We found copper of up to 6000% Above Recommended Level in Sachet Waragi Sold in Acholi—Researcher
This is a slightly edited Q & A between Dr Otim and the media centre of the University of California, Los Angeles in which he responds to wide range of questions on the findings and implications of his study which was last week published in the journal, Plos One
Why did you want to study this?
My personal as well as other people’s observation of high level of alcohol consumption in the region. There had been casual talks about the potency of spirits available on the market in Acoli. Plus, the public concern and demand to ban alcohol in the region. And being a chemist, I was curious to find out what could be in the alcohol that might account for the deaths anecdotally linked to high alcohol consumption. We wanted particularly to investigate and establish the evidence of the composition of the contents, and statistically and factually corroborate the claims that the sachet spirits were contaminated and contained more than just alcohol. Besides, there had been widespread talks of deaths and illnesses attributed to heavy drinking. We wanted to know if there was indeed plausible scientific / chemical basis for these fears; or to dispel them all together.
What types of health problems have people had related to the consumption of alcohol that is contaminated and how many people seem to be affected by alcohol-related illnesses?
There have been many claims linking respiratory, mental, liver, skin, kidney, cancer and all kinds of ailments to heavy consumption of alcohol in Acoli. All known symptoms of alcohol-related illness are visible in the population (weight loss, addiction, reductions in appetite, swollen stomach and cheeks, red eye, dark/dry glittery skin, deformed finger nails, etc.). It is not possible to give precise figures of how many people are victims, but it is safe to say that the problem is pervasive in the entire northern region of Uganda. Perhaps, now that we have done this study and found that these brands of spirits are contaminated and pose serious health risks, it will be possible for other researchers to specifically examine health records and be able to correctly determine the number of deaths and illnesses that can now be directly linked to the contaminants and consumption of sachet alcohol.
What did you find about carcinogens in the alcohol you sampled and how does this compare to alcohol sold in other countries?
Four known carcinogens were found in the spirits: ethanol itself (the intoxicating agent), arsenic, chromium and lead. Seventeen (17) metals, also studied, are potential carcinogens as well if their cancer slope factors were known. It must be borne in mind though that there are no safe levels of carcinogens. Only one sample from another country was included in this study, a Scottish whisky bought from San Diego, CA. This sample had only ethanol among the four known carcinogens detected in the study.
How do the metals get into the alcohol?
Your guess is as good as mine. But it is possible that the contaminants are from distillation processes, the vessels used; poor quality control, and perhaps storage and packaging containers. But God forbid that there have been deliberate contamination, as some diabolical political project as sometimes have been intimated and dismissed as wild political claims. Yet, it should be important to investigate and definitively settle the question of how these contaminants got into the spirits; and if indeed it is from distillation and packaging processes, public health, regulatory, and state authorities need to move swiftly to put the producers out of business on account of the health risks their products have exposed the public to. And this is a very sensitive question that the authorities and the manufacturers of the spirits, and the public health authorities need to make efforts to find satisfactory answers.
A lot of the alcohols you examined are sold in what are called sachets, which appear to be plastic bags. Does using plastic bags make the alcohols more vulnerable to contamination?
These are excellent questions for which there are yet no definitive answers. Further studies need to be done to pinpoint the source of the contamination. Anecdotally, we suspect that the metals could come from the following sources: The soil where the materials (millet, sorghum, potatoes, cassava, corn) used for fermentation are grown; The water used in the brewing process; The equipment (pots, condensers and pipes) used in the brewing process and the packaging materials including large metal and plastic storage and transportation containers (jerry cans and drums) and plastic bags (sachets) and glass bottles.
Did any of the findings surprise you?
The contamination did not surprise me. However,I did not know how high the level of copper was in the most available spirits in the region (up to 6000% above the recommended level). Serious public health control measures shouldn’t allow outrageous amounts of metals in foods.
In your conclusion you mention several actions to ameliorate the negative effects of alcohol, one of which was more public health education about the health risks of excessive alcohol consumption. What type of public health education exists now in Uganda and what changes do you think should be made?
No clear campaign is in place currently; the sale and consumption of alcohol is uncontrolled. The problem is also not simply the heavy consumption of spirits, but the consumption of alcohol heavily contaminated with harmful metals (and organic contaminants – a subject of another study). The first point of action is quality and standard control. The second one is the control and restriction of the availability and sale of alcohol. And finally, public education (in churches, at schools and in families) about the risks of heavy alcohol consumption (e.g. risks of contracting specific diseases like liver cirrhosis and cancer). We are aware that this will be difficult to implement because many of the production is based in the rural areas. Besides, many peasants now rely on alcohol production as a significant source of their income. Alternative source of income must be found for such people to minimize the production of unmonitored alcohol. Unfortunately, this will be difficult to accomplish for the same reason that even in the USA after about a century, some people still engage in bootlegging.
You also note in your conclusion that quality assurance in production must be brought to international standards. What can and should be done to increase the standards?
We believe that the following minimum requirements be met in Uganda: Formulate a national alcohol policy; create a government agency to monitor the quality of spirits in the country; create a national laboratory dedicated to monitoring the quality of alcohol as well as other products consumed by humans and train the necessary personnel to accomplish the two goals above.
Do you believe your findings also hold for other countries in in Sub-Saharan Africa, such as Kenya and Tanzania, and do you have evidence for the widespread contamination of alcohol in Sub-Saharan Africa?
Yes, because the conditions are similar. In 2018, the World Health Organization reported that four of every 100 deaths in Kenya is linked to alcohol use. In 2014, more than 60 people were reported to have died in Kenya after drinking homemade alcohol believed to have been laced with industrial chemicals. In 2005, a black market alcoholic brew laced with poisonous methanol caused the deaths of 49 people in Kenya. In 2016, a criminal gang flooded the Tanzania market with potentially deadly alcohol. In one other study, contaminated grain/fruit were shown to be used in spirits production in Tanzania. The distilled spirits were also found to contain 4x as much zinc as allowed by WHO.