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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 -
The Science of the Total Environment Sep 2023In rural areas of the United States, an estimated ~1.8 million people lack reliable access to safe drinking water. Considering the relative dearth of information on... (Meta-Analysis)
Meta-Analysis Review
In rural areas of the United States, an estimated ~1.8 million people lack reliable access to safe drinking water. Considering the relative dearth of information on water contamination and health outcomes in Appalachia, we conducted a systematic review of studies of microbiological and chemical drinking water contamination and associated health outcomes in rural Appalachia. We pre-registered our protocols, limiting eligibility to primary data studies published from 2000 to 2019, and searched four databases (PubMed, EMBASE, Web of Science, and the Cochrane Library). We used qualitative syntheses, meta-analyses, risk of bias analysis, and meta-regression to assess reported findings, with reference to US EPA drinking water standards. Of the 3452 records identified for screening, 85 met our eligibility criteria. 93 % of eligible studies (n = 79) used cross-sectional designs. Most studies were conducted in Northern (32 %, n = 27) and North Central (24 %, n = 20) Appalachia, and only 6 % (n = 5) were conducted exclusively in Central Appalachia. Across studies, E. coli were detected in 10.6 % of samples (sample-size-weighted mean percentage from 4671 samples, 14 publications). Among chemical contaminants, sample-size-weighted mean concentrations for arsenic were 0.010 mg/L (n = 21,262 samples, 6 publications), and 0.009 mg/L for lead (n = 23,259, 5 publications). 32 % (n = 27) of studies assessed health outcomes, but only 4.7 % (n = 4) used case-control or cohort designs (all others were cross-sectional). The most commonly reported outcomes were detection of PFAS in blood serum (n = 13), gastrointestinal illness (n = 5), and cardiovascular-related outcomes (n = 4). Of the 27 studies that assessed health outcomes, 62.9 % (n = 17) appeared to be associated with water contamination events that had received national media attention. Overall, based on the number and quality of eligible studies identified, we could not reach clear conclusions about the state of water quality, or its impacts on health, in any of Appalachia's subregions. More epidemiologic research is needed to understand contaminated water sources, exposures, and potentially associated health outcomes in Appalachia.
Topics: Humans; Drinking Water; Escherichia coli; Water Pollution; Appalachian Region; Outcome Assessment, Health Care
PubMed: 37207762
DOI: 10.1016/j.scitotenv.2023.164036 -
Environmental Geochemistry and Health Apr 2024Recent studies have found arsenic contamination of drinking water in some parts of Iran, as in many other countries. Thus, a comprehensive systematic review is necessary... (Meta-Analysis)
Meta-Analysis Review
Recent studies have found arsenic contamination of drinking water in some parts of Iran, as in many other countries. Thus, a comprehensive systematic review is necessary to assess the distribution and concentration of arsenic in drinking water sources. For this purpose, articles published from the first identification until December 2023, were retrieved from various national and international databases. Of all the studies examined (11,726), 137 articles were selected for review based on their conceptual relationship to this survey. A review of the extracted studies presented that ICP methods (ICP-MS, ICP-OES, 56%) and atomic absorption spectrophotometry (AAS, 34.1%) were the two most commonly used techniques for the analysis of arsenic in water samples. The order of arsenic content in the defined study areas is descending, as follows: northwest ˃ southeast ˃ southwest ˃ northeast. A review of studies performed in Iran depicted that provinces such as Kurdistan, Azerbaijan, and Kerman have the highest arsenic concentrations in water resources. Accordingly, the maximum concentration of arsenic was reported in Rayen, Kerman, and ranged from < 0.5-25,000 µg/L. The primary cause of elevated arsenic levels in water resources appears to be geologic structure, including volcanic activity, biogeochemical processes, sulfur-bearing volcanic rocks, Jurassic shale, the spatial coincidence of arsenic anomalies in tube wells and springs, and, to some extent, mining activities. The findings of the presented survey indicate that it is essential to take serious measures at the national level to minimize the health risks of arsenic contamination from drinking water consumption.
