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Drinking Water Quality and Human Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (30 June 2018) | Viewed by 159266

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Patrick Levallois

E-Mail Website
Guest Editor
Direction de la santé environnementale et de la toxicologie, Institut national de santé publique du Québec (INSPQ), Québec, QC, Canada
Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC, Canada
Interests: health impact of chemical and microbiological contamination of drinking water, drinking water standards, risk analysis, environmental epidemiology
Prof. Dr. Cristina Villanueva Belmonte

E-Mail Website
Guest Editor
ISGlobal - Barcelona Institute for Global Health, 08003 Barcelona, Spain
Interests: drinking water; biomarkers; disinfection by-products; environmental epidemiology; exposure assessment; water quality

Special Issue Information

Dear Colleagues,

Quality of drinking water is paramount for public health. Despite important improvements in the last decades, access to safe drinking water is not universal. The World Health Organization estimates that almost 10% of the population in the world do not have access to improved drinking water sources. Among other diseases, waterborne infections cause diarrhoea, which kills nearly one million people every year, mostly children under 5 years of age. On the other hand, chemical pollution is a concern in high-income countries and an increasing problem in low- and middle-income countries. Exposure to chemicals in drinking water may lead to a range of chronic non-communicable diseases (e.g., cancer, cardiovascular disease), adverse reproductive outcomes and effects on children’s health (e.g., neurodevelopment), among other health effects. Although drinking water quality is regulated and monitored in many countries, increasing knowledge leads to the need for reviewing standards and guidelines on a nearly permanent basis, both for regulated and newly identified contaminants. Drinking water standards are mostly based on animal toxicity data, and more robust epidemiologic studies with accurate exposure assessment are needed. The current risk assessment paradigm dealing mostly with one-by-one chemicals dismisses potential synergisms or interactions from exposures to mixtures of contaminants, particularly at the low-exposure range. Thus, evidence is needed on exposure and health effects of mixtures of contaminants in drinking water. In addition, drinking water components and even quantity of water ingested may have some health benefits, which are currently under evaluated. Finally, water stress and water quality problems are expected to increase in the coming years due to climate change and increasing water demand by population growth, and new evidence is needed to design appropriate adaptation policies.

This special issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the links between drinking water quality and human health. New research papers, reviews, case reports and conference papers are welcome to this issue. Papers dealing with new approaches to derive drinking water standards or risk assessment and management are also welcome. Other manuscript types accepted include methodological papers, position papers, brief reports, and commentaries.

We will accept manuscripts from different disciplines including exposure assessment science, epidemiology, intervention studies, risk and health impact assessment, risk management including drinking water standards. Here are some examples of topics that could be addressed in this Special Issue:

  1. Contaminants at the source of drinking water
    • Microorganisms and infectious diseases: virus, bacteria, parasites, etc.
    • Natural contaminants: arsenic, barium, manganese, fluoride, radiation, etc.
    • Anthropogenic chemicals: nitrate, pesticides, pharmaceutical and veterinary residues, personal care products, household products, antimicrobial resistance, organic compounds, etc.
    • Algal blooms and microcystins.
  2. Contaminants due to treatment of drinking water: disinfection by-products, fluoride, by-products of flocculants or coagulants, etc.
  3. Contaminants from drinking water distribution: metals (e.g., lead, copper), and other compounds released by pipes (e.g., vinyl chloride).
  4. Bottled water quality.
  5. Mixtures of contaminants.
  6. Other water parameters, e.g., hardness, minerals.
  7. Interaction/balance between microorganisms and chemicals.
  8. Health benefits associated with drinking water.
  9. Climate change and drinking water quality.

Prof. Patrick Levallois
Dr. Cristina Villanueva Belmonte
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Drinking water
  • Chemicals
  • Microorganisms
  • Infectious diseases
  • Non-communicable diseases
  • Biomarkers
  • Epidemiology
  • Health impact
  • Drinking water standards
  • Emerging contaminants
  • Exposure assessment
  • Multiroute exposure
  • Risk assessment
  • Risk management
  • Risk communication

Published Papers (21 papers)

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Editorial

Jump to: Research, Review

4 pages, 266 KiB  
Editorial
Drinking Water Quality and Human Health: An Editorial
by Patrick Levallois and Cristina M. Villanueva
Int. J. Environ. Res. Public Health 2019, 16(4), 631; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph16040631 - 21 Feb 2019
Cited by 41 | Viewed by 10391
Abstract
Drinking water quality is paramount for public health [...] Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)

