Arsenic, cadmium, lead, and chromium in well water, rice, and human urine in Sri Lanka in relation to chronic kidney disease of unknown etiology

Herath, H M Ayala S; Kawakami, Tomonori; Nagasawa, Shiori; Yuka, Serikawa; Motoyama, Ayuri; Chaminda, G. G. Tushara; Weragoda, S. K.; Yatigammana, S. K.; Amarasooriya, A.A.G.D.

doi:10.2166/wh.2018.070

Cited by 67 publications

(38 citation statements)

References 15 publications

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“…However, the actual hierarchy of importance of the various contributing disease causes or, importantly, any risk-enhancing or mitigating interactions between these remain to be established 15 – 18 . Heavy metal exposure from groundwater has largely been ruled out as the major causal factor for CKDu in Sri Lanka 7 , 19 , however, contamination by pathogens and bacterial toxins in water used for irrigation, domestic and potable water supply remains a valid hypothesis 17 , 18 , 20 – 23 .…”

Section: Introductionmentioning

confidence: 99%

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

McDonough

Meredith

Nikagolla

et al. 2020

Sci Rep

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Chronic kidney disease (CKD) of unknown etiology (CKDu) mostly affects agricultural communities in Central America, South Asia, Africa, but likely also in North America and Australia. One such area with increased CKDu prevalence is the Medawachchiya District Secretariat Division of the Anuradhapura District in the North Central Province of Sri Lanka. Recent research has focused on the presence of various microbial pathogens in drinking water as potential causal or contributing factors to CKDu, yet no study to date has performed a more comprehensive microbial and water chemistry assessment of household wells used for domestic water supply in areas of high CKDu prevalence. In this study, we describe the chemical composition and total microbial content in 30 domestic household wells in the Medawachchiya District Secretariat Division. While the chemical composition in the tested wells mostly lies within standard drinking water limits, except for high levels of fluoride (F), magnesium (Mg), sodium (Na), chloride (Cl) and calcium (Ca) in some samples, we find a frequent presence of cyanotoxin-producing Microcystis, confirming earlier studies in Sri Lanka. Since the total microbial content of drinking water also directly influences the composition of the human gut microbiome, it can be considered an important determinant of health. Several bacterial phyla were previously reported in the gut microbiome of patients with CKD. Using these bacteria phyla to define operational taxonomic units, we found that these bacteria also occur in the microbiome of the sampled well water. Based on available environmental data, our study demonstrates associations between the abundances of these bacteria with geographical distribution, well water temperature and likely fertilizer use in the local surface water catchment area of the individual household wells. Our results reinforce the recommendation that household wells with stagnant or infrequently used water should be purged prior to use for drinking water, bathing and irrigation. The latter is suggested because of the reported potential accumulation of bacterial toxins by agricultural crops. The observation that bacteria previously found in chronic kidney disease patients are also present in household wells requires a more detailed systematic study of both the human gut and drinking water microbiomes in CKDu patients, in relation to disease prevalence and progression.

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Section: Introductionmentioning

confidence: 99%

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

McDonough

Meredith

Nikagolla

et al. 2020

Sci Rep

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“…Many studies have investigated the effects of Pb on human health; the reports show that Pb has a severe impact on the hemopoietic, nervous, endocrine, and cardiovascular systems in the human body. For arsenic, it was shown that long-term exposure from drinking water can cause cancer in the skin, lungs, bladder, and kidneys [32,[37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Health Risk Assessment of Household Drinking Water in a District in the UAE

Mahmoud

Hamouda

Kendi

et al. 2018

Water

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The quality of household drinking water in a community of 30 houses in a district in Abu Dhabi, United Arab Emirates (UAE) was assessed over a period of one year (January to November 2015). Standard analytical techniques were used to screen for water quality parameters and contaminants of concern. Water quality was evaluated in the 30 households at four sampling points: kitchen faucet, bathroom faucet, household water tank, and main water pipe. The sampling points were chosen to help identify the source when an elevated level of a particular contaminant is observed. Water quality data was interpreted by utilizing two main techniques: spatial variation analysis and multivariate statistical techniques. Initial analysis showed that many households had As, Cd, and Pb concentrations that were higher than the maximum allowable level set by UAE drinking water standards. In addition, the water main samples had the highest concentration of the heavy metals compared to other sampling points. Health risk assessment results indicated that approximately 30%, 55%, and 15% of the houses studied had a high, moderate, and low risk from the prolonged exposure to heavy metals, respectively. The analysis can help with planning a spatially focused sampling plan to confirm the study findings and set an appropriate course of action.

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“…Consumption of contaminated water containing nephrotoxins, such as excess fluoride, cadmium, lead, arsenic, or uranium, etc., is known cause tubule-nephropathy. However, none of the investigations have reported meaningful concentrations of the HMs in drinking water in Sri Lanka [44]. Groundwater contamination with geogenic components is common in CKDmfo-affected regions.…”

Section: Sources Of Water Contamination With Nephrotoxinsmentioning

confidence: 97%

“…Additional anthropogenic contaminants of water include emissions from coal-fired power plants and other air-and water-polluting industrial sources, including fluoride and HMs. However, none of the investigations have reported meaningful concentrations of any HMs or F − in drinking water or locally grown food in Sri Lanka [44]. Much fluoride in water comes from natural, geological sources, such as the mica, hornblende, fluorite, and fluorochloro-hydroxyapatite deposits abundant across the NCP.…”

Section: Summary Of Proposed Causes Of Ckdmfomentioning

confidence: 99%

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Factors Affecting the Environmentally Induced, Chronic Kidney Disease of Unknown Aetiology in Dry Zonal Regions in Tropical Countries—Novel Findings

Wimalawansa¹,

Dissanayake

2019

Environments

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A new form of chronic tubulointerstitial kidney disease (CKD) not related to diabetes or hypertension appeared during the past four decades in several peri-equatorial and predominantly agricultural countries. Commonalities include underground stagnation of drinking water with prolonged contact with rocks, harsh climatic conditions with protracted dry seasons, and rampant poverty and malnutrition. In general, the cause is unknown, and the disease is therefore named CKD of unknown aetiology (CKDu). Since it is likely caused by a combination of factors, a better term would be CKD of multifactorial origin (CKDmfo). Middle-aged malnourished men with more than 10 years of exposure to environmental hazards are the most vulnerable. Over 30 factors have been proposed as causative, including agrochemicals and heavy metals, but none has been properly tested nor proven as causative, and unlikely to be the cause of CKDmfo/CKDu. Conditions such as, having favourable climatic patterns, adequate hydration, and less poverty and malnutrition seem to prevent the disease. With the right in vivo conditions, chemical species such as calcium, phosphate, oxalate, and fluoride form intra-renal nanomineral particles initiating the CKDmfo. This article examines the key potential chemical components causing CKDmfo together with the risk factors and vulnerabilities predisposing individuals to this disease. Research findings suggest that in addition to drinking water from stagnant sources that contain high ionic components, more than 10 years of exposure to environmental nephrotoxins and micronutrient malnutrition are needed to contract this fatal disease.

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Arsenic, cadmium, lead, and chromium in well water, rice, and human urine in Sri Lanka in relation to chronic kidney disease of unknown etiology

Cited by 67 publications

References 15 publications

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

Health Risk Assessment of Household Drinking Water in a District in the UAE

Factors Affecting the Environmentally Induced, Chronic Kidney Disease of Unknown Aetiology in Dry Zonal Regions in Tropical Countries—Novel Findings

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