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Human Practices

Specialists Opinion

Doctor

Finally, to take a step forward to understand better the problem which we want to contribute to solve, we interviewed a doctor Lucas Santos Zambon who has treated and wrote an article related to contamination by methanol.He graduated in University of São Paulo Medical School (FMUSP), is a doctor at the department of Clinical Emergency in FMUSP Hospital and is also head of the Brazilian Institute for Pacient’s Safety.In the interview Doctor Zambon provided their views on the causes and consequences of methanol presence in beverages, and also gave his opinion about our initiative. The doctor also provided relevant information about the symptoms that we must be alert.

In 2012, a research was done by scientists from Unifesp with producers, sellers and consumers of alcohol in the city of São Paulo (SP) and found the presence of methanol in 37% of cachaça, liquors, wines, cognacs and whiskeys analyzed in a percentage above of that permitted by law.Could you explain to us how much is that limit and why beyond this the presence of methanol offers a risk to health?

This limit is established by the law in Brazil. For example, methanol is an alcohol naturally present in “cachaça” in concentrations lower than 20mg 100 mL-1 of anidri alcohol (AA) and it origins from hydrolysis of pectins derived from the raw material. In very small proportions, methanol is hardly toxic, especially when it is ingested with ethanol (as in the case of alcoholic beverages), because ethanol acts as an antidote for the formation of toxic metabolites of methanol. However, there is not absolutely safe levels from the point of view of toxicity. The point is that methanol can be formed as a natural fermentation process of alcohol, so there must be a limit of what is tolerable, since it is a natural process, not a content tampering. If I'm not mistaken, these laws are here: Decree 73,267, of 6.12.73, set by the President and Ordinance 371 of the Ministry of Agriculture, published in the Gazette of 9/19/74.

High consumption of adulterated beverage is related to the low price and its easy access . In your view and considering what you have witnessed, the biggest problem is in the fact that people are unaware that the drink contains components that pose risks to health or not that they do not to take the risks seriously?

People are unaware of the methanol issue. Sometimes not only those who buy, but also owners of bars and places where they sell drinks are unaware that when buying "cheap" or “clandestine” beverage, which actually are adulterated, are offering a serious risk to the consumer. The biggest problem is the lack of information.

Have you ever dealt directly with patients with methanol poisoning? What are the most common symptom?

I have already attended several instances in the Emergency Room. Usually are serious conditions, and symptoms are variable, but most cases have neurological symptoms, often confused with a simple situation of abuse of alcoholic beverages, but with far greater severity of impact.

A current project in development by students of USP aims to create a device that would detect the presence of methanol from a sample of any alcoholic beverage. This device would consist in genetically modified and lyophilized microorganisms that in the presence of methanol above the allowed limit would produce a red fluorescent protein. In your opinion, would this device become a useful tool to prevent more cases of contamination by methanol?

I believe that such an instrument, if cost-effective, could help a lot of the regulatory and inspection bodies such as the Ministry of Agriculture.

In your opinion of a medical professional, do you believe that this device could found applications in healthcare, considering possible adaptations?

Yes, and I would be willing to help and participate in the development for an application in emergency. In my view, the idea need to be transported to a situation where detection is done in body fluids such as blood where the individual is suspected of toxicity. Doctor’s biggest source of doubt is to complete medical diagnosis and suggest a suitable treatment consequently.

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