Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method

Duygu Nur Mert; Merve Kuloğlu Genç; Mihriban Dilan Kılıç; Tuğba Tekin Bülbül; Selda Mercan

doi:10.18596/jotcsa.1822598

Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method

Abstract

Wastewater-based epidemiology provides an objective and complementary means of monitoring community alcohol consumption by measuring alcohol biomarkers excreted by the population. This approach enables the assessment of temporal and regional trends, offering valuable insights into consumption behavior and its public health implications. In this study, a previously established analytical method based on liquid chromatography-tandem mass spectrometry for the quantification of ethyl sulfate was re-optimized to enhance sensitivity and reduce analysis time, ensuring its effective applicability for routine monitoring. The improved direct injection method was validated and successfully met all analytical performance criteria. It was then applied to wastewater samples collected from a treatment plant across four seasons in 2019, 2020, and 2021 to estimate population-level alcohol consumption. Mean annual consumption ranged between 0.62 and 87.84 L/day/1000 inhabitants. A pronounced decline in estimated alcohol use was observed within the catchment area served by the monitored wastewater treatment plant over the monitoring years, potentially associated with the combined influence of the COVID-19 pandemic and increased alcohol taxation. These findings highlight the value of WBE as a cost-effective, non-invasive, and population-level tool that complements conventional epidemiological and sales data, providing real-time evidence to support alcohol-related public health strategies and policy development.

Keywords

Supporting Institution

This study was funded by Scientific Research Projects Coordination Unit of Istanbul University - Cerrahpasa Rectorate, Project No: FYL-2018-32800.

Project Number

FYL-2018-32800

References

1. EPA. Global status report on alcohol and health and treatment of substance use disorders [Internet]. [cited 2026 Feb 10]. Available from: .
2. Oshaug K, Kronstrand R, Kugelberg FC, Kristoffersen L, Mørland J, Høiseth G. Frequency of postmortem ethanol formation in blood, urine and vitreous humor – Improving diagnostic accuracy with the use of ethylsulphate and putrefactive alcohols. Forensic Sci Int [Internet]. 2022 Feb;331:111152. Available from: .
3. Wang H, Li B, Wang F, Chang J, Zhang Y, Rao Y. Determination of ethyl glucuronide and ethyl sulfate in human whole blood and vitreous humor by LC–MS-MS and applications to the interpretation of postmortem ethanol findings. J Anal Toxicol [Internet]. 2021 May 14;45(5):484–9. Available from: .
4. Thai PK, Tscharke BJ, O’Brien JW, Zheng Q, Thomas K V., Mueller JF. Estimating alcohol consumption by wastewater-based epidemiology: An assessment of the correction factor for ethyl sulfate using large-scale national monitoring data. Environ Sci Technol Lett [Internet]. 2021 Apr 13;8(4):333–8. Available from: .
5. Torp N, Bech KT, Schnefeld HL, Johansen S, Hansen CD, Semmler G, et al. Phosphatidylethanol and self-reported alcohol intake to subclassify individuals at risk of steatotic liver disease: An analysis of data from a prospective cohort study. Lancet Gastroenterol Hepatol [Internet]. 2025 Nov;10(11):975–85. Available from: .
6. Vanlerberghe BTK, Dumitrascu C, den Eede N Van, Neels H, van Malenstein H, Gevers TJG, et al. Phosphatidylethanol and ethyl glucuronide to categorize alcohol consumption in alcohol-related cirrhosis. JHEP Reports [Internet]. 2025 Aug;7(8):101433. Available from: .
7. Tegner M, Ott IR, Guterres F de S, de Barros VM, Linden R, Antunes MV. Determination of ethyl glucuronide and ethyl sulfate in dried blood spots by UHPLC–MS-MS: Method validation and assessment of ethanol exposure in postmortem samples from road traffic victims. J Anal Toxicol [Internet]. 2023 Jan 24;46(9):e223–31. Available from: .
8. Alsayed SN, Alharbi AG, Alhejaili AS, Aljukhlub RJ, Al-Amoudi DH, Ashankyty AI, et al. Ethyl glucuronide and ethyl sulfate: A review of their roles in forensic toxicology analysis of alcohol postmortem. Forensic Toxicol [Internet]. 2022 Jan 19;40(1):19–48. Available from: .

