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International Journal of Environmental... Feb 2024are pathogenic and antibiotic-resistant organisms that can spread to humans through water. However, there is sparse synthesised information on the dissemination of... (Review)
Review
are pathogenic and antibiotic-resistant organisms that can spread to humans through water. However, there is sparse synthesised information on the dissemination of antibiotic-resistant through drinking water in Africa. This review provides an overview of the environmental spread of antimicrobial-resistant through drinking water in Africa. We performed a systematic review based on PRISMA guidelines, and 40 eligible studies from 12 countries were identified until June 2023. Four electronic databases (PubMed, Elsevier, AJOL, and DOAJ) were searched. Studies that employed phenotypic tests ( = 24/40) in identifying the bacterium outstripped those that utilised genome-based methods ( = 13). Of the 40 studies, nine and five, respectively, assessed the bacterium for antimicrobial resistance (AMR) phenotype and genotype. Multiple antibiotic resistance indices of 0.04-0.1 revealed a low level of antibiotic resistance. The detection of multidrug-resistant carrying resistance genes in certain water sources suggests that AMR-surveillance expansion should include drinking water.
PubMed: 38379376
DOI: 10.1080/09603123.2024.2320934 -
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 -
PloS One 2020Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water.
BACKGROUND
Microplastics (MPs) are omnipresent in the environment, including the human food chain; a likely important contributor to human exposure is drinking water.
OBJECTIVE
To undertake a systematic review of MP contamination of drinking water and estimate quantitative exposures.
METHODS
The protocol for the systematic review employed has been published in PROSPERO (PROSPERO 2019, Registration number: CRD42019145290). MEDLINE, EMBASE and Web of Science were searched from launch to the 3rd of June 2020, selecting studies that used procedural blank samples and a validated method for particle composition analysis. Studies were reviewed within a narrative analysis. A bespoke risk of bias (RoB) assessment tool was used.
RESULTS
12 studies were included in the review: six of tap water (TW) and six of bottled water (BW). Meta-analysis was not appropriate due to high statistical heterogeneity (I2>95%). Seven studies were rated low RoB and all confirmed MP contamination of drinking water. The most common polymers identified in samples were polyethylene terephthalate (PET) and polypropylene (PP), Methodological variability was observed throughout the experimental protocols. For example, the minimum size of particles extracted and analysed, which varied from 1 to 100 μm, was seen to be critical in the data reported. The maximum reported MP contamination was 628 MPs/L for TW and 4889 MPs/L for BW, detected in European samples. Based on typical consumption data, this may be extrapolated to a maximum yearly human adult uptake of 458,000 MPs for TW and 3,569,000 MPs for BW.
CONCLUSIONS
This is the first systematic review that appraises the quality of existing evidence on MP contamination of drinking water and estimates human exposures. The precautionary principle should be adopted to address concerns on possible human health effects from consumption of MPs. Future research should aim to standardise experimental protocols to aid comparison and elevate quality.
Topics: Drinking Water; Environmental Monitoring; Food Chain; Microplastics; Polyethylene Terephthalates; Polypropylenes; Public Health; Water Pollutants, Chemical
PubMed: 32735575
DOI: 10.1371/journal.pone.0236838 -
Toxicology Reports Jun 2024PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production,... (Review)
Review
PAE and PC polymers, such as BPA, are utilized to make water bottles. Due to the lack of polymer-chemical interaction, PAE can enter drinking bottles during production, wrapping, and keeping. Phthalates can transfer from the bottle to the water depending on keeping conditions (temperature, time, sunlight intensity), pH, and bottle capacity. Since there haven't been previous studies published on the subject, the aim of this meta-analysis and systematic review research is to determine the level of phthalates in drinking water consumed in Iranian cities. Web of Science, Science of Direct, Scopus, and PubMed, databases have been used in this study. Eight studies were selected from 556 initial publications after screening for duplication and irrelevant information. Articles from January 1, 2000, to February 10, 2024, were found in the mentioned databases. Among the types of phthalates, the concentration of DEHP was reported higher than the others Because its concentration has been reported in seven out of eight studies. The highest concentration of DEHP was reported by Mehraie(2.22 µg/l), Zare Jeddi (0.8 µg/l), Yousefi (0.77 µg/l), Abtahi (0.76 µg/l), Zare Jeddi (0.42 µg/l), Abdolahnejad(0.15 µg/l), and Pourzamani (0.08 µg/l). The highest concentration of DEP, DBP, BBP, and PA was reported by Abtahi (0.77 µg/l) and Esteki (2.25 µg/l), Mehraie(0.93 µg/l), and Pourzamani (0.83 µg/l). The results of this study showed that the most important phthalates measured in drinking water include DEP, DEHP, DBP, BBP, and PA. According to the results of the present studies, the most important factor in the increase of phthalates is the storage conditions of drinking water (temperature, sunlight, and the type of pipe or bottle).
