Assessing alcohol consumption through wastewater-based epidemiology: Spain as a case study. (1st October 2020)

• Record Type: Journal Article
• Authors: López-García, Ester; Pérez-López, Carlos; Postigo, Cristina; Andreu, Vicente; Bijlsma, Lubertus; González-Mariño, Iria; Hernández, Félix; Marcé, Rosa Maria; Montes, Rosa; Picó, Yolanda; Pocurull, Eva; Rico, Andreu; Rodil, Rosario; Rosende, María; Valcárcel, Yolanda; Zuloaga, Olatz; Quintana, José Benito; López de Alda, Miren
• Is Part Of: Drug and alcohol dependence. Volume 215(2020)
• Publication Date: 2020-10-01
• Subjects: Sewage epidemiology -- Alcohol abuse -- Liquid chromatography-mass spectrometry -- Consumption patterns; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108241
• Languages: English
• ISSNs: 0376-8716

Abstract

Graphical abstract: Highlights: First nationwide study in Spain to assess alcohol consumption from a wastewater biomarker. Circa 6 million people (12.8% of the Spanish population) covered in the sampling. Wastewater-derived alcohol consumption figures ranged from 4.5 to 46 mL/day/inhabitant. Significant differences in consumption among regions and between weekdays and weekends. Wastewater-derived estimates comparable with National Health Survey data. Abstract: Background: In this study, an alternative and complementary method to those approaches currently used to estimate alcohol consumption by the population is described. This method, known as wastewater-based epidemiology (WBE), allows back-calculating the alcohol consumption rate in a given population from the concentrations of a selected biomarker measured in wastewater. Methods: Composite (24-h) wastewater samples were collected at the inlet of 17 wastewater treatment plants located in 13 Spanish cities for seven consecutive days in 2018. The sampled area covered 12.8% of the Spanish population. Wastewater samples were analyzed to determine the concentration of ethyl sulfate, the biomarker used to back-calculate alcohol consumption. Results: Alcohol consumption ranged from 4.5 to 46 mL/day/inhabitant. Differences in consumption were statistically significant among the investigated cities and between weekdays and weekends. WBE-derived estimates of alcohol consumption were comparable to those reported by its corresponding region in the Spanish National Health Survey in most cases. At the national level, comparable results were obtained between the WBE-derived annual consumption rate (5.7 ± 1.2 L ethanol per capita (aged 15+)) and that reported by the National Health Survey (4.7 L ethanol per capita (aged 15+)). Conclusions: This is the largest WBE study carried out to date in Spain to estimate alcohol consumption rates. It confirms that this approach is useful for establishing spatial and temporal patterns of alcohol consumption, which could contribute to the development of health care management plans and policies. Contrary to established methods, it allows obtaining information in a fast and relatively economical way.