. These findings enhance food safety enforcement, protect consumer rights, and preserve brand reputations. The study underscores the importance of advanced analytical tools in combating beverage adulteration, ensuring public health, and maintaining market integrity, offering a replicable model for similar research in other regions.

Intentional Adulteration of Foods with Chemicals: Snapshot for 2009-2022

Global occurrences of the intentional adulteration of food with a chemical toxicant culled from the literature and news reports from 2009 to 2022 were analyzed in terms of their ability to cause mass public health harm. A total of 76 intentional adulteration events that involved over 27 chemicals and 16 foods were identified. The chemicals used included pesticides, rat poisons, illicit drugs, and commercial chemicals. A total of 253 deaths and 4,887 illnesses were attributed to intentional adulteration events; there were deaths in 20% and illnesses in 50% of the events. Intentional adulteration during manufacturing, which accounted for 21 events (28%), resulted in 205 deaths (81%) and 3,572 illnesses (73%). Intentional adulteration at the food preparation node, which accounted for 17 events (22%), resulted in 39 deaths (15%) and 387 illnesses (8%). On-farm intentional adulteration, eight events (10%) resulted in 843 illnesses (17%) and no deaths. The perpetrators who were identified generally had legitimate access to the food, although in 63% of the cases studied, the perpetrator was not identified. Economically motivated adulteration and revenge resulted in over 80% of the deaths and illnesses.

Trends in purchasing cross-border, illicit and home-brewed alcohol: A population study in Great Britain, 2020-2023

INTRODUCTION

The last 3 years have seen substantial changes in Great Britain (GB) including the COVID-19 pandemic, cost-of-living crisis and policy changes such as minimum unit pricing. We examined changes in purchasing cross-border, illicit and home-brewed alcohol among risky drinkers over this period.

METHODS

Data were used from 22,086 adult (≥18 years) increasing/higher-risk drinkers (AUDIT-C ≥5) participating in a monthly cross-sectional survey between October 2020 and August 2023. We estimated time trends in the proportion reporting obtaining alcohol from: (i) cross-border (any/within-GB/international); (ii) illicit; and (iii) home-brewed sources in the past 6 months.

RESULTS

Between October 2020 and August 2023, the proportion reporting cross-border alcohol purchases increased (from 8.5% to 12.5% overall; prevalence ratio [PR] = 1.47 [95% CI 1.17-1.86]). This was largely driven by an increase in cross-border purchases abroad (PR = 1.52 [1.13-2.05]), with a smaller, uncertain increase in cross-border purchases within GB (PR = 1.37 [0.96-1.95]). The prevalence of cross-border alcohol purchasing was higher in Wales (13.8% [12.3-15.4%]) and Scotland (6.1% [5.4-6.8%]) than England (3.6% [3.3-3.9%]). There was little change in illicit alcohol purchasing in England or Wales (4.1% [3.7-4.4%]; 4.2% [3.2-5.1%]), but in Scotland it fell from 5.7% to 2.4% (PR = 0.42 [0.19-0.81]). Home-brewed alcohol was rare (GB: 3.1% [2.9-3.4]) and stable.

DISCUSSION AND CONCLUSIONS

The proportion of increasing/higher-risk drinkers in GB purchasing cross-border alcohol increased between October 2020 and August 2023, due to an increase in people buying alcohol abroad. Cross-border alcohol purchases within GB were more commonly reported in Wales and Scotland. The small proportion purchasing illicit alcohol did not change substantially in England or Wales, but fell by half in Scotland.

Substances of health concern in home-distilled and commercial alcohols from Texas

Objective

Poor distillation practices in the production of spirits have historically resulted in many instances of adverse health outcomes including death. Concern has focused on lead and copper contamination as well as unhealthy levels of methanol and glyphosate. This study assesses home-distilled and commercially distilled alcohols from Texas for these substances of concern, highlighting their potential risks to public health.

Methods

Atomic absorption spectroscopy, gas chromatography, and enzyme-linked immunosorbent assay were employed to determine lead and copper, methanol, and glyphosate levels in 12 commercial and 36 home-distilled alcohol samples.

Results

Our findings showed that 11 % of the home-distilled alcohols exceeded the U.S. Alcohol and Tobacco Tax and Trade Bureau's copper safety limits of 0.5 mg/L for wine. Additionally, 36 % of these samples surpassed the European Commission (EC)'s lead legal threshold of 0.15 mg/L set for wine products. Results from commercial alcohols indicated that no samples exceeded the same safety limits for copper, and 33 % exceeded the same legal threshold for lead. Both commercial and home-distilled alcohols exhibited methanol concentrations remarkably below the 0.35 % limit for brandy set by the U.S. Food and Drug Administration. Only two home-distilled samples contained detectable glyphosate concentrations well below 100 μg/L, the maximum residue level in beer and wine established by the EC.

Conclusions

Our findings suggested that consumption of alcohol in Texas may pose potential health risks associated with the elevated content of lead and copper. There is a need for increased focus on alcohol as a potential source of exposure to heavy metals.

Alcohol and other drug use patterns and services in an integrated refugee settlement in Northern Zambia: a formative research study

BACKGROUND

Evidence on patterns of alcohol and other drug (AOD) use and how to effectively deliver services to address AOD use in humanitarian settings is limited. This study aimed to qualitatively explore the patterns of AOD use among Congolese refugees in Mantapala Refugee Settlement and members of the surrounding host community and identify potential appropriate intervention and implementation approaches to address AOD use disorders among conflict-affected populations.

METHODS

Fifty free listing interviews, 25 key informant interviews, and four focus group discussions were conducted among refugees, host community members, humanitarian implementing agency staff, and refugee incentive workers. These participants were selected based on their knowledge of AOD use and related problems in the settlement and the surrounding host community in northern Zambia.