Research

Jump to: Editorial, Review

15 pages, 1104 KiB  
Article
Associations between Water Quality Measures and Chronic Kidney Disease Prevalence in Taiwan
by Kuan Y. Chang, I-Wen Wu, Bo-Ruei Huang, Jih-Gau Juang, Jia-Chyi Wu, Su-Wei Chang and Chung Cheng Chang
Int. J. Environ. Res. Public Health 2018, 15(12), 2726; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15122726 - 03 Dec 2018
Cited by 8 | Viewed by 4811
Abstract
To determine the relationships between exposure to environmental contaminants in water and chronic kidney disease (CKD), we investigated the associations of 61 water attributes with the prevalence of CKD and End-Stage Renal Disease (ESRD) using data from 2005 to 2011 from all 22 [...] Read more.
To determine the relationships between exposure to environmental contaminants in water and chronic kidney disease (CKD), we investigated the associations of 61 water attributes with the prevalence of CKD and End-Stage Renal Disease (ESRD) using data from 2005 to 2011 from all 22 counties and cities in the main island of Taiwan. We acquired patient information from the Taiwan Longitudinal Health Insurance Database to calculate the age-standardized CKD and ESRD prevalence rates and linked the patients’ residences to the water quality monitoring data, which were sampled periodically for a total of over 45,000 observations obtained from the Taiwan Environmental Water Quality Information Database. The association analysis adjusting for gender, age, and annual effects showed that the zinc (Zn), ammonia, chemical oxygen demand (COD), and dissolved oxygen in rivers were weakly correlated with CKD (τ = 0.268/0.250/0.238/−0.267, p = 6.01×10−6/2.52×10−5/6.05×10−5/3.30×10−5, respectively), but none for ESRD. The importances of Zn and COD in rivers were also demonstrated in a CKD regression model. Moreover, an unusually high CKD prevalence was related to arsenic contamination in groundwater. A further prospective cohort study would improve our understanding of what level of environmental water with risky properties could affect the development of CKD. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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19 pages, 2932 KiB  
Article
Health Risk of Polonium 210 Ingestion via Drinking Water: An Experience of Malaysia
by Minhaz Farid Ahmed, Lubna Alam, Che Abd Rahim Mohamed, Mazlin Bin Mokhtar and Goh Choo Ta
Int. J. Environ. Res. Public Health 2018, 15(10), 2056; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102056 - 20 Sep 2018
Cited by 17 | Viewed by 6146
Abstract
The presence of toxic polonium-210 (Po-210) in the environment is due to the decay of primordial uranium-238. Meanwhile, several studies have reported elevated Po-210 radioactivity in the rivers around the world due to both natural and anthropogenic factors. However, the primary source of [...] Read more.
The presence of toxic polonium-210 (Po-210) in the environment is due to the decay of primordial uranium-238. Meanwhile, several studies have reported elevated Po-210 radioactivity in the rivers around the world due to both natural and anthropogenic factors. However, the primary source of Po-210 in Langat River, Malaysia might be the natural weathering of granite rock along with mining, agriculture and industrial activities. Hence, this is the first study to determine the Po-210 activity in the drinking water supply chain in the Langat River Basin to simultaneously predict the human health risks of Po-210 ingestion. Therefore, water samples were collected in 2015–2016 from the four stages of the water supply chain to analyze by Alpha Spectrometry. Determined Po-210 activity, along with the influence of environmental parameters such as time-series rainfall, flood incidents and water flow data (2005–2015), was well within the maximum limit for drinking water quality standard proposed by the Ministry of Health Malaysia and World Health Organization. Moreover, the annual effective dose of Po-210 ingestion via drinking water supply chain indicates an acceptable carcinogenic risk for the populations in the Langat Basin at 95% confidence level; however, the estimated annual effective dose at the basin is higher than in many countries. Although several studies assume the carcinogenic risk of Po-210 ingestion to humans for a long time even at low activity, however, there is no significant causal study which links Po-210 ingestion via drinking water and cancer risk of the human. Since the conventional coagulation method is unable to remove Po-210 entirely from the treated water, introducing a two-layer water filtration system at the basin can be useful to achieve SDG target 6.1 of achieving safe drinking water supplies well before 2030, which might also be significant for other countries. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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14 pages, 668 KiB  
Article
Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006–2008
by Kirsten S. Almberg, Mary E. Turyk, Rachael M. Jones, Kristin Rankin, Sally Freels and Leslie T. Stayner
Int. J. Environ. Res. Public Health 2018, 15(9), 1889; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15091889 - 31 Aug 2018
Cited by 64 | Viewed by 9060
Abstract
Atrazine, a common water contaminant in the U.S., has been associated with adverse birth outcomes in previous studies. This study aimed to determine if atrazine concentrations in drinking water are associated with adverse birth outcomes including small for gestational age (SGA), term low [...] Read more.
Atrazine, a common water contaminant in the U.S., has been associated with adverse birth outcomes in previous studies. This study aimed to determine if atrazine concentrations in drinking water are associated with adverse birth outcomes including small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB). This study included 14,445 live singleton births from Ohio communities served by 22 water systems enrolled in the U.S. Environmental Protection Agency’s Atrazine Monitoring Program between 2006 and 2008. Mean gestational and trimester-specific atrazine concentrations were calculated. Significantly increased odds of term LBW birth was associated with atrazine exposure over the entire gestational period (OR 1.27, 95% CI 1.10, 1.45), as well as the first (OR 1.20, 95% CI 1.08, 1.34) and second trimesters (OR 1.13, 95% CI 1.07, 1.20) of pregnancy. We observed no evidence of an association between atrazine exposure via drinking water and SGA, VLBW, PTB, or VPTB. Our results suggest that atrazine exposure is associated with reduced birth weight among term infants and that exposure to atrazine in drinking water in early and mid-pregnancy may be most critical for its toxic effects on the fetus. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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17 pages, 3630 KiB  
