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Biological Trace Element Research Mar 2023The intake of high concentrations of fluoride, mainly through drinking water, diet and fluoridated dentifrices, produces fluorosis, which in its early stages is... (Meta-Analysis)
Meta-Analysis Review
The intake of high concentrations of fluoride, mainly through drinking water, diet and fluoridated dentifrices, produces fluorosis, which in its early stages is manifested as dental fluorosis (DF). To recognize exposure to fluoride in endemic areas and to evaluate the risk of developing health impairment, the WHO has established several biomarkers that are used to determine systemic fluorine (F) exposure. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the relationship between the severity of DF and fluoride biomarkers in endemic areas. The protocol of this study was previously registered as CRD42021244974. A digital search was carried out in PubMed/Medline, SpringerLink, Scopus, Cochrane and Google Scholar by employing the keywords "urine", "nails", "hair", "plasma", "saliva" and "dental fluorosis" for the original studies with content associated with F for the biomarkers and DF. The mean difference was established as the effect measure for the meta-analysis. Seven studies fulfilled the eligibility criteria, among which five assessed urine and two employed nails as fluoride biomarkers. A positive significant difference was found between the biomarkers and the severity of DF (0.27, p < 0.001) and individually for each biomarker (urine: 0.14, p = 0.001; nails: 0.88, p < 0.05). The F concentration in urine and nails is correlated with the severity of DF, with the most evident differences between healthy individuals and those with mild severity. Both biomarkers are adequate to assess this relationship in endemic areas of fluoride and DF.
Topics: Humans; Fluorides; Fluorosis, Dental; Drinking Water; Diet; Biomarkers; Prevalence
PubMed: 35397104
DOI: 10.1007/s12011-022-03227-1 -
Biomedica : Revista Del Instituto... Jun 2023Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which...
INTRODUCTION
Early introduction of fluids and water affects the duration of breastfeeding, the infant immune system, and possibly causes infants to consume less breast milk, which may, in turn, affect their nutritional and immune status.
OBJECTIVE
This study was carried out to determine water consumption in 0-6-month-old infants and the factors affecting this consumption.
MATERIALS AND METHODS
A literature review was conducted in seven electronic databases (Medline, Web of Science, PubMed, ScienceDirect, Scopus, Cochrane Library, and TÜBITAK) for studies published until April 25, 2022, using the keywords: drinking water, infant, and breastfeeding.
RESULTS
The systematic review included 13 studies. Five studies were crosssectional, three were descriptive and quasi-experimental, and the others were case-control and cohort studies. It was reported in the examined studies that 86.2% of the infants were around 6 weeks old, 44 % of the infants were 1 month old, 77% were 3 months old, 2.5% were 4 months old, and 2.5 to 85% of the infants were around 6 months old when they first consumed water. The prominent reasons for making the infants drink water are the thought that they need it and cultural reasons.
CONCLUSIONS
The exclusive breastfeeding of 0-6-month-old infants is the recommendation of reliable health authorities. Nurses play a key role in implementing this practice. In this systematic review, it was seen that families gave their infants water at varying rates in the 0-6-month period, and the factors affecting this situation were revealed. If nurses determine which factors affect families in terms of the early introduction of fluids, they could be able to plan the necessary education and interventions.
Topics: Female; Humans; Infant; Infant, Newborn; Drinking; Water; Breast Feeding; Databases, Factual; Educational Status
PubMed: 37433164
DOI: 10.7705/biomedica.6745 -
The Cochrane Database of Systematic... Sep 2015Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may... (Review)
Review
BACKGROUND
Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may provide a relatively cost-effective vehicle for fluoride delivery in the prevention of dental caries. This is an update of a Cochrane review first published in 2005.
OBJECTIVES
To assess the effects of milk fluoridation for preventing dental caries at a community level.
SEARCH METHODS
We searched the Cochrane Oral Health Group Trials Register (inception to November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 10), MEDLINE via OVID (1946 to November 2014) and EMBASE via OVID (1980 to November 2014). We also searched the U.S. National Institutes of Health Trials Register (https://clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (http://apps.who.int/trialsearch) for ongoing trials. We did not place any restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials (RCTs), with an intervention and follow-up period of at least two years, comparing fluoridated milk with non-fluoridated milk.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial risk of bias and extracted data. We used standard methodological procedures expected by The Cochrane Collaboration.
