Drinking-Water Nitrate, Methemoglobinemia, and Global Burden of Disease: A Discussion

Fewtrell, Lorna

doi:10.1289/ehp.7216

Cited by 499 publications

(234 citation statements)

References 39 publications

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“…The higher levels of NO 2 -N observed in these three locations may be due to the entry of human sewage into the water. A previous study showed that presence of higher concentrations of NO 2 -N in water is a potential problem due to its toxicity to humans (more potential health effects are seen in infants) and livestock when consumed [49].…”

Section: Physico-chemical and Microbiological Parametersmentioning

confidence: 99%

Assessment of Water Quality and Identification of Pollution Risk Locations in Tiaoxi River (Taihu Watershed), China

Vadde

Wang

Cao

et al. 2018

Water

102

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Taihu Lake is the third largest freshwater lake in China and serves as a drinking water source for~30 million residents. Tiaoxi River is one of the main rivers connected to this lake and contributes >60% of the source water. Taihu Lake has been facing various environmental issues; therefore, it is important to study the water quality of its inflow rivers. This study aimed to evaluate the physico-chemical and microbiological characteristics of Tiaoxi River and to determine the spatial and seasonal variations in the water quality. Water samples were collected from 25 locations across the Tiaoxi River in three seasons in 2014-2015. Fourteen water quality parameters including multiple nutrients and indicator bacteria were assessed, and the data analyzed by multivariate statistical analyses. The physico-chemical analysis showed high levels (>1 mg/L) of total nitrogen (TN) in all locations for all seasons. Total phosphorus (TP), nitrite-N (NO 2 -N), and ammonium-N (NH 4 -N) exceeded the acceptable limits in some locations and fecal coliform counts were high (>250 CFU/100 mL) in 15 locations. Hierarchical cluster analysis showed that the sampling sites could be grouped into three clusters based on water quality, which were categorized as low, moderate, and high pollution areas. Principal component analysis (PCA) applied to the entire dataset identified four principal components which explained 83% of the variation; pH, conductivity, TP, and NO 3 -N were found to be the key parameters responsible for variations in water quality. The overall results indicated that some of the sampling locations in the Tiaoxi River are heavily contaminated with pollutants from various sources which can be correlated with land use patterns and anthropogenic activities.

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Section: Physico-chemical and Microbiological Parametersmentioning

confidence: 99%

Assessment of Water Quality and Identification of Pollution Risk Locations in Tiaoxi River (Taihu Watershed), China

Vadde

Wang

Cao

et al. 2018

Water

102

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“…Declining surface water quality directly affects human and ecosystem health, which further impacts economic development and social wellbeing. Degraded water quality may induce various forms of illness, and exhibit reproductive and developmental toxicity (Horrigan et al 2002;Fewtrell 2004;Avalanja and Bonner 2005). Excess nutrient and pollutant loadings have also been linked to several problems in aquatic ecosystems, including increased frequency and severity of harmful algal blooms, dramatic shifts in trophic relationships, direct toxicity to aquatic organisms, and expansion of coastal hypoxic zones (Boesch et al 2001;Ocean Commission 2004;Diaz and Rosenberg 2008).…”

Section: Introductionmentioning

confidence: 99%

Spatial and temporal variations of nitrogen pollution in Wen-Rui Tang River watershed, Zhejiang, China

Mei

Zhang

et al. 2010

Environ Monit Assess

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Water quality has degraded dramatically in Wen-Rui Tang River watershed, Zhejiang, China, especially due to rapid economic development since 1995. This paper aims to assess spatial and temporal variations of the main pollutants (NH + 4 -N, TN, BOD 5 , COD Mn , DO) of water quality in Wen-Rui Tang River watershed, using the geographic information system, cluster analysis (CA) and principal component analysis (PCA). Results showed that concentrations of BOD 5 , COD Mn , NH + 4 -N, and TN were significantly higher in tertiary rivers than in primary and secondary rivers. From April 2006 to March 2007, the concentrations of NH + 4 -N (2.25-57.9 mg/L) and TN (3.78-70.4 mg/L) in all samples exceeded Type V national water quality standards (≥2 mg/L), while 5.3% of all COD Mn (1.83-27.5 mg/L) and 4 -N and TN in tertiary rivers had a significant negative correlation with 5-day cumulative rainfall and monthly rainfall, while there were no significant correlations in primary and secondary rivers. The results of CA and spatial analysis showed that the northern part of WenRui Tang River watershed was the most seriously polluted. This region is characterized by the high population density and industrial and commercial activities. The PCA and spatial analysis indicated that the degraded water quality is caused by anthropogenic activities and poor wastewater management.

