title: Analysis and interpretation of specific ethanol metabolites, ethyl sulfate, and ethyl glucuronide in sewage effluent for the quantitative measurement of regional alcohol consumption.
abstract: BACKGROUND
  The quantitative measurement of urinary metabolites in sewage streams and the subsequent estimation of consumption rates of the parent compounds have previously been demonstrated for pharmaceuticals and narcotics. Ethyl sulfate and ethyl glucuronide are excreted in urine following the ingestion of alcohol, and are useful biomarkers for the identification of acute alcohol consumption. This study reports a novel ion-exchange-mediated chromatographic method for the quantitative measurement of ethyl sulfate and ethyl glucuronide in sewage effluent, and presents a novel calculation method for the purposes of relating the resulting sewage concentrations with rates of alcohol consumption in the region.
  
  
  METHODS
  A total of 100 sewage samples covering a 25-day period were collected from a treatment plant servicing approximately 500,000 people, and analyzed for levels of ethyl sulfate and ethyl glucuronide. The resulting data were then used to estimate combined alcohol consumption rates for the region, and the results were compared with alcohol related sales statistics for the same region.
  
  
  RESULTS
  Ethyl glucuronide was found to be unstable in sewage effluent. Ethyl sulfate was stable and measurable in all samples at concentrations ranging from 16 to 246 nM. The highest concentrations of the alcohol biomarker were observed during weekend periods. Sixty one percent of the total mass of ethyl sulfate in sewage effluent corresponds to alcohol consumption on Friday and Saturday. Sales statistics for alcohol show that consumption in the region is approximately 6,750 kg/d. The quantity of ethyl sulfate passing through the sewage system is consistent with consumption of 4,900 to 7,800 kg/d.
  
  
  CONCLUSIONS
  Sewage epidemiology assessments of ethyl sulfate can provide accurate estimates of community alcohol consumption, and detailed examination of the kinetics of this biomarker in sewage streams can also identify time-dependent trends in alcohol consumption patterns.
authors.affiliation: Norwegian Institute for Water Research, Oslo, Norway. malcolm.reid@niva.no
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Reid
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Langford
authors.forename: Jørg
authors.initials: J
authors.lastname: Mørland
authors.forename: Kevin V
authors.initials: KV
authors.lastname: Thomas
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D015415:Biomarkers / Q000032:analysis / Q000652:urine; D002492:Central Nervous System Depressants / Q000378:metabolism; D002853:Chromatography, Liquid; D000431:Ethanol / Q000378:metabolism; D005965:Glucuronates / Q000032:analysis* / Q000378:metabolism / Q000652:urine; D006801:Humans; D013058:Mass Spectrometry; D012722:Sewage / Q000737:chemistry*; D015813:Substance Abuse Detection / Q000379:methods*; D013463:Sulfuric Acid Esters / Q000032:analysis* / Q000378:metabolism / Q000652:urine
chemical_list: D015415:Biomarkers; D002492:Central Nervous System Depressants; D005965:Glucuronates; D012722:Sewage; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; C011612:diethyl sulfate