MAIN RESULTS
We included one unpublished RCT, randomising 180 children aged three years at study commencement. The setting was nursery schools in an area with high prevalence of dental caries and a low level of fluoride in drinking water. Data from 166 participants were available for analysis. The study carried a high risk of bias. After three years, there was a reduction of caries in permanent teeth (mean difference (MD) -0.13, 95% confidence interval (CI) -0.24 to -0.02) and in primary teeth (MD -1.14, 95% CI -1.86 to -0.42), as measured by the decayed, missing and filled teeth index (DMFT for permanent teeth and dmft for primary teeth). For primary teeth, this is a substantial reduction, equivalent to a prevented fraction of 31%. For permanent teeth, the disease level was very low in the study, resulting in a small absolute effect size. The included study did not report any other outcomes of interest for this review (adverse events, dental pain, antibiotic use or requirement for general anaesthesia due to dental procedures).
AUTHORS' CONCLUSIONS
There is low quality evidence to suggest fluoridated milk may be beneficial to schoolchildren, contributing to a substantial reduction in dental caries in primary teeth. Due to the low quality of the evidence, further research is likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There was only one relatively small study, which had important methodological limitations on the data for the effectiveness in reducing caries. Furthermore, there was no information about the potential harms of the intervention. Additional RCTs of high quality are needed before we can draw definitive conclusions about the benefits of milk fluoridation.
Topics: Animals; Cariostatic Agents; Child; Child, Preschool; Dental Caries; Fluoridation; Fluorides; Humans; Milk; Randomized Controlled Trials as Topic
PubMed: 26334643
DOI: 10.1002/14651858.CD003876.pub4 -
The Cochrane Database of Systematic... Aug 2015Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may... (Review)
Review
BACKGROUND
Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of schoolchildren and the vast majority of adults. Milk may provide a relatively cost-effective vehicle for fluoride delivery in the prevention of dental caries. This is an update of a Cochrane review first published in 2005.
OBJECTIVES
To assess the effects of milk fluoridation for preventing dental caries at a community level.
SEARCH METHODS
We searched the Cochrane Oral Health Group Trials Register (inception to November 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 10), MEDLINE via OVID (1946 to November 2014) and EMBASE via OVID (1980 to November 2014). We also searched the U.S. National Institutes of Health Trials Register (https://clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (http://apps.who.int/trialsearch) for ongoing trials. We did not place any restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials (RCTs), with an intervention and follow-up period of at least two years, comparing fluoridated milk with non-fluoridated milk.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial risk of bias and extracted data. We used standard methodological procedures expected by The Cochrane Collaboration.
MAIN RESULTS
We included one unpublished RCT, randomising 180 children aged three years at study commencement. The setting was nursery schools in an area with high prevalence of dental caries and a low level of fluoride in drinking water. Data from 166 participants were available for analysis. The study carried a high risk of bias. After three years, there was a reduction of caries in permanent teeth (mean difference (MD) -0.13, 95% confidence interval (CI) -0.24 to -0.02) and in primary teeth (MD -1.14, 95% CI -1.86 to -0.42), as measured by the decayed, missing and filled teeth index (DMFT for permanent teeth and dmft for primary teeth). For primary teeth, this is a substantial reduction, equivalent to a prevented fraction of 31%. For permanent teeth, the disease level was very low in the study, resulting in a small absolute effect size. The included study did not report any other outcomes of interest for this review (adverse events, dental pain, antibiotic use or requirement for general anaesthesia due to dental procedures).
AUTHORS' CONCLUSIONS
There is low quality evidence to suggest fluoridated milk may be beneficial to schoolchildren, contributing to a substantial reduction in dental caries in primary teeth. Due to the low quality of the evidence, further research is likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There was only one relatively small study, which had important methodological limitations on the data for the effectiveness in reducing caries. Furthermore, there was no information about the potential harms of the intervention. Additional RCTs of high quality are needed before we can draw definitive conclusions about the benefits of milk fluoridation.