Article
The Seasonality of Nitrite Concentrations in a Chloraminated Drinking Water Distribution System
by Pirjo-Liisa Rantanen, Ilkka Mellin, Minna M. Keinänen-Toivola, Merja Ahonen and Riku Vahala
Int. J. Environ. Res. Public Health 2018, 15(8), 1756; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15081756 - 15 Aug 2018
Cited by 10 | Viewed by 5670
Abstract
We studied the seasonal variation of nitrite exposure in a drinking water distribution system (DWDS) with monochloramine disinfection in the Helsinki Metropolitan Area. In Finland, tap water is the main source of drinking water, and thus the nitrite in tap water increases nitrite [...] Read more.
We studied the seasonal variation of nitrite exposure in a drinking water distribution system (DWDS) with monochloramine disinfection in the Helsinki Metropolitan Area. In Finland, tap water is the main source of drinking water, and thus the nitrite in tap water increases nitrite exposure. Our data included both the obligatory monitoring and a sampling campaign data from a sampling campaign. Seasonality was evaluated by comparing a nitrite time series to temperature and by calculating the seasonal indices of the nitrite time series. The main drivers of nitrite seasonality were the temperature and the water age. We observed that with low water ages (median: 6.7 h) the highest nitrite exposure occurred during the summer months, and with higher water ages (median: 31 h) during the winter months. With the highest water age (190 h), nitrite concentrations were the lowest. At a low temperature, the high nitrite concentrations in the winter were caused by the decelerated ammonium oxidation. The dominant reaction at low water ages was ammonium oxidation into nitrite and, at high water ages, it was nitrite oxidation into nitrate. These results help to direct monitoring appropriately to gain exact knowledge of nitrite exposure. Also, possible future process changes and additional disinfection measures can be designed appropriately to minimize extra nitrite exposure. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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13 pages, 1807 KiB  
Article
Prevalence of Microbiological and Chemical Contaminants in Private Drinking Water Wells in Maryland, USA
by Rianna T. Murray, Rachel E. Rosenberg Goldstein, Elisabeth F. Maring, Daphne G. Pee, Karen Aspinwall, Sacoby M. Wilson and Amy R. Sapkota
Int. J. Environ. Res. Public Health 2018, 15(8), 1686; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15081686 - 07 Aug 2018
Cited by 13 | Viewed by 5377
Abstract
Although many U.S. homes rely on private wells, few studies have investigated the quality of these water sources. This cross-sectional study evaluated private well water quality in Maryland, and explored possible environmental sources that could impact water quality. Well water samples (n [...] Read more.
Although many U.S. homes rely on private wells, few studies have investigated the quality of these water sources. This cross-sectional study evaluated private well water quality in Maryland, and explored possible environmental sources that could impact water quality. Well water samples (n = 118) were collected in four Maryland counties and were analyzed for microbiological and chemical contaminants. Data from the U.S. Census of Agriculture were used to evaluate associations between the presence of animal feeding operations and well water quality at the zip code level using logistic regression. Overall, 43.2% of tested wells did not meet at least one federal health-based drinking water standard. Total coliforms, fecal coliforms, enterococci, and Escherichia coli were detected in 25.4%, 15.3%, 5.1%, and 3.4% of tested wells, respectively. Approximately 26%, 3.4%, and <1% of wells did not meet standards for pH, nitrate-N, and total dissolved solids, respectively. There were no statistically significant associations between the presence of cattle, dairy, broiler, turkey, or aquaculture operations and the detection of fecal indicator bacteria in tested wells. In conclusion, nearly half of tested wells did not meet federal health-based drinking water standards, and additional research is needed to evaluate factors that impact well water quality. However, homeowner education on well water testing and well maintenance could be important for public health. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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13 pages, 1594 KiB  
Article
An Assessment of Current and Past Concentrations of Trihalomethanes in Drinking Water throughout France
by Magali Corso, Catherine Galey, René Seux and Pascal Beaudeau
Int. J. Environ. Res. Public Health 2018, 15(8), 1669; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15081669 - 06 Aug 2018
Cited by 8 | Viewed by 3364
Abstract
In France, 95% of people are supplied with chlorinated tap water. Due to the presence of natural organic matter that reacts with chlorine, the concentrations of chlorination by-products (CBPs) are much higher in chlorinated water produced from surface water than from groundwater. Surface [...] Read more.