Topics: Drinking Water; Iran; Arsenic; Databases, Factual; Geology
PubMed: 38592550
DOI: 10.1007/s10653-024-01943-2 -
Critical Reviews in Toxicology Jan 2024Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns... (Review)
Review
INTRODUCTION
Fluoride is a naturally occurring substance that is also added to drinking water, dental hygiene products, and food supplements for preventing dental caries. Concerns have been raised about several other potential health risks of fluoride.
OBJECTIVE
To conduct a robust synthesis of evidence regarding human health risks due to exposure to fluoride in drinking water, and to develop a point of departure (POD) for setting a health-based value (HBV) for fluoride in drinking water.
METHODS
A systematic review of evidence published since recent reviews of human, animal, and data was carried out. Bradford Hill considerations were used to weigh the evidence for causality. Several key studies were considered for deriving PODs.
RESULTS
The current review identified 89 human studies, 199 animal studies, and 10 major reviews. The weight of evidence on 39 health endpoints was presented. In addition to dental fluorosis, evidence was considered strong for reduction in IQ scores in children, moderate for thyroid dysfunction, weak for kidney dysfunction, and limited for sex hormone disruptions.
CONCLUSION
The current review identified moderate dental fluorosis and reduction in IQ scores in children as the most relevant endpoints for establishing an HBV for fluoride in drinking water. PODs were derived for these two endpoints, although there is still some uncertainty in the causal weight of evidence for causality for reducing IQ scores in children and considerable uncertainty in the derivation of its POD. Given our evaluation of the overall weight of evidence, moderate dental fluorosis is suggested as the key endpoint until more evidence is accumulated on possible reduction of IQ scores effects. A POD of 1.56 mg fluoride/L for moderate dental fluorosis may be preferred as a starting point for setting an HBV for fluoride in drinking water to protect against moderate and severe dental fluorosis. Although outside the scope of the current review, precautionary concerns for potential neurodevelopmental cognitive effects may warrant special consideration in the derivation of the HBV for fluoride in drinking water.
Topics: Child; Animals; Humans; Fluorides; Fluorosis, Dental; Drinking Water; Dental Caries; Dietary Supplements
PubMed: 38318766
DOI: 10.1080/10408444.2023.2295338 -
Iranian Journal of Public Health Jan 2023Selenium (Se) is an essential element playing a vital role in the metabolism of organisms. Se can generally be discharged in the potable water through natural and... (Review)
Review
BACKGROUND
Selenium (Se) is an essential element playing a vital role in the metabolism of organisms. Se can generally be discharged in the potable water through natural and anthropogenic activities. Both excess and shortage of Se can cause significant adverse health effects in humans. Excess values of se may toxicity, leading to selenosis and alkali disease in humans and grazing animals, respectively.
METHODS
A review search was systematically carried out from the databases Embase, PubMed/MEDLINE, Scopus, PubMed Central (PMC), Google Scholar, as well as medRxiv by using the following keywords: "waste water", "bioremediation", "selenium removal", "adsorption", and "drinking water". This study provides a review of the recent literature covering the period between 2011 and 2021. After screening the full text of the articles, 27 papers were enrolled. This study reviews the reported techniques for Se removal from water and wastewater, including adsorption, biological treatment, microbial reduction, bioreactors, fungal bioreactor, algal treatment, phytoremediation, and photocatalysis.
RESULTS
Biological and bioremediation techniques, such as microbial reduction, biotransformation, and fluidized bed reactor have removal efficiency about 100%. The highest Se concentration of 15-7600 μg/L was achieved in ground waters in Ethiopia and the lowest level of 0.07 μg/L in Finland.
CONCLUSION
The combination of biological treatment with chemical or physical technologies is envisaged to optimize se elimination and to ensure ecological protection and human health safety.