Topics: Animals; Cariostatic Agents; Child, Preschool; Dental Caries; Fluoridation; Fluorides; Humans; Milk; Randomized Controlled Trials as Topic
PubMed: 26329305
DOI: 10.1002/14651858.CD003876.pub3 -
Scientific Reports Jan 2023Exposure to low levels of nitrate in drinking water may have adverse reproductive effects. We reviewed evidence about the association between nitrate in drinking water... (Meta-Analysis)
Meta-Analysis
Exposure to low levels of nitrate in drinking water may have adverse reproductive effects. We reviewed evidence about the association between nitrate in drinking water and adverse reproductive outcomes published to November 2022. Randomized trials, cohort or case-control studies published in English that reported the relationship between nitrate intake from drinking water and the risk of perinatal outcomes were included. Random-effect models were used to pool data. Three cohort studies showed nitrate in drinking water is associated with an increased risk of preterm birth (odds ratio for 1 mg/L NO-N increased (OR) = 1.01, 95% CI 1.00, 1.01, I = 23.9%, 5,014,487 participants; comparing the highest versus the lowest nitrate exposure groups pooled OR (OR) = 1.05, 95% CI 1.01, 1.10, I = 0%, 4,152,348 participants). Case-control studies showed nitrate in drinking water may be associated with the increased risk of neural tube defects OR = 1.06, 95% CI 1.02, 1.10; 2 studies, 2196 participants; I = 0%; and OR = 1.51, 95% CI 1.12, 2.05; 3 studies, 1501 participants; I = 0%). The evidence for an association between nitrate in drinking water and risk of small for gestational age infants, any birth defects, or any congenital heart defects was inconsistent. Increased nitrate in drinking water may be associated with an increased risk of preterm birth and some specific congenital anomalies. These findings warrant regular review as new evidence becomes available.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Nitrates; Drinking Water; Premature Birth; Reproduction; Parturition
PubMed: 36631499
DOI: 10.1038/s41598-022-27345-x -
Water Research Apr 2021The emergence of next generation sequencing (NGS) is revolutionizing the potential to address complex microbiological challenges in the water industry. NGS technologies... (Review)
Review
The emergence of next generation sequencing (NGS) is revolutionizing the potential to address complex microbiological challenges in the water industry. NGS technologies can provide holistic insight into microbial communities and their functional capacities in water and wastewater systems, thus eliminating the need to develop a new assay for each target organism or gene. However, several barriers have hampered wide-scale adoption of NGS by the water industry, including cost, need for specialized expertise and equipment, challenges with data analysis and interpretation, lack of standardized methods, and the rapid pace of development of new technologies. In this critical review, we provide an overview of the current state of the science of NGS technologies as they apply to water, wastewater, and recycled water. In addition, a systematic literature review was conducted in which we identified over 600 peer-reviewed journal articles on this topic and summarized their contributions to six key areas relevant to the water and wastewater fields: taxonomic classification and pathogen detection, functional and catabolic gene characterization, antimicrobial resistance (AMR) profiling, bacterial toxicity characterization, Cyanobacteria and harmful algal bloom identification, and virus characterization. For each application, we have presented key trends, noteworthy advancements, and proposed future directions. Finally, key needs to advance NGS technologies for broader application in water and wastewater fields are assessed.
Topics: Cyanobacteria; Harmful Algal Bloom; High-Throughput Nucleotide Sequencing; Wastewater; Water
PubMed: 33610927
DOI: 10.1016/j.watres.2021.116907 -
Toxicology and Applied Pharmacology Feb 2024The association between higher arsenic concentrations in drinking water and lung cancer is well-established. However, the risk associated with lower levels of arsenic... (Meta-Analysis)
Meta-Analysis
The association between higher arsenic concentrations in drinking water and lung cancer is well-established. However, the risk associated with lower levels of arsenic exposure remains uncertain. This systematic review and meta-analysis summarizes the evidence on the relationship between exposure to arsenic in drinking water and lung cancer outcomes as measured over a broad range of exposures, including lower levels. A total of 51 studies were included in the review and 15 met criteria for inclusion in meta-analysis. Risk estimates for lung cancer incidence and mortality were pooled and analyzed separately using Bayesian hierarchical random-effects models with a Gaussian observation submodel for log(Risk), computed using the "brms" R package. For lung cancer incidence, the predicted posterior mean relative risks (RRs) at arsenic concentrations of 10, 50 and 150 μg/L were 1.11 (0.86-1.43), 1.67 (1.27-2.17) and 2.21 (1.61-3.02), respectively, with posterior probabilities of 79%, 100% and 100%, respectively, for the RRs to be >1. The posterior mean mortality ratios at 20, 50 and 150 μg/L were 1.22 (0.83-1.78), 2.10 (1.62-2.71) and 2.41 (1.88-3.08), respectively, with posterior probabilities being above 80%. In addition to observing the dose-response relationship, these findings demonstrate that individuals exposed to low to moderate levels of arsenic (<150 μg/L) were at an elevated risk of developing or dying from lung cancer. Given the widespread exposure to lower levels of arsenic, there is an urgent need for vigilance and potential revisions to regulatory guidelines to protect people from the cancer risks associated with arsenic exposure.
Topics: Humans; Drinking Water; Arsenic; Bayes Theorem; Water Pollutants, Chemical; Lung Neoplasms; Environmental Exposure
PubMed: 38218206
DOI: 10.1016/j.taap.2024.116808 -
PloS One 2014Current guidelines recommend the use of Escherichia coli (EC) or thermotolerant ("fecal") coliforms (FC) as indicators of fecal contamination in drinking water. Despite... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Current guidelines recommend the use of Escherichia coli (EC) or thermotolerant ("fecal") coliforms (FC) as indicators of fecal contamination in drinking water. Despite their broad use as measures of water quality, there remains limited evidence for an association between EC or FC and diarrheal illness: a previous review found no evidence for a link between diarrhea and these indicators in household drinking water.