9. Andresen-Streichert H, Müller A, Glahn A, Skopp G, Sterneck M. Alcohol biomarkers in clinical and forensic contexts. Dtsch Arztebl Int [Internet]. 2018 May 4; Available from: .
10. Mercan S, Kuloglu M, Asicioglu F. Monitoring of illicit drug consumption via wastewater: Development, challenges, and future aspects. Curr Opin Environ Sci Heal [Internet]. 2019 Jun;9:64–72. Available from: .
11. Daughton CG. Illicit drugs in municipal sewage. In: Pharmaceuticals and Care Products in the Environment [Internet]. 2001. p. 348–64. Available from: .
12. Zuccato E, Chiabrando C, Castiglioni S, Calamari D, Bagnati R, Schiarea S, et al. Cocaine in surface waters: A new evidence-based tool to monitor community drug abuse. Environ Heal [Internet]. 2005 Dec 5;4(1):14. Available from: .
13. Zuccato E, Chiabrando C, Castiglioni S, Bagnati R, Fanelli R. Estimating community drug abuse by wastewater analysis. Environ Health Perspect [Internet]. 2008 Aug;116(8):1027–32. Available from: .
14. Zheng Q, Tscharke BJ, Krapp C, O’Brien JW, Mackie RS, Connor J, et al. New approach for the measurement of long-term alcohol consumption trends: Application of wastewater-based epidemiology in an Australian regional city. Drug Alcohol Depend [Internet]. 2020 Feb 1;207(3):107795. Available from: .
15. López-García E, Pérez-López C, Postigo C, Andreu V, Bijlsma L, González-Mariño I, et al. Assessing alcohol consumption through wastewater-based epidemiology: Spain as a case study. Drug Alcohol Depend [Internet]. 2020 Oct 1;215:108241. Available from: .
16. Salgueiro-González N, Rousis NI, Gracia-Lor E, Borsotti A, Zuccato E, Castiglioni S. First comprehensive study of alcohol consumption in Italy using wastewater-based epidemiology. Sci Total Environ [Internet]. 2021 Jul;776:145863. Available from: .
17. Yao Y, Wang J, Zhong Y, Chen W, Rao Y, Su M. Investigating alcohol consumption in China via wastewater-based epidemiology. Environ Geochem Health [Internet]. 2024 Jan 15;46(1):24. Available from: .
18. Reid MJ, Langford KH, Mørland J, Thomas K V. Analysis and interpretation of specific ethanol metabolites, ethyl sulfate, and ethyl glucuronide in sewage effluent for the quantitative measurement of regional alcohol consumption. Alcohol Clin Exp Res [Internet]. 2011 Jun 1;35(9):1593–9. Available from: .
19. Mercan S, Kuloglu M, Tekin T, Turkmen Z, Dogru AO, Safran AN, et al. Wastewater-based monitoring of illicit drug consumption in Istanbul: Preliminary results from two districts. Sci Total Environ [Internet]. 2019 Mar 15;656(2):231–8. Available from: .
20. Daglioglu N, Atasoy A, Asadi A, Guzel EY, Dengiz H. Estimating alcohol consumption by using wastewater-based epidemiology in Adana province, Turkey. Environ Sci Pollut Res [Internet]. 2020 Sep 6;27(25):31884–91. Available from: .
21. Asicioglu F, Kuloglu Genc M, Tekin Bulbul T, Yayla M, Simsek S, Adioren C, et al. Investigation of temporal illicit drugs, alcohol and tobacco trends in Istanbul city: Wastewater analysis of 14 treatment plants. Water Res [Internet]. 2021 Feb;190:116729. Available from: .
22. Kuloglu Genc M, Mercan S, Yayla M, Tekin Bulbul T, Adioren C, Simsek SZ, et al. Monitoring geographical differences in illicit drugs, alcohol, and tobacco consumption via wastewater-based epidemiology: Six major cities in Turkey. Sci Total Environ [Internet]. 2021 Nov;797:149156. Available from: .