PubMed: 36824240
DOI: 10.18502/ijph.v52i1.11667 -
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 -
Environmental Health Perspectives Jul 2014Water distribution systems are vulnerable to performance deficiencies that can cause (re)contamination of treated water and plausibly lead to increased risk of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Water distribution systems are vulnerable to performance deficiencies that can cause (re)contamination of treated water and plausibly lead to increased risk of gastrointestinal illness (GII) in consumers.
OBJECTIVES
It is well established that large system disruptions in piped water networks can cause GII outbreaks. We hypothesized that routine network problems can also contribute to background levels of waterborne illness and conducted a systematic review and meta-analysis to assess the impact of distribution system deficiencies on endemic GII.
METHODS
We reviewed published studies that compared direct tap water consumption to consumption of tap water re-treated at the point of use (POU) and studies of specific system deficiencies such as breach of physical or hydraulic pipe integrity and lack of disinfectant residual.
RESULTS
In settings with network malfunction, consumers of tap water versus POU-treated water had increased GII [incidence density ratio (IDR) = 1.34; 95% CI: 1.00, 1.79]. The subset of nonblinded studies showed a significant association between GII and tap water versus POU-treated water consumption (IDR = 1.52; 95% CI: 1.05, 2.20), but there was no association based on studies that blinded participants to their POU water treatment status (IDR = 0.98; 95% CI: 0.90, 1.08). Among studies focusing on specific network deficiencies, GII was associated with temporary water outages (relative risk = 3.26; 95% CI: 1.48, 7.19) as well as chronic outages in intermittently operated distribution systems (odds ratio = 1.61; 95% CI: 1.26, 2.07).
CONCLUSIONS
Tap water consumption is associated with GII in malfunctioning distribution networks. System deficiencies such as water outages also are associated with increased GII, suggesting a potential health risk for consumers served by piped water networks.
Topics: Drinking Water; Gastrointestinal Diseases; Humans; Incidence; Water Purification; Water Supply
PubMed: 24659576
DOI: 10.1289/ehp.1306912 -
The Cochrane Database of Systematic... 2003Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration. Recent... (Review)
Review
BACKGROUND
Fasting before general anaesthesia aims to reduce the volume and acidity of stomach contents during surgery, thus reducing the risk of regurgitation/aspiration. Recent guidelines have recommended a shift in fasting policy from the standard 'nil by mouth from midnight' approach to more relaxed policies which permit a period of restricted fluid intake up to a few hours before surgery. The evidence underpinning these guidelines however, was scattered across a range of journals, in a variety of languages, used a variety of outcome measures and methodologies to evaluate fasting regimens that differed in duration and the type and volume of intake permitted during a restricted fasting period. Practice has been slow to change.
OBJECTIVES
To systematically review the effect of different preoperative fasting regimens (duration, type and volume of permitted intake) on perioperative complications and patient wellbeing (including aspiration, regurgitation and related morbidity, thirst, hunger, pain, nausea, vomiting, anxiety) in different adult populations.
SEARCH STRATEGY
Electronic databases, conference proceedings and reference lists from relevant articles were searched for studies of preoperative fasting in August 2003 and experts in the area were consulted.
SELECTION CRITERIA
Randomised controlled trials which compared the effect on postoperative complications of different preoperative fasting regimens on adults were included.
DATA COLLECTION AND ANALYSIS
Details of the eligible studies were independently extracted by two reviewers and where relevant information was unavailable from the text attempts were made to contact the authors.
MAIN RESULTS
Thirty eight randomised controlled comparisons (made within 22 trials) were identified. Most were based on 'healthy' adult participants who were not considered to be at increased risk of regurgitation or aspiration during anaesthesia. Few trials reported the incidence of aspiration/regurgitation or related morbidity but relied on indirect measures of patient safety i.e. intra-operative gastric volume and pH. There was no evidence that the volume or pH of participants' gastric contents differed significantly depending on whether the groups were permitted a shortened preoperative fluid fast or continued a standard fast. Fluids evaluated included water, coffee, fruit juice, clear fluids and other drinks (e.g. isotonic drink, carbohydrate drink). Participants given a drink of water preoperatively were found to have a significantly lower volume of gastric contents than the groups that followed a standard fasting regimen. This difference was modest and clinically insignificant. There was no indication that the volume of fluid permitted during the preoperative period (i.e. low or high) resulted in a difference in outcomes from those participants that followed a standard fast. Few trials specifically investigated the preoperative fasting regimen for patient populations considered to be at increased risk during anaesthesia of regurgitation/aspiration and related morbidity.
