Is there any difference between the health risk from consumption of recorded and unrecorded spirits containing alcohols other than ethanol? A population-based comparative risk assessment.

Alcohol-attributable mortality in certain countries of Central and Eastern Europe (CEE) remains higher than in their western neighbours. The effect of unrecorded alcohol consumption, including home-made fruit spirits have been suggested as an explanation. Besides ethanol, recorded and unrecorded spirits frequently contain other aliphatic alcohols (OAAs). Our aim was to ascertain whether there is any difference in the amounts of OAAs in recorded and unrecorded spirits, and thus the health risk associated with their consumption. The concentrations of ethanol and OAAs in recorded (n = 119) and unrecorded (n = 87) spirits were determined by gas chromatography and used in a Monte Carlo type probabilistic simulation to assess the risk based on average consumption level, consumption by regular drinkers and chronic heavy drinkers. The concentrations of OAAs in unrecorded spirits were significantly higher [median: 9896.1 mg/L, interquartile range (IQR): 7898.3-12 634.6 mg/L] than those in their recorded (median: 975.6 mg/L, IQR: 136.9-4006.7 mg/L) counterparts. Besides ethanol, methanol also posed a health risk at each consumption level. The risk associated with exposure to OAAs was higher only in chronic heavy drinkers consuming unrecorded spirits. These findings reinforce the importance of action to address the risks associated with consumption of recorded and unrecorded spirits.