In France, 95% of people are supplied with chlorinated tap water. Due to the presence of natural organic matter that reacts with chlorine, the concentrations of chlorination by-products (CBPs) are much higher in chlorinated water produced from surface water than from groundwater. Surface water supplies 33% of the French population. Until the 1980s, almost all surface water utilities pre-chlorinated water at the intake. Pre-chlorination was then gradually banned from 1980 to 2000. Trihalomethanes (THMs) are the only regulated CBP in France. Since 2003, THMs have been monitored at the outlet of all utilities. This study assessed current (2005–2011) and past (1960–2000) exposure of the French population to THMs. We developed an original method to model THM concentrations between 1960 and 2000 according to current concentrations of THMs, concentration of total organic carbon in raw and finished water, and the evolution of water treatments from 1960 onward. Current and past mean exposure of the French population to THMs was estimated at 11.7 µg·L−1 and 17.3 µg·L−1, respectively. In the past, approximately 10% of the French population was exposed to concentrations >50 µg·L−1 vs. 1% currently. Large variations in exposure were observed among France’s 100 administrative districts, mainly depending on the water origin (i.e., surface vs. ground), ranging between 0.2 and 122.1 µg·L−1 versus between 1.8 and 38.6 µg·L−1 currently. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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23 pages, 2028 KiB  
Article
Assessing the Impact of a Risk-Based Intervention on Piped Water Quality in Rural Communities: The Case of Mid-Western Nepal
by Dorian Tosi Robinson, Ariane Schertenleib, Bal Mukunda Kunwar, Rubika Shrestha, Madan Bhatta and Sara J. Marks
Int. J. Environ. Res. Public Health 2018, 15(8), 1616; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15081616 - 31 Jul 2018
Cited by 21 | Viewed by 6854
Abstract
Ensuring universal access to safe drinking water is a global challenge, especially in rural areas. This research aimed to assess the effectiveness of a risk-based strategy to improve drinking water safety for five gravity-fed piped schemes in rural communities of the Mid-Western Region [...] Read more.
Ensuring universal access to safe drinking water is a global challenge, especially in rural areas. This research aimed to assess the effectiveness of a risk-based strategy to improve drinking water safety for five gravity-fed piped schemes in rural communities of the Mid-Western Region of Nepal. The strategy was based on establishing community-led monitoring of the microbial water quality and the sanitary status of the schemes. The interventions examined included field-robust laboratories, centralized data management, targeted infrastructure improvements, household hygiene and filter promotion, and community training. The results indicate a statistically significant improvement in the microbial water quality eight months after intervention implementation, with the share of taps and household stored water containers meeting the international guidelines increasing from 7% to 50% and from 17% to 53%, respectively. At the study endline, all taps had a concentration of <10 CFU Escherichia coli/100 mL. These water quality improvements were driven by scheme-level chlorination, improved hygiene behavior, and the universal uptake of household water treatment. Sanitary inspection tools did not predict microbial water quality and, alone, are not sufficient for decision making. Implementation of this risk-based water safety strategy in remote rural communities can support efforts towards achieving universal water safety. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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15 pages, 1471 KiB  
Article
Waterborne Disease Outbreak Detection: A Simulation-Based Study
by Damien Mouly, Sarah Goria, Michael Mounié, Pascal Beaudeau, Catherine Galey, Anne Gallay, Christian Ducrot and Yann Le Strat
Int. J. Environ. Res. Public Health 2018, 15(7), 1505; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071505 - 17 Jul 2018
Cited by 8 | Viewed by 3991
Abstract
Waterborne disease outbreaks (WBDOs) remain a public health issue in developed countries, but to date the surveillance of WBDOs in France, mainly based on the voluntary reporting of clusters of acute gastrointestinal infections (AGIs) by general practitioners to health authorities, is characterized by [...] Read more.
Waterborne disease outbreaks (WBDOs) remain a public health issue in developed countries, but to date the surveillance of WBDOs in France, mainly based on the voluntary reporting of clusters of acute gastrointestinal infections (AGIs) by general practitioners to health authorities, is characterized by low sensitivity. In this context, a detection algorithm using health insurance data and based on a space–time method was developed to improve WBDO detection. The objective of the present simulation-based study was to evaluate the performance of this algorithm for WBDO detection using health insurance data. The daily baseline counts of acute gastrointestinal infections were simulated. Two thousand simulated WBDO signals were then superimposed on the baseline data. Sensitivity (Se) and positive predictive value (PPV) were both used to evaluate the detection algorithm. Multivariate regression was also performed to identify the factors associated with WBDO detection. Almost three-quarters of the simulated WBDOs were detected (Se = 73.0%). More than 9 out of 10 detected signals corresponded to a WBDO (PPV = 90.5%). The probability of detecting a WBDO increased with the outbreak size. These results underline the value of using the detection algorithm for the implementation of a national surveillance system for WBDOs in France. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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18 pages, 6757 KiB  
Article
A Physiologically-Based Pharmacokinetic Modeling Approach Using Biomonitoring Data in Order to Assess the Contribution of Drinking Water for the Achievement of an Optimal Fluoride Dose for Dental Health in Children
by Keven J. Jean, Nancy Wassef, Fabien Gagnon and Mathieu Valcke
Int. J. Environ. Res. Public Health 2018, 15(7), 1358; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071358 - 28 Jun 2018
Cited by 3 | Viewed by 5881
Abstract
Due to an optimal fluoride concentration in drinking water advised for caries prevention purposes, the population is now exposed to multiple sources of fluoride. The availability of population biomonitoring data currently allow us to evaluate the magnitude of this exposure. The objective of [...] Read more.
