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Comparative measurement and quantitative risk assessment of alcohol consumption through wastewater-based epidemiology: An international study in 20 cities

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Yeonsuk Ryu, Damià Barceló, Leon P. Barron, Lubertus Bijlsma, Sara Castiglioni, Pim de Voogt, Erik Emke, Félix Hernández, Foon Yin Lai, Alvaro Lopes, Miren López de Alda, Nicola Mastroianni, Kelly Munro, Jake O'Brien, Christoph Ort, Benedek G. Plósz, Malcolm J. Reid, Viviane Yargeau, Kevin V. Thomas

Original languageEnglish
Pages (from-to)977-983
Number of pages7
JournalScience of the Total Environment
Early online date14 May 2016
Publication statusPublished - Sep 2016


King's Authors


Quantitative measurement of drug consumption biomarkers in wastewater can provide objective information on community drug use patterns and trends. This study presents the measurement of alcohol consumption in 20 cities across 11 countries through the use of wastewater-based epidemiology (WBE), and reports the application of these data for the risk assessment of alcohol on a population scale using the margin of exposure (MOE) approach. Raw 24-h composite wastewater samples were collected over a one-week period from 20 cities following a common protocol. For each sample a specific and stable alcohol consumption biomarker, ethyl sulfate (EtS) was determined by liquid chromatography coupled to tandem mass spectrometry. The EtS concentrations were used for estimation of per capita alcohol consumption in each city, which was further compared with international reports and applied for risk assessment by MOE. The average per capita consumption in 20 cities ranged between 6.4 and 44.3 L/day/1000 inhabitants. An increase in alcohol consumption during the weekend occurred in all cities, however the level of this increase was found to differ. In contrast to conventional data (sales statistics and interviews), WBE revealed geographical differences in the level and pattern of actual alcohol consumption at an inter-city level. All the sampled cities were in the “high risk” category (MOE 

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