PubMed: 38495472
DOI: 10.1016/j.toxrep.2024.02.009 -
Environmental Research May 2016The objective of this systematic review is to assess the effectiveness of regulatory, environmental and educational interventions for reducing blood lead levels (BLLs)... (Review)
Review
OBJECTIVES
The objective of this systematic review is to assess the effectiveness of regulatory, environmental and educational interventions for reducing blood lead levels (BLLs) and associated health outcomes in children, pregnant women and the general population.
METHODS
Searches were run in MEDLINE, EMBASE and the Global Health Library up until August 2015. Studies were eligible for inclusion if they assessed the impact of regulatory, environmental or educational interventions, stand-alone or in combination, on BLLs among children, pregnant women or the general population through randomized controlled trials (RCT), controlled before-after (CBA), interrupted time series (ITS), uncontrolled before-after (UBA) or repeated cross-sectional studies. Studies assessing the impact of interventions to reduce exposure to lead in paint or household dust as well as studies concerned exclusively with environmental concentrations of lead were not included. As documented in a detailed protocol, screening, data extraction and quality appraisal were largely undertaken according to Cochrane standards. Harvest plots were used to graphically summarize evidence of effectiveness.
RESULTS
The searches yielded 6466 unique records, of which five met our eligibility criteria; two additional eligible studies were identified by experts. We did not find any studies regarding the effectiveness of regulatory, educational or environmental interventions targeting exposure to lead in consumer products. Evidence regarding the effectiveness of interventions in reducing BLLs from exposures through drinking water is limited in both quantity and quality. Stand-alone targeted educational interventions showed no statistically significant reductions in children's BLL (two RCT) when compared to general educational interventions. Likewise, instructing women to reduce or eliminate lead-contaminated drinking water showed no effect on BLL (one RCT). Stand-alone environmental interventions appeared more promising in reducing BLL (three UBA). Combining educational and environmental interventions and targeting multiple settings may be effective in reducing BLL, as suggested by one uncontrolled before-after study. No studies examining the effectiveness of regulatory interventions were found.
CONCLUSIONS
The limited quantity and quality of the evidence measuring BLL and associated health outcomes points to an urgent need for more robust research into the effectiveness of interventions to reduce lead exposure from consumer products and drinking water, especially for regulatory interventions.
