Groups want explicit warnings on alcohol.

The Irish Medical Organisation (IMO) has petitioned the Government to introduce explicit health warnings on alcohol pro-ducts. The doctors’ union believes the labels should include alcohol gram content rather than the traditional units of alcohol so that individuals understand the actual amount they are consuming.

As well as warning of the dangers of drink-driving, the labels should also give the calorie content of the drink, as a ‘considerable proportion of Irish adult calorie intake is in the form of alcohol’, the IMO said.

In its submission to the Department of Health – made as part of a public consultation process – the IMO said Government needed to legislate for mandatory health warnings in respect of pregnancy.

“Consuming alcohol during pregnancy increases the risk of Foetal Alcohol Spectrum Disorder, yet 63 per cent of women report drinking alcohol during pregnancy with 7 per cent drinking six or more units per week,” it stated.

‘Low-cost’ strategy
While such explicit health warnings on alcohol were a ‘low-cost’ strategy, they would only be effective in altering behaviour if implemented alongside a wide range of other measure, the IMO added.

It thus used its submission to once again call for: alcohol sponsorship of sporting events to be prohibited; a pre-9pm watershed ban on alcohol advertising on TV; a ban on below- cost selling; a minimum pricing structure for alcohol; the immediate reduction of the drink driving limit to 50mg/100ml; and mandatory drug and alcohol screening after road traffic accidents. It also wants to introduce a traceability mechanism so that alcohol sold in off-licences to underage drinkers can be traced.

Submission
The IMO’s submission – obtained by IMT under the Freedom of Information Act and revealed in last week’s issue – was one of eight sent to the Department in preparation of new legislation due to be introduced by Minister of Health Mary Harney.

Minister Harney proposes to introduce legislation to provide for the placing of health advice and warnings on all alcoholic drink containers and on promotional material.

The health advice will relate to the consumption of alcohol during pregnancy. It is also proposed that the amount of pure alcohol contained in each bottle or can be displayed on the label or container so that the consumer will be better informed in relation to what is being consumed.

The Faculty of Public Health Medicine of the RCPI echoed the IMO’s call to include information on the amount of alcohol in grams and the amount of calories contained in each drink. It pointed out that alcohol should not be exempted from labelling requirements demanded of other potentially harmful substances.

“Alcohol consumption is linked to more than 60 diseases and conditions affecting nearly every organ in the human body and is the third highest risk factor for premature death and ill-health in the European Union,” the public health specialists stated.

“Alcohol-related harm includes such problems as accidents, injuries, chronic ill-health, premature death, public safety, violence, child neglect, marital problems and lost productivity due to absenteeism or poor performance at work,” the Faculty listed, putting the cost to the economy at more than E2.65 billion.

Contrary to Fianna Fáil TD Mattie McGrath’s comments late last year that alcohol could relax nervous or ‘jumpy’ drivers, the submission – sent in by the Faculty’s Dean Dr Patricia Fitzpatrick – stressed there was ‘no evidence’ to show that any amount of alcohol makes driving safer.

The Faculty pointed out that repeated studies from the European School Survey Project on Alcohol and Other Drugs showed Ireland’s young people to be among the very highest for consumption and for binge drinking. “This bodes very badly for the future,” it warned.

“Young people are particularly susceptible to advertisements and the promotion of alcohol and most likely to be harmed by drinking. It is therefore vital to delay the age of onset of drinking by young people, as recommended by the WHO.”

More than 20 countries have recognised the need for mandatory labelling of alcohol.

France was the first country in the EU to pass such legislation in 2006, and is one of the few worldwide to use graphic logos warning against drinking alcohol during pregnancy.

The content of these warnings vary significant in tone and detail. For example, in the US drinkers are warned that ‘According to the Surgeon General, women should not drink alcoholic beverages during pregnancy because of the risk of birth defects’.

Three different wordings are available to the authorities in the Republic of Korea, each of which is a lot more specific. For example, one states: “Excessive consumption of alcohol may cause liver cirrhosis or liver cancer, and especially, women who drink while they are pregnant increase the risk of congenital anomalies.”

In its submission to Hawkins House, the Food Safety Authority of Ireland (FSAI) revealed that it had carried out a survey of more than 1,000 people last year on attitudes and behaviours to food and drink labelling, including health warnings on alcohol. The vast majority (81 per cent) believed alcoholic products should carry health warnings.

In the FSAI survey, consumers were shown two ‘warning’ images and almost two-thirds (63 per cent) believed the logo used in France — of a pregnant women in silhouette drinking, with a red line through her — best conveyed the message not to consume alcohol during pregnancy.

Regarding the exact amount of alcohol contained in products, the Authority believed that to require a simple quantity-of-pure-alcohol declaration may not add much value to a consumers’ understanding of the potential dangers. “However, a declaration indicating the number of units a container or serving provided could help consumers make informed and educated decisions about their alcohol consumption,” it stated.

Alcohol Action Ireland also believed that the number of alcohol units in the product should be one of the key pieces of health information on all packaging.

Risk in pregnancy
The Health Research Board (HRB), in its submission, however, did want the number of grams of pure alcohol clearly labelled, together with the ingredients and nutritional information.

While there was currently no data available for the incidence of Foetal Alcohol Spectrum Disorders in Ireland, the US has reported an incidence of between 0.2 and 2 per 1,000 live births, even though only 10 per cent of American pregnant women report any consumption of alcohol during pregnancy and only 2 per cent engage in binge drinking or frequent use. This compares with almost two-thirds of Irish pregnant women, according to one study, drinking some alcohol and 7 per cent consuming six standard drinks per week – which is 60g of pure alcohol.

“These results would imply that a substantial number of newborns each year are at risk of impaired development due to prenatal alcohol exposure,” the HRB indicated.

Neurological damage
The group Fetal (sic) Alcohol Spectrum Disorders Ireland agreed that Ireland needed to warn of the neurological damage from alcohol, which, it said, may only become evident further on in childhood. “The US only warns of birth defects, so this is Ireland’s chance to lead,” it stated.

However, the group was against the use of a logo showing a red line through a pregnant woman seeming drinking alcohol, believing that this ‘trivialises the message to the status of a joke, as is the intention and practice of such a pictogram on a certain brand of chocolate bar.’ Instead, it believed the red line should be through the product — a suggestion not supported by the research from the Food Safety Authority.

At six pages, the Alcohol Beverage Federation of Ireland (ABFI) sent in one of the most detailed submissions, in which it stressed the industry provided more than 85,000 full or part-time jobs and contributed more than E2.2 billion in tax every year.

Industry support
While the group said it ‘fully supported’ the provision of information to the public, it was concerned that too much information was likely to ‘reduce legibility’ of the label and be ‘unhelpful to the consumer’. It believed the provision of unit information should be deemed a ‘priority’, but acknowledged that this was not sufficient for pregnant women.

“[The] ABFI accepts the Department of Health position that a health advice label for pregnant women should also be applied,” the industry body added, although later on it stated that there were conflicting views among scientists regarding the consumption of alcohol during pregnancy.

It was supportive, however, of the introduction of a pictogram warning aimed at pregnant women, similar to the image used in France. “In order to be effective, such a measure would need to be accompanied by a major awareness campaign incorporating members of the medical profession,” it added.

The Federation believed introducing grams of alcohol on labels would only confuse consumers just beginning to understand the concept of a unit. In the long term, it would like to see a common approach to units adopted across the EU.

Legislation introducing labelling advising of the risk of consuming alcohol is part of a miscellaneous public health Bill currently being prepared.

Soure: Dara Gantly, Irish Medical Times, 22/01/2010.