With the new attention to moonshine and the rising cost of licensed alcohol, it is predictable that more people will be using moonshine as a replacement. So what are the likely side effects?
First the very good news. Methanol content is way down, so a first time drinker is unlikely to go blind after a few sips.
Now the bad news, moonshiners don’t seem to test consistently for lead levels, or they may even allow for lead levels to sweeten the ‘shine, much as the Romans did. In either case, there are consistent reports of elevated lead levels in moonshine drinkers over the last thirty years whenever a medical department undertakes a study.
The side effects of high lead levels are not romantic or fun. There are a number of instant lead testing kits out on the market that would allow both producers and consumers of moonshine to not end their indulgent weekends with a visit to the local emergency room for convulsions. Blood lead levels are also an easy test to obtain, and relatively accurate. Those consuming moonshine in the last month were likely to have the highest blood lead levels.
J Toxicol Clin Toxicol. 2004;42(5):597-601.
Analysis of moonshine for contaminants.
Holstege CP, Ferguson JD, Wolf CE, Baer AB, Poklis A.
Blue Ridge Poison Center, Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia, P.O. Box 800699, Charlottesville, VA 22908-0699, USA. firstname.lastname@example.org
In the past, some moonshine products contained potentially toxic contaminants. Although moonshine production continues in the United States, no studies have analyzed the content of moonshine since the early 1960s. We hypothesize that moonshine continues to contain potentially toxic concentrations of contaminants.
Forty-eight samples of illicitly distilled moonshine were obtained from law enforcement agencies. An independent laboratory, blinded to both the moonshine source and a control sample of ethanol, conducted the analysis. Lead content was determined using atomic absorption spectrophotometry with a graphite tube atomizer. Alcohol content, including ethanol, acetone, isopropanol, methanol, and ethylene glycol, was determined using gas liquid chromatography with flame ionization detection.
Ethanol content ranged from 10.5% to 66.0% with a mean value of 41.2%. Lead was found in measurable quantities in 43 of 48 samples with values ranging from 5 to 599 parts per billion (ppb) with a mean value of 80.7 ppb. A total of 29 of 48 (60%) of samples contained lead concentrations above or equal to the EPA water guideline of 15 ppb. Methanol was found in only one sample at a concentration of 0.11%. No samples contained detectable concentrations of acetone, isopropanol, or ethylene glycol.
Many moonshine samples contain detectable concentrations of lead. Extrapolations based on the described moonshine lead content suggest that chronic consumers of moonshine may develop elevated lead concentrations. Physicians should consider lead toxicity in the differential diagnosis when evaluating patients consuming moonshine.
Arch Environ Health. 1980 Nov-Dec;35(6):332-4.
Trace element content of moonshine.
Gerhardt RE, Crecelius EA, Hudson JB.
Although the contamination of illicit whiskey with lead is widely accepted, the potential for exposure to other trace elements from drinking “moonshine” is less well appreciated. To better understand the potential for trace element poisoning, we undertook an analysis of samples of Georgia moonshine. Although a number of elements were not found in significant quantities to be considered harmful, four elements (copper, zinc, lead, and arsenic) were present in potentially toxic concentrations. The possible implications and sources of the contamination are discussed.
Arch Intern Med. 1980 Feb;140(2):211-3.
Moonshine-related arsenic poisoning.
Gerhardt RE, Crecelius EA, Hudson JB.
Twelve sequential cases of arsenic poisoning were reviewed for possible sources of ingestion. Contaminated illicit whiskey (moonshine) appeared to be the source in approximately 50% of the patients. An analysis of confiscated moonshine revealed that occasional specimens contained high levels of arsenic as a contaminant. Although arsenic poisoning occurs relatively infrequently, contaminated moonshine may be an important cause of the poisoning in some areas of the country.
Arch Intern Med. 1993 Jun 28;153(12):1501-4.
Elevated blood lead levels associated with illegally distilled alcohol.
Pegues DA, Hughes BJ, Woernle CH.
Division of Field Epidemiology, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Ga.
Whiskey produced in illegal stills (ie, “moonshine”) remains an important and underappreciated source of lead toxicity in some rural counties of the Southeast. From March 5 through October 26, 1991, eight adult patients with elevated blood lead levels were identified at a rural county hospital in Alabama and were reported to the Alabama Department of Public Health notifiable disease surveillance system. A case-patient was defined as any person 17 years of age or more who presented to the hospital from January 1, 1990, through December 31, 1991, and had a blood lead level of 0.72 mumol/L or more (15 micrograms/dL or more). To identify cases and potential sources of lead exposure, we reviewed medical and laboratory records from the hospital, interviewed patients with elevated blood lead levels, and determined the lead content of moonshine samples. Nine patients met the case definition, including one patient who was not reported to the state. Patients ranged in age from 28 to 62 years; blood lead values ranged from 0.77 to 12.50 mumol/L (16 to 259 micrograms/dL). The most frequent signs of possible lead toxicity included seizures (six), microcytic anemia (five), and encephalopathy (two); one patient died. The only identified source of lead exposure for the nine patients was moonshine ingestion. Moonshine samples available from local stills contained sufficient amounts of lead (340 to 4600 mumol/L) to result in the observed blood lead levels. This investigation emphasizes the adverse health effects and ongoing public health impact of moonshine ingestion.
Arch Intern Med. 1994 Feb 14;154(3):348, 351.
Ann Emerg Med. 2001 Jan;37(1):51-4.
Elevated blood lead levels in urban moonshine drinkers.
Morgan BW, Todd KH, Moore B.
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30303-3219, USA. email@example.com
During a study of problem drinking, we found that surprisingly large numbers of emergency department patients reported moonshine consumption. Because of sporadic reports of moonshine-associated lead toxicity in rural areas, we suspected that urban ED patients might have previously unidentified elevated blood lead levels caused by moonshine consumption. We initiated an active screening program to identify patients with moonshine-associated elevated blood lead levels.
We performed a prospective case-finding effort at a large urban ED in Atlanta, GA, screening all patients admitted to the ED for a 6-month period during times when study personnel were available. Patients reporting moonshine consumption within the preceding 5 years were asked to participate. After written informed consent, subjects completed a structured interview administered by one of the investigators, and blood was obtained for determination of a whole blood lead level. We recorded the numbers of patients reporting moonshine consumption, time of most recent consumption, other potential sources of lead exposures, and whole blood lead levels.
Of 49 patients reporting consumption of moonshine within the past 5 years, 25 (51%) of 49 had elevated blood lead levels (>15 microg/dL), with 15 (31%) of 49 having extremely elevated blood lead levels (>50 microg/dL). Recent moonshine consumption (within the past month) was reported by 38 (78%) of 49 patients. Of these 38 recent consumers, 23 (61%) had elevated lead levels compared with only 2 (18%) of 11 of those reporting more remote consumption (risk difference 42%; 95% confidence interval 15% to 70%).
A high percentage of patients who reported moonshine consumption had elevated blood lead levels. Emergency physicians should consider screening to determine the prevalence of moonshine consumption in their practice settings, as well as the possibility of lead intoxication among patients with suggestive symptoms. All patients reporting moonshine consumption within the past 5 years should be tested for lead exposure.
Ann Emerg Med. 2001 Oct;38(4):460-1.