Pál , LászlóMuhollari, Teuta2024-05-292024-05-292024https://hdl.handle.net/2437/370566Alcohol attributable disease burden is the highest in the European Region of the World Health Organization. However, significant differences exist within this region. Previous investigations have suggested that the intake of low-quality unrecorded alcohol can contribute to the elevated alcohol-attributable disease burden in Central and Easter Europe and Western Balkan countries including Hungary and Albania. Therefore, our aims were to determine the chemical composition of recorded and unrecorded spirits collected in Hungary and unrecorded Albanian rakia and to estimate the health risks associated with their intake. In addition, the daily methanol intake and related blood methanol levels (BMLs) attributable to drinking unrecorded fruit spirits in the European Union (EU) was estimated. Inductively coupled plasma optical emission spectrometric analysis was used to determine the concentration of 24 elements and in 97 recorded and 100 unrecorded Hungarian spirit samples, as well as in 30 unrecorded Albanian rakia. Ethanol concentration was determined using gas chromatography/mass spectrometry. Concentration data on the metals detected in spirit samples were used to carry out a statistical analysis and a probabilistic risk assessment, characterized by the combined target hazard quotient (THQc) method with different scenarios considering average, regular and chronic heavy drinkers. THQc values higher than 1 were considered as public health concerns. In addition, data on methanol concentrations in unrecorded fruit spirits across EU member states were collected from the literature and the health risk associated with their consumption was estimated. We demonstrated that levels of Cu, Zn, and Sn in unrecorded spirits collected in Hungary were significantly higher than those in their recorded counterparts. In addition, the concentrations of Fe, Mn, and Ni were significantly higher in recorded spirits. The distributions of THQc values associated with the consumption of recorded spirits, brandy, pálinka, whiskey, and vodka containing heavy metals were less than 1.0 for both sexes, and separately for men and women. Average and regular consumers, as well as chronic heavy drinkers consuming recorded pálinka (p<0.001), whiskey (p<0.001), and vodka (p<0.001) collected in Hungary had significantly lower THQc values than those who drink recorded brandy. THQc values were also less than 1.0 at each drinking level, when consuming unrecorded spirits. The distributions of THQc values for men consuming recorded spirits, brandy and pálinka reached above 1.0 and were significantly lower for chronic heavy drinker males consuming recorded vodka (p<0.001). Distributions of THQc values reached above 1.0 for women consuming recorded spirits, brandy and pálinka and were significantly lower for chronic heavy drinker females consuming recorded whiskey (p<0.001) and vodka (p<0.001) collected in Hungary. In addition, compared to chronic heavy drinker males and females consuming recorded spirits and recorded pálinka, THQc values were significantly lower for those who drink unrecorded spirits (p<0.001). Our findings showed that there was a significant difference between the measured and the reported ethanol levels in unrecorded Albanian rakia. Of the metals detected in unrecorded rakia, Cu and Pb were found to be the greatest concern. Although the estimated daily intake of these heavy metals was below their toxicological limit, the concentrations of Cu and Pb were above their limit in 90% and 33% of our rakia samples, respectively. We also found that the consumption of unrecorded fruit spirits containing methanol at levels above 8598.1 or 6382.1 mg/l of pure alcohol and 10 g ethanol, can result in a methanol intake exceeding the oral reference dose of methanol in men and women, respectively. Our results indicate that the intake of heavy metals in recorded spirits can poses a potential risk for Hungarian chronic heavy drinkers. Additionally, we found that the occurrence of adverse health effects associated with the consumption of unrecorded Albanian rakia cannot be entirely excluded. Furthermore, our study suggests that individuals regularly consuming unrecorded fruit spirits with methanol may face a realistic risk of exceeding the RfD over an extended period. However, it was also demonstrated that the levels of methanol published in the literature for unrecorded fruit spirits with methanol are unlikely to result in BMLs above the maximum tolerable blood methanol level in alcohol drinkers residing in CEE countries. In light of our findings, there is a compelling need for the establishment of a comprehensive public health surveillance system to monitor both the safety and quality of recorded and unrecorded spirits consumed in Albania and Hungary.129enAlbaniaAliphatic alcoholsBlood methanol levelEthanolFruit spiritHealth risk estimationHeavy metalsHungaryMethanolUnrecorded alcoholEgészségtudományokOrvostudományok