Elevated blood lead levels associated with the consumption of moonshine among emergency department patients in Atlanta, Georgia

Study objectives In February and March 2000, 4 adult emergency care patients were identified with potentially lethal lead toxicity at Grady Memorial Hospital, an urban Atlanta, GA, hospital. All were moonshine drinkers, prompting concern that lead exposure from moonshine was underrecognized in this setting. Methods We conducted a 2-phased, nested, cross-sectional study throughout a 14-day period in the emergency care center of Grady Memorial Hospital. The prevalence phase consisted of demographic data collection, eligibility screening, and a brief interview pertaining to alcohol and moonshine consumption. During the nested phase, a full interview and blood lead analyses were conducted on all consenting moonshine drinkers and a time-matched comparison group of non–moonshine drinkers. Results In the prevalence phase, of 581 patients interviewed, 8.6% reported consuming moonshine in the past 5 years. Moonshine drinkers were predominantly men between the ages of 40 and 59 years. In the nested phase, the median blood lead levels among moonshine drinkers and nondrinkers were 11.0 μg/dL (0.531 μmol/L) and 2.5 μg/dL (0.121 μmol/L), respectively. Moonshine drinkers were significantly more likely to have blood lead levels of 10 μg/dL (0.483 μmol/L) or greater (odds ratio [OR] 10.94; 95% confidence interval 3.76 to 31.85). Patients who consumed moonshine in the previous week were significantly more likely to have a blood lead level of 10 μg/dL (0.483 μmol/L) or greater than were individuals who reported less recent consumption. Patients who consumed moonshine more than once a month were significantly more likely to have a blood lead level of 10 μg/dL (0.483 μmol/L) or greater than were those reporting less frequent use. Moonshine users were more likely to report heavy alcohol use. Conclusion Moonshine consumption was more prevalent than expected in our patient population and was strongly associated with elevated blood lead levels, particularly among recent moonshine drinkers.