23. Daglioglu N, Guzel EY, Atasoy A, Gören İE. Comparison of community illicit drug use in 11 cities of Turkey through wastewater-based epidemiology. Environ Sci Pollut Res [Internet]. 2021 Mar 23;28(12):15076–89. Available from: .
24. Pihlström T, Fernández-Alba AR, Ferrer Amate C, Erecius Poulsen M, Lippold R, Carrasco Cabrera L, et al. Analytical quality control and method validation procedures for pesticide residues analysis in food and feed SANTE 11312/2021 v2026. 2021; Available from: .
25. van Wel JHP, Gracia-Lor E, van Nuijs ALN, Kinyua J, Salvatore S, Castiglioni S, et al. Investigation of agreement between wastewater-based epidemiology and survey data on alcohol and nicotine use in a community. Drug Alcohol Depend [Internet]. 2016 May;162:170–5. Available from: .
26. Wilson MK, Phung K, Chappell A, Pilkington LI. Wastewater‐based epidemiology to investigate spatio‐temporal trends in alcohol consumption in aotearoa, New Zealand. Chem – An Asian J [Internet]. 2024 Mar 15;19(6):e202301120. Available from: .
27. Psichoudaki M, Tzelios D, Savvidou M, Mina C, Michael C, Fatta-Kassinos D. The first wastewater-based epidemiology study for alcohol monitoring in Cyprus: Temporal and spatial consumption trends from a one-year study. Sci Total Environ [Internet]. 2025 Sep;995:180113. Available from: .
28. Tscharke BJ, O’Brien JW, Ort C, Grant S, Gerber C, Bade R, et al. Harnessing the power of the census: Characterizing wastewater treatment plant catchment populations for wastewater-based epidemiology. Environ Sci Technol [Internet]. 2019 Sep 3;53(17):10303–11. Available from: .
29. Quireyns M, Boogaerts T, Giraldo JSP, Van Wichelen N, Feremans L, Benaissati I, et al. Comparing the applicability of de facto population markers for spatiotemporal trend analysis in wastewater-based epidemiology. J Hazard Mater [Internet]. 2025 Sep;496:139332. Available from: .
30. Baz-Lomba JA, Di Ruscio F, Amador A, Reid M, Thomas K V. Assessing alternative population size proxies in a wastewater catchment area using mobile device data. Environ Sci Technol [Internet]. 2019 Feb 19;53(4):1994–2001. Available from: .
31. Ramalho R. Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: A narrative review. Australas Psychiatry [Internet]. 2020 Oct 28;28(5):524–6. Available from: .
32. Anderson P, Llopis EJ, O’Donnell A, Kaner E. Impact of COVID-19 confinement on alcohol purchases in great britain: Controlled interrupted time-series analysis during the first half of 2020 compared with 2015–2018. Alcohol Alcohol [Internet]. 2021 Apr 29;56(3):307–16. Available from: .
33. Bade R, Simpson BS, Ghetia M, Nguyen L, White JM, Gerber C. Changes in alcohol consumption associated with social distancing and self‐isolation policies triggered by COVID‐19 in South Australia: A wastewater analysis study. Addiction [Internet]. 2021 Jun;116(6):1600–5. Available from: .
34. White HR, Stevens AK, Hayes K, Jackson KM. Changes in alcohol consumption among college students due to COVID-19: Effects of campus closure and residential change. J Stud Alcohol Drugs [Internet]. 2020 Nov;81(6):725–30. Available from: .
35. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: Results of the ECLB-COVID19 international online survey. Nutrients [Internet]. 2020 May 28;12(6):1583. Available from: .
36. Calina D, Hartung T, Mardare I, Mitroi M, Poulas K, Tsatsakis A, et al. COVID-19 pandemic and alcohol consumption: Impacts and interconnections. Toxicol Reports [Internet]. 2021;8:529–35. Available from: .