Due to an optimal fluoride concentration in drinking water advised for caries prevention purposes, the population is now exposed to multiple sources of fluoride. The availability of population biomonitoring data currently allow us to evaluate the magnitude of this exposure. The objective of this work was, therefore, to use such data in order to estimate whether community water fluoridation still represents a significant contribution toward achieving a suggested daily optimal fluoride (external) intake of 0.05 mg/kg/day. Therefore, a physiologically-based pharmacokinetic model for fluoride published in the literature was used and adapted in Excel for a typical 4-year-old and 8-year-old child. Biomonitoring data from the Canadian Health Measures Survey among people living in provinces with very different drinking water fluoridation coverage (Quebec, 2.5%; Ontario, 70% of the population) were analyzed using this adapted model. Absorbed doses for the 4-year-old and 8-year-old children were, respectively, 0.03 mg/kg/day and 0.02 mg/kg/day in Quebec and of 0.06 mg/kg/day and 0.05 mg/kg/day in Ontario. These results show that community water fluoridation contributes to increased fluoride intake among children, which leads to reaching, and in some cases even exceeding, the suggested optimal absorbed dose of 0.04 mg/kg/day, which corresponds to the suggested optimal fluoride intake mentioned above. In conclusion, this study constitutes an incentive to further explore the multiple sources of fluoride intake and suggests that a new balance between them including drinking water should be examined in accordance with the age-related physiological differences that influence fluoride metabolism. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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22 pages, 1513 KiB  
Article
A Method for Developing Rapid Screening Values for Active Pharmaceutical Ingredients (APIs) in Water and Results of Initial Application for 119 APIs
by Ashley Suchomel, Helen Goeden and Julia Dady
Int. J. Environ. Res. Public Health 2018, 15(7), 1308; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071308 - 22 Jun 2018
Cited by 5 | Viewed by 4868
Abstract
Americans fill upward of four billion prescriptions for pharmaceuticals each year, and many of those pharmaceuticals eventually make their way into the environment. Hundreds of different active pharmaceutical ingredients (APIs) are detected in ambient waters and source water used for drinking water in [...] Read more.
Americans fill upward of four billion prescriptions for pharmaceuticals each year, and many of those pharmaceuticals eventually make their way into the environment. Hundreds of different active pharmaceutical ingredients (APIs) are detected in ambient waters and source water used for drinking water in the U.S. Very few of these drugs have health-based guidance values that suggest a safe level for individuals exposed in the ambient environment through drinking water. The Minnesota Department of Health (MDH) has developed a novel method to derive screening-level human health guidance values for APIs. This method was designed for rapid evaluation and relies on Food and Drug Administration (FDA)-approved drug labels and limited additional public data resources for necessary information. MDH developed an analytical framework using traditional and novel uncertainty and adjustment factors specific to the information available for APIs. This framework, along with an estimated lowest therapeutic dose (LTD), was used to derive screening reference dose (sRfD) values. Water screening values (WSV) were then derived using the sRfD, a relative source contribution factor (RSC), and a water intake rate for infants to represent a highly exposed population. MDH used this new method to derive water screening values for 119 APIs that are commonly prescribed and/or commonly monitored in Minnesota waters, including antibiotics, antidepressants, steroids, and other classes of drugs. The derived WSVs can be used to provide context to environmental detections, prioritize APIs for further health-based guidance development, prioritize APIs for future environmental monitoring studies, and inform the development or refinement of analytical methods. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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16 pages, 420 KiB  
Article
Deriving A Drinking Water Guideline for A Non-Carcinogenic Contaminant: The Case of Manganese
by Mathieu Valcke, Marie-Hélène Bourgault, Sami Haddad, Michèle Bouchard, Denis Gauvin and Patrick Levallois
Int. J. Environ. Res. Public Health 2018, 15(6), 1293; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061293 - 20 Jun 2018
Cited by 8 | Viewed by 5538
Abstract
Manganese is a natural contaminant of water sources. It is an essential oligo-element, which may exert toxicity at high doses, particularly via inhalation. Its toxicity by the oral route is less known, but epidemiological and experimental studies tend to support its neurodevelopmental toxicity [...] Read more.
Manganese is a natural contaminant of water sources. It is an essential oligo-element, which may exert toxicity at high doses, particularly via inhalation. Its toxicity by the oral route is less known, but epidemiological and experimental studies tend to support its neurodevelopmental toxicity in infants and children. This paper describes the method used by a middle-size public health institution to derive a Drinking Water Guideline (DWG) for manganese. After reviewing the work done by major public health institutions, authors confirmed the use of experimental data to derive a point-of-departure (POD) of 25 mg of manganese/kg/day, based on neurodevelopmental effects on pup rats. Then, a total uncertainty factor of 450 was applied to calculate a Toxicological Reference Value (TRV) of 55 µg/kg/day. The final DWG proposed for manganese is 60 µg/L and is based on a relative source contribution (RSC) of water of 20% and an infant drinking scenario of 182 mL/kg of body weight (BW) of water (95th percentile of the ingestion rate distribution for 0–6 months). Despite its limitations, e.g., starting with the work done by other agencies, such an approach demonstrates in a transparent way the rationale and challenging choices made by regulators when deriving a DWG. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