Topics: Consumer Product Safety; Environmental Exposure; Humans; Lead
PubMed: 26990846
DOI: 10.1016/j.envres.2016.03.004 -
Water Research Apr 2019Secondary disinfectants, such as chlorine and chloramine, have been widely applied to minimise microbial risks in drinking water during distribution. Key challenges have... (Review)
Review
Secondary disinfectants, such as chlorine and chloramine, have been widely applied to minimise microbial risks in drinking water during distribution. Key challenges have included the maintenance of stable concentrations of disinfectant residuals and the control of disinfection by-products that may form as a consequence of residual decay processes. Many factors may influence disinfectant residual stability and the consequential formation of by-products. Thus predictions of disinfectant stability and by-product formation are multifactorial problems, complete with numerous complications of parameter co-dependence and feedback amplification of some key parameters. The aim of this review was to derive an understanding of how disinfectant residual stability in drinking water distribution systems is impacted by various influencing factors such as water quality and operational parameters. Factors known to influence disinfectant stability and by-product formation were critically reviewed. A systematic review method was applied to identify 1809 journal articles published in the two decades from January 1998 to December 2017. From the initial screening, 161 papers were selected for detailed assessment. Important factors were identified to include temperature, water age, piping material, corrosion products, pH, hydraulic condition, disinfectant residual type and dosage and microbial activity. Microbial activity is a particularly complex parameter on which to base predictions since many factors are known to influence the degree and nature of such activity. These include temperature, water age, piping material, corrosion products, nutrients, natural organic matter, hydraulic condition and disinfectant residual type and dosage. Disinfectant types and dosages were found to be among the most important factors. Many knowledge gaps and research needs still remain, including the need for a more complete understanding of the factors that influence the production of nitrogenous disinfection by-products.
Topics: Chlorine; Disinfectants; Disinfection; Drinking Water; Water Purification; Water Supply
PubMed: 30743084
DOI: 10.1016/j.watres.2019.01.020 -
BMJ Clinical Evidence Aug 2013Amoebic dysentery is caused by the protozoan parasite Entamoeba histolytica. It is transmitted in areas where poor sanitation allows contamination of drinking water and... (Review)
Review
INTRODUCTION
Amoebic dysentery is caused by the protozoan parasite Entamoeba histolytica. It is transmitted in areas where poor sanitation allows contamination of drinking water and food with faeces. In these areas, up to 40% of people with diarrhoea may have amoebic dysentery.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of drug treatments for amoebic dysentery in endemic areas? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 6 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: diiodohydroxyquinoline (iodoquinol), diloxanide, emetine, metronidazole, nitazoxanide, ornidazole, paromomycin, secnidazole, and tinidazole.
Topics: Administration, Oral; Diarrhea; Dysentery, Amebic; Entamoeba histolytica; Feces; Humans; Metronidazole; Paromomycin; Tinidazole
PubMed: 23991750
DOI: No ID Found -
The Science of the Total Environment Feb 2021Regular monitoring of drinking water in China is carried out by the Centers for Disease Control and Prevention at all levels and some articles were published for the...
Regular monitoring of drinking water in China is carried out by the Centers for Disease Control and Prevention at all levels and some articles were published for the public to understand the status of drinking water. However, these published articles were limited to small areas and reported almost exclusively in Chinese. In order to give the public a comprehensive understanding of the situation of drinking water sanitation in China and provide specific directions for ensuring drinking water safety in the future, we review the sanitation status of drinking water in different regions of China from 2007 to 2018, the changes over time and the factors affecting drinking water quality by means of systematic review for the first time. Our results show that the quality of drinking water in China has shown an upward trend from 2007 to 2018. The qualification rate of urban drinking water (85.51%) was much higher than that of rural drinking water (51.12%), and the dry season (56.93%) was higher than the wet season (50.54%), and the terminal tap water (59.88%) was higher than the outlet water of waterworks (55.87%). In addition, the regions with low qualification rate of water quality in China were mainly distributed in several southern provinces, such as Yunnan, Guizhou, Hainan, etc. What's more, the qualified rate of the three microbiological indicators was the lowest, all below 85%. All the results indicate that the sanitation status of drinking water in China is unsatisfactory, and the biggest risk affecting water safety is microbial pollution. The central and local governments should work hard to improve people's drinking water quality and continue to strengthen the treatment and supervision of drinking water, especially in rural areas and undeveloped southern areas.
Topics: China; Drinking Water; Humans; Rural Population; Sanitation; Water Quality; Water Supply
PubMed: 33310571
DOI: 10.1016/j.scitotenv.2020.143923 -
Clinical Nutrition (Edinburgh, Scotland) May 2021Considerable controversy exists regarding the association between nitrate intake and risk of colorectal cancer. Therefore, we performed a dose-response meta-analysis of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Considerable controversy exists regarding the association between nitrate intake and risk of colorectal cancer. Therefore, we performed a dose-response meta-analysis of observational studies.