Details

Primary Language

English

Subjects

Forensic Chemistry

Journal Section

Research Article

Authors

Duygu Nur Mert
0000-0002-5861-8212
Türkiye

Merve Kuloğlu Genç
0000-0002-3670-3168
Türkiye

Mihriban Dilan Kılıç
0009-0004-7242-7641
Türkiye

Tuğba Tekin Bülbül
0000-0002-2535-8039
Türkiye

Selda Mercan
0000-0002-0431-6972
Türkiye

Publication Date

April 25, 2026

Submission Date

November 12, 2025

Acceptance Date

February 26, 2026

Published in Issue

Year 2026 Number: 2026-1

DOI

https://doi.org/10.18596/jotcsa.1822598

IZ

https://izlik.org/JA85DN43XF

Cite

RIS / Bibtex

APA

Mert, D. N., Kuloğlu Genç, M., Kılıç, M. D., Tekin Bülbül, T., & Mercan, S. (2026). Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method. Journal of the Turkish Chemical Society Section A: Chemistry, 2026-1, 1-10. https://doi.org/10.18596/jotcsa.1822598

AMA

1.Mert DN, Kuloğlu Genç M, Kılıç MD, Tekin Bülbül T, Mercan S. Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method. JOTCSA. 2026;(2026-1):1-10. doi:10.18596/jotcsa.1822598

Chicago

Mert, Duygu Nur, Merve Kuloğlu Genç, Mihriban Dilan Kılıç, Tuğba Tekin Bülbül, and Selda Mercan. 2026. “Monitoring of Ethyl Sulfate Biomarker for the Estimation of Community Alcohol Consumption via Wastewater Using a Direct Injection Method”. Journal of the Turkish Chemical Society Section A: Chemistry, no. 2026-1: 1-10. https://doi.org/10.18596/jotcsa.1822598.

EndNote

Mert DN, Kuloğlu Genç M, Kılıç MD, Tekin Bülbül T, Mercan S (April 1, 2026) Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method. Journal of the Turkish Chemical Society Section A: Chemistry 2026-1 1–10.

IEEE

[1]D. N. Mert, M. Kuloğlu Genç, M. D. Kılıç, T. Tekin Bülbül, and S. Mercan, “Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method”, JOTCSA, no. 2026-1, pp. 1–10, Apr. 2026, doi: 10.18596/jotcsa.1822598.

ISNAD

Mert, Duygu Nur - Kuloğlu Genç, Merve - Kılıç, Mihriban Dilan - Tekin Bülbül, Tuğba - Mercan, Selda. “Monitoring of Ethyl Sulfate Biomarker for the Estimation of Community Alcohol Consumption via Wastewater Using a Direct Injection Method”. Journal of the Turkish Chemical Society Section A: Chemistry. 2026-1 (April 1, 2026): 1-10. https://doi.org/10.18596/jotcsa.1822598.

JAMA

1.Mert DN, Kuloğlu Genç M, Kılıç MD, Tekin Bülbül T, Mercan S. Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method. JOTCSA. 2026;:1–10.

MLA

Mert, Duygu Nur, et al. “Monitoring of Ethyl Sulfate Biomarker for the Estimation of Community Alcohol Consumption via Wastewater Using a Direct Injection Method”. Journal of the Turkish Chemical Society Section A: Chemistry, no. 2026-1, Apr. 2026, pp. 1-10, doi:10.18596/jotcsa.1822598.

Vancouver

1.Duygu Nur Mert, Merve Kuloğlu Genç, Mihriban Dilan Kılıç, Tuğba Tekin Bülbül, Selda Mercan. Monitoring of ethyl sulfate biomarker for the estimation of community alcohol consumption via wastewater using a direct injection method. JOTCSA. 2026 Apr. 1;(2026-1):1-10. doi:10.18596/jotcsa.1822598