12 pages, 900 KiB  
Article
Burden of Common Childhood Diseases in Relation to Improved Water, Sanitation, and Hygiene (WASH) among Nigerian Children
by Zhifei He, Ghose Bishwajit, Dongsheng Zou, Sanni Yaya, Zhaohui Cheng and Yan Zhou
Int. J. Environ. Res. Public Health 2018, 15(6), 1241; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061241 - 12 Jun 2018
Cited by 31 | Viewed by 6684
Abstract
Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can significantly enhance the burden of infectious diseases among children and affect nutritional status and growth. [...] Read more.
Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can significantly enhance the burden of infectious diseases among children and affect nutritional status and growth. In this study we examined the prevalence of some common infectious diseases/disease symptoms of childhood among under-five children in Nigeria, and the association between the occurrence of these diseases with household’s access to WASH facilities. Types of diseases used as outcome variables included diarrheal, and acute respiratory infections (fever and cough). Access to WASH facilities were defined by WHO classification. The association between diarrhoea, fever and chronic cough with sanitation, and hygiene was analyzed by logistic regression techniques. Results showed that the prevalence of diarrhoea, fever and cough was respectively 10.5% (95% CI = 9.7–2.0), 13.4% (95% CI = 11.9–14.8), and 10.4% (95% CI = 9.2–11.5). In the regression analysis, children in the households that lacked all three types of facilities were found to have respectively 1.32 [AOR = 1.329, 95% CI = 1.046–1.947], 1.24 [AOR = 1.242, 95% CI = 1.050–1.468] and 1.43 [AOR = 1.432, 95% CI = 1.113–2.902] times higher odds of suffering from diarrhea, fever and cough. The study concludes that unimproved WASH conditions is an important contributor to ARIs and diarrheal morbidities among Nigerian children. In light of these findings, it is recommended that programs targeting to reduce childhood morbidity and mortality from common infectious diseases should leverage equitable provision of WASH interventions. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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18 pages, 1929 KiB  
Article
Measuring the Impacts of Water Safety Plans in the Asia-Pacific Region
by Emily Kumpel, Caroline Delaire, Rachel Peletz, Joyce Kisiangani, Angella Rinehold, Jennifer De France, David Sutherland and Ranjiv Khush
Int. J. Environ. Res. Public Health 2018, 15(6), 1223; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061223 - 10 Jun 2018
Cited by 31 | Viewed by 7174
Abstract
This study investigated the effectiveness of Water Safety Plans (WSP) implemented in 99 water supply systems across 12 countries in the Asia-Pacific region. An impact assessment methodology including 36 indicators was developed based on a conceptual framework proposed by the Center for Disease [...] Read more.
This study investigated the effectiveness of Water Safety Plans (WSP) implemented in 99 water supply systems across 12 countries in the Asia-Pacific region. An impact assessment methodology including 36 indicators was developed based on a conceptual framework proposed by the Center for Disease Control (CDC) and before/after data were collected between November 2014 and June 2016. WSPs were associated with infrastructure improvements at the vast majority (82) of participating sites and to increased financial support at 37 sites. In addition, significant changes were observed in operations and management practices, number of water safety-related meetings, unaccounted-for water, water quality testing activities, and monitoring of consumer satisfaction. However, the study also revealed challenges in the implementation of WSPs, including financial constraints and insufficient capacity. Finally, this study provided an opportunity to test the impact assessment methodology itself, and a series of recommendations are made to improve the approach (indicators, study design, data collection methods) for evaluating WSPs. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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16 pages, 4693 KiB  
Article
Stability of Major Geogenic Cations in Drinking Water—An Issue of Public Health Importance: A Danish Study, 1980–2017
by Kirstine Wodschow, Birgitte Hansen, Jörg Schullehner and Annette Kjær Ersbøll
Int. J. Environ. Res. Public Health 2018, 15(6), 1212; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061212 - 08 Jun 2018
Cited by 17 | Viewed by 4152
Abstract
Concentrations and spatial variations of the four cations Na, K, Mg and Ca are known to some extent for groundwater and to a lesser extent for drinking water. Using Denmark as case, the purpose of this study was to analyze the spatial and [...] Read more.
Concentrations and spatial variations of the four cations Na, K, Mg and Ca are known to some extent for groundwater and to a lesser extent for drinking water. Using Denmark as case, the purpose of this study was to analyze the spatial and temporal variations in the major cations in drinking water. The results will contribute to a better exposure estimation in future studies of the association between cations and diseases. Spatial and temporal variations and the association with aquifer types, were analyzed with spatial scan statistics, linear regression and a multilevel mixed-effects linear regression model. About 65,000 water samples of each cation (1980–2017) were included in the study. Results of mean concentrations were 31.4 mg/L, 3.5 mg/L, 12.1 mg/L and 84.5 mg/L for 1980–2017 for Na, K, Mg and Ca, respectively. An expected west-east trend in concentrations were confirmed, mainly explained by variations in aquifer types. The trend in concentration was stable for about 31–45% of the public water supply areas. It is therefore recommended that the exposure estimate in future health related studies not only be based on a single mean value, but that temporal and spatial variations should also be included. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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13 pages, 599 KiB  
Article
Heterogeneity in the Relationship between Disinfection By-Products in Drinking Water and Cancer: A Systematic Review
