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. 2005 Nov;113(11):1607-14.
doi: 10.1289/ehp.8043.

Workgroup report: Drinking-water nitrate and health--recent findings and research needs

Mary H Ward  1 , Theo M deKok, Patrick Levallois, Jean Brender, Gabriel Gulis, Bernard T Nolan, James VanDerslice; International Society for Environmental Epidemiology
Affiliations

Workgroup report: Drinking-water nitrate and health--recent findings and research needs

Mary H Ward et al. Environ Health Perspect. 2005 Nov.

Abstract

Human alteration of the nitrogen cycle has resulted in steadily accumulating nitrate in our water resources. The U.S. maximum contaminant level and World Health Organization guidelines for nitrate in drinking water were promulgated to protect infants from developing methemoglobinemia, an acute condition. Some scientists have recently suggested that the regulatory limit for nitrate is overly conservative; however, they have not thoroughly considered chronic health outcomes. In August 2004, a symposium on drinking-water nitrate and health was held at the International Society for Environmental Epidemiology meeting to evaluate nitrate exposures and associated health effects in relation to the current regulatory limit. The contribution of drinking-water nitrate toward endogenous formation of N-nitroso compounds was evaluated with a focus toward identifying subpopulations with increased rates of nitrosation. Adverse health effects may be the result of a complex interaction of the amount of nitrate ingested, the concomitant ingestion of nitrosation cofactors and precursors, and specific medical conditions that increase nitrosation. Workshop participants concluded that more experimental studies are needed and that a particularly fruitful approach may be to conduct epidemiologic studies among susceptible subgroups with increased endogenous nitrosation. The few epidemiologic studies that have evaluated intake of nitrosation precursors and/or nitrosation inhibitors have observed elevated risks for colon cancer and neural tube defects associated with drinking-water nitrate concentrations below the regulatory limit. The role of drinking-water nitrate exposure as a risk factor for specific cancers, reproductive outcomes, and other chronic health effects must be studied more thoroughly before changes to the regulatory level for nitrate in drinking water can be considered.

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Figures

Figure 1
Figure 1
Interquartile range of total nitrogen in streams and nitrate-N in groundwater in agricultural, urban, and mixed land use, and undeveloped areas of the United States. Upper bound of bar represents 90th percentile and lower bound represents 10th percentile. Along the top of the graph are the number of stream sampling stations and groundwater networks (group of wells in an aquifer).
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Comment in

  • Dietary nitrate: where is the risk?
    L'hirondel JL, Avery AA, Addiscott T. L'hirondel JL, et al. Environ Health Perspect. 2006 Aug;114(8):A458-9; author reply A459-61. doi: 10.1289/ehp.114-1552029. Environ Health Perspect. 2006. PMID: 16882507 Free PMC article. No abstract available.

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