RESULTS

Cannabis and home-brewed alcohol were the substances that were perceived to be most commonly used and have the greatest impact on the community. Participants reported that self-medication, boredom, and relief of daily stressors associated with lack of housing, safety, and employment were reasons that people used AODs. Participants recommended that programming include components to address the underlying causes of AOD use, such as livelihood activities. Stigma due to the criminalization of and societal ideals and religious beliefs regarding AOD use was identified as a substantial barrier to accessing and seeking treatment.

CONCLUSIONS

Our study's findings indicate the need for services to address AOD use in Mantapala Refugee Settlement. Interventions should consider the social and structural determinants of AOD use.

Case Reports Study on Methanol Poisoning in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia

Methanol poisoning is a challenging issue due to its inducing acute multiple organ failures, and especially due to a lack of preparedness, available antidotes, and management protocols. The current study presents six cases of methanol poisoning that attended the emergency department of King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, between March and November 2022. All of the patients suffered from severe metabolic acidosis and visual impairment following the ingestion of homemade alcoholic beverages and colonia. Three patients were comatose, suffered from post-cardiac pulmonary arrest, and, finally, died, while the other three were non-comatose and discharged from the ICU after improvement. Management was based on clinical symptoms and other laboratory findings due to a shortage of methanol level measurement resources. The antidote, fomepizole, was not given to all of the cases due to its deficiency, and ethanol was given only to one patient due to difficulties in administering it without monitoring its concentration. Methanol poisoning and its outbreak provide insights into the dangers of hazardous homemade alcohol and other pharmaceutical preparations that might be adulterated with methanol, particularly to the shortage of suitable diagnostic testing and antidotes in addition to poor resources for management of intoxicated patients in some regions of Saudi Arabia.

Acil Servise Başvuran Metil Alkol Zehirlenmelerinin Geriye Dönük Analizi

Objective: Methyl alcohol poisoning remains a significant cause of mortality and morbidity. This poisoning is still one of the important reasons for admission to emergency services. We aimed to examine the admission complaints, laboratory findings, treatment methods, clinical outcomes and examine the factors affecting the mortality of patients diagnosed with methyl alcohol poisoning in the emergency department. Methods: In this retrospective descriptive study, we analysed the patients who were considered to be diagnosed with methyl alcohol intoxication among those who came to our emergency department due to alcohol intoxication from June 1, 2018 to June 1, 2020. Results: The study included 20 (4.86%) individuals with methyl alcohol poisoning among 411 people who presented to the emergency department due to ethyl and methyl alcohol intake and resulting effects.The mean age of the patients was 47.35±14.2 years and 85% (n=17/20) were male. Upon reviewing the patients' admission symptoms, 70% were observed to have visual problems, 60% complaints of vomiting, 45% shortness of breath, and 40% changes in consciousness. In the study, it was revealed that 18.2%(n=2/11) females and 81.8%(n=9/11) males died, and the mortality rate was calculated as 55%(n=11/20). Conclusions: The presence of visual problems, hypotension, and coma in clinical findings, high anion gap metabolic acidosis, marked osmolar gap, an increase in lactate level, and hyperglycemia in laboratory findings may be the early signs of mortality in patients with methyl alcohol poisoning. Therefore, patients with these signs should be followed up more closely and treated.

Nanosensor Based on Thermal Gradient and Machine Learning for the Detection of Methanol Adulteration in Alcoholic Beverages and Methanol Poisoning

Methanol, naturally present in small quantities in the distillation of alcoholic beverages, can lead to serious health problems. When it exceeds a certain concentration, it causes blindness, organ failure, and even death if not recognized in time. Analytical techniques such as chromatography are used to detect dangerous concentrations of methanol, which are very accurate but also expensive, cumbersome, and time-consuming. Therefore, a gas sensor that is inexpensive and portable and capable of distinguishing methanol from ethanol would be very useful. Here, we present a resistive gas sensor, based on tin oxide nanowires, that works in a thermal gradient. By combining responses at various temperatures and using machine learning algorithms (PCA, SVM, LDA), the device can distinguish methanol from ethanol in a wide range of concentrations (1–100 ppm) in both dry air and under different humidity conditions (25–75% RH). The proposed sensor, which is small and inexpensive, demonstrates the ability to distinguish methanol from ethanol at different concentrations and could be developed both to detect the adulteration of alcoholic beverages and to quickly recognize methanol poisoning.

Food Safety Governance and Guardianship: The Role of the Private Sector in Addressing the EU Ethylene Oxide Incident

Sesame seeds within the European Union (EU) are classified as foods not of animal origin. Two food safety issues associated with sesame seeds have emerged in recent years, i.e., Salmonella contamination and the presence of ethylene oxide. Fumigation with ethylene oxide to reduce Salmonella in seeds and spices is not approved in the EU, so its presence in sesame seeds from India was a sentinel incident sparking multiple trans-European product recalls between 2020-2021. Following an interpretivist approach, this study utilises academic and grey sources including data from the EU Rapid Alert System for Food and Feed (RASFF) database to inform a critical appraisal of current EU foods not of animal origin legislation and associated governance structures and surveillance programs. This is of particular importance as consumers are encouraged towards plant-based diets. This study shows the importance of collaborative governance utilizing data from company testing and audits as well as official regulatory controls to define the depth and breadth of a given incident in Europe. The development of reflexive governance supported by the newest technology (e.g., blockchain) might be of value in public-private models of food safety governance. This study contributes to the literature on the adoption of risk-based food safety regulation and the associated hybrid public-private models of food safety governance where both regulators and private organizations play a vital role in assuring public health.