OBJECTIVES
We conducted a systematic review and meta-analysis to update the results of the previous review with newly available evidence, to explore differences between EC and FC indicators, and to assess the quality of available evidence.
METHODS
We searched major databases using broad terms for household water quality and diarrhea. We extracted study characteristics and relative risks (RR) from relevant studies. We pooled RRs using random effects models with inverse variance weighting, and used standard methods to evaluate heterogeneity and publication bias.
RESULTS
We identified 20 relevant studies; 14 studies provided extractable results for meta-analysis. When combining all studies, we found no association between EC or FC and diarrhea (RR 1.26 [95% CI: 0.98, 1.63]). When analyzing EC and FC separately, we found evidence for an association between diarrhea and EC (RR: 1.54 [95% CI: 1.37, 1.74]) but not FC (RR: 1.07 [95% CI: 0.79, 1.45]). Across all studies, we identified several elements of study design and reporting (e.g., timing of outcome and exposure measurement, accounting for correlated outcomes) that could be improved upon in future studies that evaluate the association between drinking water contamination and health.
CONCLUSIONS
Our findings, based on a review of the published literature, suggest that these two coliform groups have different associations with diarrhea in household drinking water. Our results support the use of EC as a fecal indicator in household drinking water.
Topics: Diarrhea; Drinking Water; Enterobacteriaceae; Escherichia coli; Family Characteristics; Feces; Humans; Reproducibility of Results; Risk Assessment; Risk Factors; Water Quality
PubMed: 25250662
DOI: 10.1371/journal.pone.0107429 -
The Science of the Total Environment Jun 2019Achieving sufficient, safe, continuously-available drinking water services in rural areas is a challenge, in high- and especially low-and middle-income countries.... (Review)
Review
Achieving sufficient, safe, continuously-available drinking water services in rural areas is a challenge, in high- and especially low-and middle-income countries. External support programs (ESPs) - which may include administrative, financial, and technical assistance - have been hypothesized to contribute to sustainable rural water services. While there are many descriptions of ESPs, a standard terminology and typology of ESP activities does not exist and the effect of ESP activities on system sustainability remains inadequately characterized. We conducted a systematic review of ESPs for rural drinking water systems to identify ESP terminology and describe ESP activities. Findings from 218 publications from low-, middle-, and high-income countries were analyzed. ESP terms were used inconsistently between regions and income classifications. There were few studies describing ESP activities related to mechanized piped water systems. Few studies quantitatively assess the effect of ESPs. Those that did found positive associations with functionality, household satisfaction, household participation, and financial stability. This review is the first comprehensive evaluation of the ESP literature and we derive a definition of external support programs and typology of ESP activities from the descriptions of ESPs. A common understanding of ESPs facilitates discussion and knowledge transfer between stakeholders. Consistent terminology creates a foundation for adapting ESPs to water services in community institutions and for mechanized piped water systems.
PubMed: 30909048
DOI: 10.1016/j.scitotenv.2019.03.069 -
Obesity Reviews : An Official Journal... Sep 2019The objective of this study is to identify promising strategies for improving drinking-water access and consumption among children aged 0 to 5 years. MEDLINE/PubMed,...
The objective of this study is to identify promising strategies for improving drinking-water access and consumption among children aged 0 to 5 years. MEDLINE/PubMed, Embase, ERIC, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched in this review. Studies included peer-reviewed, full-text studies from high-income countries, published in English between January 1, 2000, and January 12, 2018, that evaluated interventions to increase water access or consumption in children aged 0 to 5 years. Twenty-five studies met inclusion criteria; 19 used an effective intervention strategy to increase water access or water consumption. Three studies addressed both water access and consumption. Frequently used strategies included policy and practice changes, increasing water access and convenience, and education, training, or social support for caregivers. Studies were of fair methodological quality (average score: 18.8 of 26) for randomized studies and of moderate quality (5.1 of 9) for non-randomized studies. To date, few high-quality studies with objectively measured outcomes have clearly demonstrated strategies that may influence water intake and consumption among young children aged 0 to 5 years.
Topics: Caregivers; Child Nutritional Physiological Phenomena; Child, Preschool; Drinking; Drinking Water; Health Promotion; Humans; Infant; Infant, Newborn; Parents; Reward
PubMed: 31250960
DOI: 10.1111/obr.12833