METHODS
We identified relevant studies by searching PubMed, Scopus and ISI Web of Knowledge until April 2020 and references of retrieved relevant articles. The random-effects model was used to calculate pooled effect size (ESs) and 95% confidence intervals (CIs).
RESULTS
Fifteen prospective cohort and case-control papers were included in this systematic review and meta-analysis. In total, 2,573,524 participants with an age range between 20 and 85 years were included. The total number of colorectal cancer cases was 38,848. Intake of nitrate from diet was associated with a risk of colorectal cancer (Pooled HR: 1.13; 95% CI: 1.04-1.23, I = 38%; P = 0.08). Nitrite in diet was not significantly associated with risk of colorectal cancer (pooled HR: 1.07; 95% CI: 0.95-1.21, I = 61.6%; P = 0.005). Nitrate in water did not show an association with risk of colorectal cancer (pooled HR: 1.04; 95% CI: 0.92-1.19, I = 64.7%; P = 0.002). Non-linear dose-response analysis revealed no significant association of dietary nitrite and also nitrate of drinking water with risk of colorectal cancer. However, dietary nitrate was marginally associated with a greater risk of colorectal cancer. Linear dose-response analysis of nitrate from diet was not associated with colorectal cancer risk by an additional 50 mg per day. Such a non-significant association was also seen for colorectal cancer risk by an additional 1 mg per day and 1 mg/l from dietary nitrite and water nitrate respectively.
CONCLUSIONS
Dietary nitrate was related to a higher risk of colorectal cancer risk. However, intake of nitrite from diet and nitrate from the drinking water was not associated with colorectal cancer risk.
Topics: Colorectal Neoplasms; Diet; Drinking Water; Humans; Nitrates; Nitrites; Risk Assessment
PubMed: 33298332
DOI: 10.1016/j.clnu.2020.11.010 -
The Australian and New Zealand Journal... Feb 2021Lithium in drinking water may have significant mental health benefits. We investigated the evidence on the association between lithium concentrations in drinking water... (Meta-Analysis)
Meta-Analysis
The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million people.
BACKGROUND
Lithium in drinking water may have significant mental health benefits. We investigated the evidence on the association between lithium concentrations in drinking water and their neuropsychiatric outcomes.
METHODS
We conducted a systematic review and meta-analysis and searched Pubmed, Embase, Web of Science, PsycINFO and CINAHL up to 19 January 2020, for peer-reviewed research examining the association between lithium concentrations in drinking water and neuropsychiatric outcomes. We used a pairwise analysis and a random effects model to meta-analyse suicide rates and psychiatric hospital admissions. We assessed for publication bias using Egger's test and Duval and Tweedie's Trim and Fill analysis.
RESULTS
Twenty-seven studies including 113 million subjects were included in this systematic review. Meta-analysis of 14 studies including 94 million people found higher lithium concentrations were associated with reduced suicide rates ( = -0.191, 95% confidence interval = [-0.287, -0.090], < 0.001) and meta-analysis of two studies including 5 million people found higher lithium concentrations were associated with fewer hospital admissions ( = -0.413, 95% confidence interval = [-0.689, -0.031], = 0.035). We found significant heterogeneity between studies ( = 67.4, < 0.001, = 80.7%) and the presence of publication bias (Egger's test; value = 2.90, = 0.013). Other included studies did not provide sufficient data to analyse other neuropsychiatric outcomes quantitatively.
CONCLUSION
Higher lithium concentrations in drinking water may be associated with reduced suicide rates and inpatient psychiatric admissions. The relationship with other neuropsychiatric outcomes and complications remains unclear. Further research is required before any public health recommendations can be made. The study was registered with PROSPERO, number CRD42018090145.
Topics: Drinking Water; Humans; Lithium; Mental Health; Publication Bias; Suicide
PubMed: 33045847
DOI: 10.1177/0004867420963740