The Amount of Alcohol Consumption and Its Quantitative Risk Assessment through Wastewater-Based Epidemiology: a Case Study in Kermanshah City

Monitoring alcohol consumption in population is very important for planning public health and evaluation of the efficiency of intervention strategies. The aim of this study was to use wastewater-based epidemiology (WBE) to estimate alcohol consumption in a Kermanshah City and calculate risk assessment using the margin of exposure (MOE) approach.

Raw composite wastewater samples (5 hours) were collected form the entrance of Kermanshah wastewater plant over a 30 days’ period. Ethyl sulfate metabolite was used to measure the alcohol content of the samples, which is excreted in the urine after consuming alcohol by humans and enters into the wastewater collection network. After centrifugation and filtration, the samples were directly injected into the liquid chromatography with tandem mass spectrometry LC-MS/MS for analysis. After calculation of alcohol consumption rate with back-calculation method, the results were used for risk assessment by MOE.

In general, the average amount of alcohol consumption during sampling in the society was 0.332 ml per person of equal age and over 15 years of age (adult) per day, which was equal to 0.121 liters of pure alcohol per person per year. We found no significant difference in the amount of alcohol consumption between the weekend and working days of the week, and also between  sampling days in Ramadan and ordinary  days. In 90% of the samples taken, the risk associated with alcohol consumption was higher than MOE=100 and only in 3 samples the MOE value was in the "risk" category.

The results of this study showed that wastewater-based epidemiology can provide appropriate timely and transisional  information on alcohol use and its associated exposure risks in the community. Also, the amount of alcohol consumption in the population in our study was much lower than those in the European and American countries.