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 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.
journal_name
Int J Environ Res Public Healthauthors
Ward MH,Jones RR,Brender JD,de Kok TM,Weyer PJ,Nolan BT,Villanueva CM,van Breda SGdoi
10.3390/ijerph15071557subject
Has Abstractpub_date
2018-07-23 00:00:00issue
7eissn
1661-7827issn
1660-4601pii
ijerph15071557journal_volume
15pub_type
杂志文章,评审abstract::Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs f...
journal_title:International journal of environmental research and public health
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更新日期:2019-08-28 00:00:00
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pub_type: 杂志文章,多中心研究
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