by Tarik Benmarhnia, Ianis Delpla, Lara Schwarz, Manuel J. Rodriguez and Patrick Levallois
Int. J. Environ. Res. Public Health 2018, 15(5), 979; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15050979 - 14 May 2018
Cited by 14 | Viewed by 5048
Abstract
The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. [...] Read more.
The epidemiological evidence demonstrating the effect of disinfection by-products (DBPs) from drinking water on colon and rectal cancers is well documented. However, no systematic assessment has been conducted to assess the potential effect measure modification (EMM) in the relationship between DBPs and cancer. The objective of this paper is to conduct a systematic literature review to determine the extent to which EMM has been assessed in the relationship between DBPs in drinking water in past epidemiological studies. Selected articles (n = 19) were reviewed, and effect estimates and covariates that could have been used in an EMM assessment were gathered. Approximately half of the studies assess EMM (n = 10), but the majority of studies only estimate it relative to sex subgroups (n = 6 for bladder cancer and n = 2 both for rectal and colon cancers). Although EMM is rarely assessed, several variables that could have a potential modification effect are routinely collected in these studies, such as socioeconomic status or age. The role of environmental exposures through drinking water can play an important role and contribute to cancer disparities. We encourage a systematic use of subgroup analysis to understand which populations or territories are more vulnerable to the health impacts of DBPs. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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13 pages, 570 KiB  
Article
Focus on Chronic Exposure for Deriving Drinking Water Guidance Underestimates Potential Risk to Infants
by Helen Goeden
Int. J. Environ. Res. Public Health 2018, 15(3), 512; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15030512 - 14 Mar 2018
Cited by 14 | Viewed by 4566
Abstract
In 2007, the Minnesota Department of Health (MDH) developed new risk assessment methods for deriving human health-based water guidance (HBG) that incorporated the assessment of multiple exposure durations and life stages. The methodology is based on US Environmental Protection Agency recommendations for protecting [...] Read more.
In 2007, the Minnesota Department of Health (MDH) developed new risk assessment methods for deriving human health-based water guidance (HBG) that incorporated the assessment of multiple exposure durations and life stages. The methodology is based on US Environmental Protection Agency recommendations for protecting children’s health (US EPA 2002). Over the last 10 years, the MDH has derived multiple duration (e.g., short-term, subchronic, and chronic) water guidance for over 60 chemicals. This effort involved derivation of multiple duration reference doses (RfDs) and selection of corresponding water intake rates (e.g., infant, child, and lifetime). As expected, RfDs typically decreased with increasing exposure duration. However, the corresponding HBG frequently did not decrease with increasing duration. For more than half of the chemicals, the shorter duration HBG was lower than chronic HBG value. Conventional wisdom has been that chronic-based values will be the most conservative and will therefore be protective of less than chronic exposures. However, the MDH’s experience highlights the importance of evaluating short-term exposures. For many chemicals, elevated intake rates early in life, coupled with short-term RfDs, resulted in the lowest HBG. Drinking water criteria based on chronic assessments may not be protective of short-term exposures in highly exposed populations such as formula-fed infants. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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17 pages, 2427 KiB  
Article
Dramatic Reduction in Diarrhoeal Diseases through Implementation of Cost-Effective Household Drinking Water Treatment Systems in Makwane Village, Limpopo Province, South Africa
by Resoketswe Charlotte Moropeng, Phumudzo Budeli, Lizzy Mpenyana-Monyatsi and Maggy Ndombo Benteke Momba
Int. J. Environ. Res. Public Health 2018, 15(3), 410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15030410 - 27 Feb 2018
Cited by 21 | Viewed by 5875
Abstract
The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver [...] Read more.
The main purpose of this study was to implement cost-effective household water treatment systems in every household of Makwane Village for the reduction of diarrhoeal diseases. These household water treatment systems were constructed with locally available materials and consisted of the biosand zeolite-silver impregnated granular clay filters and the silver-impregnated porous pot filters. During the study period (April 2015 to September 2015), the entire village had 88 households with a population size of 480. Prior to the implementation, a survey was conducted and results revealed that 75% (360/480) of the Makwane residents suffered from diarrhoeal disease and the majority of the cases were reported in children that were less than five years of age. Out of the 480 participants, 372 (77.5%) from 70 households accepted the installation of the systems (intervention group) and 108 (25.5%) from 18 households were reluctant to use the systems (the control group). To date, in the intervention group, only 3.8% (14/372) of participants reported cases of diarrhoea. In the control group, 57.4% (62/108) participants reported cases of diarrhoea and most of the episodes of diarrhoea were reported in children of less than five years old (85%), followed by the group aged ≥56 years (75%). The findings of the current study unequivocally demonstrated that the BSZ-SICG and SIPP filters were able to reduce the incidence of diarrhoea by 96.2%. These findings further demonstrate the importance of household water treatment systems (HWTS) interventions in rural areas to bring about meaningful reductions in diarrhoeal diseases by providing safe potable water. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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Review