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“…[11] Although it is not evaluated in our study, MetHb also can develop due to ingestion of nitrates in drinking water or food, dehydration, use of various drugs, and cardiac or respiratory system diseases. [18] Therefore, it is important to consider these factors. Methemoglobinemia is a rare but potentially lethal condition.…”

Section: Discussionmentioning

confidence: 99%

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

Günal¹,

Akkuş

Çığşar³

et al. 2017

Agri

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SummaryObjectives: Methemoglobinemia (MetHb) is a rare condition that may have mortal consequences. Literature shows cases of methemoglobinemia due to the use of lidocaine and other local anesthetics. This is a cross-sectional study to determine the incidence of methemoglobinemia after the application of lidocaine. Methods: In this study, 88 patients admitted to the emergency department of a university hospital between May 2014 and May 2015 and needed lidocaine application for small surgical procedures were included. When compared before and after the administration of lidocaine <2 mg/kg and >2 mg/kg, there was not a significant difference in the level of methemoglobin, hemoglobin, or in the hematocrit (p=0.604, p=0.502, and p=0.367, respectively). Results: Mean age of the patients was 33.85 (±17.58) years, and 83% of the patients were male. Methemoglobin levels were not significantly different before and after the procedures (p>0.05). Conclusion:The results of our study were consistent with the literature; lidocaine-associated methemoglobinemia is a rare complication.Keywords: Local lidocaine application; methemoglobinemia; small surgical procedures. ÖzetAmaç: Methemoglobulinemi nadir görülen ancak ölümcül sonuçları olan acil bir durumdur. Literatürde lokal anestezikler ve bunlar içinde yer alan lidokaine bağlı methemoglobinemi oluşumuna ilişkin vakaların olduğu bildirilmiştir. Bu nedenle çalış-mamız lidokain kullanılan hastalarda methemoglobulinemi insidansını belirlemek amacıyla kesitsel olarak yapılmıştır. Gereç ve Yöntem: Bir üniversite hastanesinin acil servisine Mayıs 2014-Mayıs 2015 tarihleri arasında başvuran küçük cerrahi işlem nedeniyle lidokain uygulanması gereken 88 hasta çalışma kapsamına alınmıştır. İşlem öncesi ve sonrası methemoglobulin değerleri ölçülmüştür. Bulgular: Hastaların yaş ortalaması 33.85 (±17.58) olup hastaların %83'ü erkekti. İşlem öncesi ve işlem sonrası karşılaştırıl-dığında lidokainin 2 mg/kg kullanımına göre methemoglobin, hemoglobin ve hemotokrit değerlerinde anlamlı bir farklılık bulunamadı (p=0.604, p=0.502 and p=0.367). Sonuç: Çalışmamızın sonuçları literatürle uyumlu olup lidokaine bağlı methemoglobinemi nadir gelişebilmektedir.Anahtar sözcükler: Lokal lidokain uygulaması; methemoglobinemia; küçük cerrahi işlem.

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Drinking-Water Nitrate, Methemoglobinemia, and Global Burden of Disease: A Discussion

Cited by 499 publications

References 39 publications

Assessment of Water Quality and Identification of Pollution Risk Locations in Tiaoxi River (Taihu Watershed), China

Assessment of Water Quality and Identification of Pollution Risk Locations in Tiaoxi River (Taihu Watershed), China

Spatial and temporal variations of nitrogen pollution in Wen-Rui Tang River watershed, Zhejiang, China

Methemoglobinemia incidence after the application of lidocaine for small surgical procedures

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