title: The composition of alcohol products from markets in Lithuania and Hungary, and potential health consequences: a pilot study.
abstract: OBJECTIVE
  The rates of alcohol-attributable mortality in Lithuania and Hungary have been shown to be higher than those in most other European countries. Quality of alcohol products is investigated as a possible explanation.
  
  
  METHODS
  In a descriptive pilot study, a convenience sample of alcohol products was collected from local city markets in both countries (Lithuania n = 10, Hungary n = 15) and chemical analyses, including some that have not been done in prior studies, were conducted. The parameters studied were alcoholic strength, volatiles (methanol, acetaldehyde, higher alcohols), ethyl carbamate, anions (including nitrate) and inorganic elements (including lead). Additionally, a multi-target screening analysis for toxicologically relevant substances was conducted.
  
  
  RESULTS
  The majority of samples (64%) had an alcohol content between 35% vol. and 40% vol., being in accordance with the typical strength of legal spirits in Europe. Three samples containing significantly higher concentrations of alcohol above 60% vol. were found to be unrecorded alcohol products, defined as any alcohol that is outside of legal and taxed production. Screening analysis showed that those samples contained various flavourings, including the hepatotoxic substance coumarin, at concentrations above the legal limit for foods. All other substance classes under study were found to be at levels of no toxicological concern.
  
  
  CONCLUSIONS
  Although some problems with the quality of the alcohol samples were found, there is insufficient evidence from this pilot study to conclude that alcohol quality has an influence on health as reflected in alcohol-attributable mortality rates. Given the extent of alcohol-attributable disease burden in central and eastern European countries, future research should focus on collection of large, representative samples, particularly of unrecorded sources, which was the most problematic product group in our study.
authors.affiliation: Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Germany. Lachenmeier@web.de
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Lachenmeier
authors.forename: Bart
authors.initials: B
authors.lastname: Sarsh
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000428:Alcohol Drinking / Q000401:mortality; D000434:Alcoholic Beverages / Q000009:adverse effects* / Q000032:analysis*; D002492:Central Nervous System Depressants / Q000032:analysis; D002851:Chromatography, High Pressure Liquid; D003374:Coumarins / Q000032:analysis; D004340:Drug Contamination; D004563:Electrochemistry; D000431:Ethanol / Q000032:analysis; D005421:Flavoring Agents / Q000032:analysis; D008401:Gas Chromatography-Mass Spectrometry; D006814:Hungary; D008097:Lithuania; D013058:Mass Spectrometry; D000432:Methanol / Q000032:analysis; D010865:Pilot Projects; D017550:Spectroscopy, Fourier Transform Infrared; D014520:Urethane / Q000032:analysis; D014881:Water Supply / Q000592:standards
chemical_list: D002492:Central Nervous System Depressants; D003374:Coumarins; D005421:Flavoring Agents; D014520:Urethane; D000431:Ethanol; D000432:Methanol