REVIEWER'S CONCLUSIONS
There was no evidence to suggest a shortened fluid fast results in an increased risk of aspiration, regurgitation or related morbidity compared with the standard 'nil by mouth from midnight' fasting policy. Permitting patients to drink water preoperatively resulted in significantly lower gastric volumes. Clinicians should be encouraged to appraise this evidence for themselves and when necessary adjust any remaining standard fasting policies (nil-by-mouth from midnight) for patients that are not considered 'at-risk' during anaesthesia.
Topics: Adult; Anesthesia, General; Drinking; Fasting; Gastroesophageal Reflux; Humans; Intraoperative Complications; Pneumonia, Aspiration; Randomized Controlled Trials as Topic
PubMed: 14584013
DOI: 10.1002/14651858.CD004423 -
International Journal of Environmental... Aug 2012A systematic review of the literature on the effects of water and sanitation in schools was performed. The goal was to characterize the impacts of water and sanitation... (Review)
Review
A systematic review of the literature on the effects of water and sanitation in schools was performed. The goal was to characterize the impacts of water and sanitation inadequacies in the academic environment. Published peer reviewed literature was screened and articles that documented the provision of water and sanitation at schools were considered. Forty-one peer-reviewed papers met the criteria of exploring the effects of the availability of water and/or sanitation facilities in educational establishments. Chosen studies were divided into six fields based on their specific foci: water for drinking, water for handwashing, water for drinking and handwashing, water for sanitation, sanitation for menstruation and combined water and sanitation. The studies provide evidence for an increase in water intake with increased provision of water and increased access to water facilities. Articles also report an increase in absenteeism from schools in developing countries during menses due to inadequate sanitation facilities. Lastly, there is a reported decrease in diarrheal and gastrointestinal diseases with increased access to adequate sanitation facilities in schools. Ensuring ready access to safe drinking water, and hygienic toilets that offer privacy to users has great potential to beneficially impact children's health. Additional studies that examine the relationship between sanitation provisions in schools are needed to more adequately characterize the impact of water and sanitation on educational achievements.
Topics: Child; Child Welfare; Developed Countries; Developing Countries; Humans; Sanitation; Schools; Water Supply
PubMed: 23066396
DOI: 10.3390/ijerph9082772 -
International Journal of Environmental... Nov 2023The relation of exposure to arsenic in drinking water during pregnancy to the risk of preterm birth (PTB) was contradictory. This meta-analysis aimed to examine the... (Review)
Review
The relation of exposure to arsenic in drinking water during pregnancy to the risk of preterm birth (PTB) was contradictory. This meta-analysis aimed to examine the association between drinking water arsenic and PTB. A systematic search in PubMed and Scopus was performed to achieve all relevant studies. Odds ratios (OR) and 95% confidence intervals (CI) were used to pool data using the random-effect models. Overall, 11 studies with a total sample size of 3,404,189 participants were included in the meta-analysis. Arsenic exposure through drinking water during pregnancy was related to an increased risk of PTB (OR = 1.06; 95%CI = 1.01-1.10 for highest versus lowest category of arsenic), with significant heterogeneity across the studies (I = 84.8%, = 0.001). This finding was supported by cohort studies (OR = 1.05; 95%CI = 1.01-1.10). This meta-analysis proposes that higher arsenic exposure in drinking water may be a risk factor for PTB.
PubMed: 37967266
DOI: 10.1080/09603123.2023.2280155