Investigating alcohol consumption in China via Wastewater-based Epidemiology

Abstract

Abstract Alcohol abuse and addiction remain priority public health issues worldwide. Accurate estimation of alcohol prevalence is increasingly challenging due to the time-consuming and labor-intensive nature of traditional survey methods. This study examined alcohol consumption in major cities of China via Wastewater-based epidemiology(WBE) and compared WBE estimates with other data sources. A simple and valid ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed for the determination of two alcohol metabolites, ethyl glucuronide (EtG) and ethyl sulfate (EtS) in wastewater. The optimized method was applied to 62 sewage samples collected from wastewater treatment plants (WWTPs) in 31 provincial capital cities across China in the fourth quarter of 2020. The methodology established in this study was validated with the lower limit of quantification (LLOQ) up to 0.1 µg/L, good linearity in the range of 0.1–50 µg/L, intra-day and inter-day precision less than 5.58% and 5.55%, respectively, and the recoveries of the extracts were higher than 97.14%. The consumption range of alcohol estimated via WBE was 1.23 ~ 18.18 mL ethanol/person /day (EPD) in the capital cities of China. There was a significant difference in alcohol consumption among cities and WBE estimates of alcohol consumption were lower than WHO survey results and higher than foreign countries. The investigation of alcohol consumption based on WBE is very potential, which can complement objective information for estimating the consumption of alcohol.