title: The total margin of exposure of ethanol and acetaldehyde for heavy drinkers consuming cider or vodka.
abstract: Heavy drinkers in Scotland may consume 1600 g ethanol per week. Due to its low price, cider may be preferred over other beverages. Anecdotal evidence has linked cider to specific health hazards beyond other alcoholic beverages. To examine this hypothesis, nine apple and pear cider samples were chemically analysed for constituents and contaminants. None of the products exceeded regulatory or toxicological thresholds, but the regular occurrence of acetaldehyde in cider was detected. To provide a quantitative risk assessment, two collectives of exclusive drinkers of cider and vodka were compared and the intake of acetaldehyde was estimated using probabilistic Monte-Carlo type analysis. The cider consumers were found to ingest more than 200-times the amount of acetaldehyde consumed by vodka consumers. The margins of exposure (MOE) of acetaldehyde were 224 for the cider and over 220,000 for vodka consumers. However, if the effects of ethanol were considered in a cumulative assessment of the combined MOE, the effect of acetaldehyde was minor and the combined MOE for both groups was 0.3. We suggest that alcohol policy priority should be given on reducing ethanol intake by measures such as minimum pricing, rather than to focus on acetaldehyde.
authors.affiliation: Chemisches und Veterinäruntersuchungsamt (CVUA) Karlsruhe, Weissenburger Strasse 3, D-76187 Karlsruhe, Germany; Epidemiological Research Unit, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. Electronic address: Lachenmeier@web.de.
authors.forename: Dirk W
authors.initials: DW
authors.lastname: Lachenmeier
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4BN, Scotland, UK.
authors.forename: Jan S
authors.initials: JS
authors.lastname: Gill
authors.affiliation: School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh EH11 4BN, Scotland, UK; Castle Craig Hospital, Blyth Bridge, West Linton, EH46 7DH Scotland, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chick
authors.affiliation: Epidemiological Research Unit, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Social and Epidemiological Research (SER) Department, Centre for Addiction and Mental Health, Toronto, Canada; Addiction Policy, Dalla Lana School of Public Health, University of Toronto (UofT), Canada; PAHO/WHO Collaborating Centre for Mental Health & Addiction, Toronto, Canada; Institute of Medical Science, UofT, Canada.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
mesh_terms: D000079:Acetaldehyde / Q000032:analysis / Q000633:toxicity*; D000328:Adult; D000434:Alcoholic Beverages / Q000009:adverse effects* / Q000032:analysis / Q000191:economics; D000437:Alcoholism / Q000503:physiopathology*; D000465:Algorithms; D000431:Ethanol / Q000032:analysis / Q000633:toxicity*; D005260:Female; D005285:Fermentation; D005506:Food Contamination; D005513:Food Inspection; D005638:Fruit / Q000737:chemistry; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D027845:Malus / Q000737:chemistry; D009010:Monte Carlo Method; D031989:Pyrus / Q000737:chemistry; D018570:Risk Assessment; D012606:Scotland / Q000453:epidemiology
chemical_list: D000431:Ethanol; D000079:Acetaldehyde
keywords: 5-Hydroxymethylfurfural (PubChem CID: 237332); Acetaldehyde; Acetaldehyde (PubChem CID: 177); Alcohol; Cider; Ethanol (PubChem CID: 702); Heavy drinking; Methanol (PubChem CID: 887); Risk assessment; Sulphur dioxide (PubChem CID: 1119); Vodka