Jump to: Editorial, Research

31 pages, 849 KiB  
Review
Drinking Water Nitrate and Human Health: An Updated Review
by Mary H. Ward, Rena R. Jones, Jean D. Brender, Theo M. De Kok, Peter J. Weyer, Bernard T. Nolan, Cristina M. Villanueva and Simone G. Van Breda
Int. J. Environ. Res. Public Health 2018, 15(7), 1557; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071557 - 23 Jul 2018
Cited by 736 | Viewed by 33282
Abstract
Nitrate levels in our water resources have increased in many areas of the world largely due to applications of inorganic fertilizer and animal manure in agricultural areas. The regulatory limit for nitrate in public drinking water supplies was set to protect against infant [...] Read more.
Nitrate levels in our water resources have increased in many areas of the world largely due to applications of inorganic fertilizer and animal manure in agricultural areas. The regulatory limit for nitrate in public drinking water supplies was set to protect against infant methemoglobinemia, but other health effects were not considered. Risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that increase formation of N-nitroso compounds. We previously reviewed epidemiologic studies before 2005 of nitrate intake from drinking water and cancer, adverse reproductive outcomes and other health effects. Since that review, more than 30 epidemiologic studies have evaluated drinking water nitrate and these outcomes. The most common endpoints studied were colorectal cancer, bladder, and breast cancer (three studies each), and thyroid disease (four studies). Considering all studies, the strongest evidence for a relationship between drinking water nitrate ingestion and adverse health outcomes (besides methemoglobinemia) is for colorectal cancer, thyroid disease, and neural tube defects. Many studies observed increased risk with ingestion of water nitrate levels that were below regulatory limits. Future studies of these and other health outcomes should include improved exposure assessment and accurate characterization of individual factors that affect endogenous nitrosation. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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25 pages, 2606 KiB  
Review
A Systematic Review of the Time Series Studies Addressing the Endemic Risk of Acute Gastroenteritis According to Drinking Water Operation Conditions in Urban Areas of Developed Countries
by Pascal Beaudeau
Int. J. Environ. Res. Public Health 2018, 15(5), 867; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15050867 - 26 Apr 2018
Cited by 10 | Viewed by 4922
Abstract
Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to [...] Read more.
Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to drinking water operation conditions in urban areas of developed countries. Eighteen studies were included, covering 17 urban sites (seven in North-America and 10 in Europe) with study populations ranging from 50,000 to 9 million people. Most studies used general practitioner consultations or visits to hospitals for acute gastroenteritis (AGE) as health outcomes. In 11 of the 17 sites, a significant and plausible association was found between turbidity (or particle count) in finished water and the AGE indicator. When provided and significant, the interquartile excess of relative risk estimates ranged from 3–13%. When examined, water temperature, river flow, and produced flow were strongly associated with the AGE indicator. The potential of TSS for the study of the health risk from fecal pathogens in tap water is limited by the lack of specificity of turbidity and its site-sensitive value as an exposure proxy. Nevertheless, at the DWS level, TSS could help water operators to identify operational conditions most at risk, almost if considering other water operation indicators, in addition to turbidity, as possible relevant proxies for exposure. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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437 KiB  
Review
Vibrio Pathogens: A Public Health Concern in Rural Water Resources in Sub-Saharan Africa
by Charles A. Osunla and Anthony I. Okoh
Int. J. Environ. Res. Public Health 2017, 14(10), 1188; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph14101188 - 07 Oct 2017
Cited by 73 | Viewed by 7439
Abstract
Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the [...] Read more.
Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens. Full article
(This article belongs to the Special Issue Drinking Water Quality and Human Health)
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