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PubMed1999

Chronic poisoning by copper in tap water: II. Copper intoxications with predominantly systemic symptoms.

Copper can induce acute and chronic intoxications in humans. Copper in tap water has caused a series of severe systemic diseases in Germany in recent years (chronic copper poisoning, CCuP). From the clinical point of view it has been difficult to establish the diagnosis on the basis of clinical and laboratory methods. In a retrospective study, we therefore looked for essential clinical signs as well as laboratory findings which might be typical and essential for the diagnosis of CCuP. - We observed that in patients with severe systemic CCuP not only the liver but also several other organs have been the target of copper. As a proof copper overload has been measured. The latter results are presented here. - During or shortly after exposure "free" serum copper (= non-ceruloplasmin-bound copper) was significantly elevated in all patients (range 5.1 to 47.1 micromol/l, or 25.7 to 56.2 % of total serum copper). The normal upper limits in infants according to Salmenperä (8) are: 0.3 micromol/l, or 1.6 % of total serum copper. - Total serum copper was elevated in 14/16 patients: 13.7 to 30.1 micromol/l in sick infants (normal upper level: 12.6 micromol/l), and 17.0 to 27.2 in sick children (normal upper level for children and adults: 21.4 micromol/l). - Urine copper excretion was found elevated in 9/10 patients, with a range of 11 to 456 microg/dl (normal upper level in adults: 15 microg/dl). - Our results show that patients with systemic CCuP are in a "hypercupric" state. The data thus firstly prove that indeed the putative agent copper is found in excess in the patients and secondly show that the estimation of "free" copper in serum and the measurement of copper in urine are reliable diagnostic methods. Elevation of total serum copper (even though not specific) can give a first hint to the diagnosis. - The hypercupric state of systemic CCuP can be differentiated from that of Wilson's disease by (1) normal levels of ceruloplasmin and (2) the observation that values for free copper in serum or urinary copper normalize in an environment without copper in tap water, for instance in a hospital.

Adult↗
PubMed1999

Early childhood cirrhoses (ECC) in Germany between 1982 and 1994 with special consideration of copper etiology.

In a multicentric retrospective clinical study with 16 pediatric centres we identified 103 cases of histologically confirmed early childhood cirrhosis (ECC) in Germany for the years 1984-1994. The most prominent diagnoses were congenital bile duct anomalies (47.5%), inborn metabolic disorders (17.5%) and unclear etiologies (17.5%). Chronic and excessive intake of copper might be discussed as an etiological factor in 8 other cases. 5 of these were proven to have coincided with very high hepatic copper contents and copper plumbing/acid well water. Their connection with copper exposure must be considered as probable, whereas 3 others were only suspected copper cases, mainly due to reliable exclusion of other etiologies. High corrosivity (base capacity) values and copper levels in the water for infants formula of 9-26.4 mg/L were determined in those probable cases for which exposure conditions could be exactly reproduced. Additional reports on copper associated ECC, either Indian Childhood Cirrhosis (ICC) from outside India or so-called Idiopathic Copper Toxicosis ( ICT ), originate from Austria, Australia, Germany, Ireland, USA.

Child, Preschool↗
PubMed1999

Factors to be considered concerning the corrosion of copper tubes.

Various corrosion processes in copper tubes may lead to elevated copper concentrations in drinking water, if the water is stagnant. Incorrect application of copper tubes in households may lead to elevated copper concentrations in tap water. Owners of private wells should carefully check the properties of the water to be used for human consumption.

Carbon Dioxide↗
PubMed1999

Copper and the liver: late lessons from the Camperdown experience.

In 1973 copper-associated liver disease was first described in an Australian boy of non-Indian origin who died at the age of 15 months with liver cirrhosis. At necropsy the hepatic copper concentration was excessively high (> 300 mg/g dry weight). It was shown that the boy s disease was caused by consumption of copper contaminated drinking water.

Australia↗
PubMed1999

Copper toxicosis in an Australian child.

A 20 month old Caucasian child living in rural Australia presented with liver failure after exposure from birth to milk formula made from acidic bore water containing excess copper leached from the copper piping. The liver pathology was identical to that seen in Indian childhood cirrhosis and similar disease in non-Indian children now termed idiopathic copper toxicosis (ICT). The only other Australian case, reported more than 20 years previously, had identical presentation, pathology and circumstances of occurrence. The rarity of ICT in Australia, despite a significant population at risk, and the implications of these cases are discussed.

Australia↗
PubMed1975

Interaction between polymeric materials and tissue -- biodeterioration of polymeric materials.

Styrene-isoprene block copolymer/methyl methacrylate graft copolymer (SIS-MMA), styrene-butadiene block copolymers (SBS), polyethylene, 1,2-polybutadiene, polysulfone, polycaprolactone polyurethane (PU) and ethylene-vinyl acetate copolymer (EVA) were implanted subcutaneously in dogs for 1 year. The same materials were stored in physiological saline solution at 37 degrees C (in vitro) and in air at room temperature (in air) for 1 year for comparative purpose. Biodeterioration or biodegradation of these materials was studied by mechanical property testing, viscometry, x-ray diffractometry, infrared spectroscopy and microscopy. A little deterioration of the mechanical properties of all the implanted samples was noticed as compared with the samples stored in vitro and in air. The infrared spectrum and x-ray diffraction pattern of the implanted sample except SIS-MMA were practically identical with the control. The implanted samples of SIS-MMA and SBS showed a cracked surface under a differential interference microscope. Viscosity measurements suggested a possible main chain scission for SIS-MMA and cross-linking for SBS and showed that the molecular weight of the other materials was almost unchanged. The intactness was rather surprising in regard to the infrared spectrum and viscosity of PU and EVA, because they were supposed to be more biodegradable. Deterioration of the mechanical properties was not always due to the results of biodegradation, as is often believed, but it must be considered that it might also be due to the absorption of some constituents such as lipids, steroids and amino acid from the body fluids and/or leaching of low molecular weight substances from the implanted materials.

Absorption↗
PubMed1975

Grandmas cove.

Explore the source record for details and available documents.

Adult↗
PubMed1999

The seasonal variation in the microbial agents implicated in the etiology of diarrheal diseases among children in Lao People's Democratic Republic.

During 1994-1995, the etiological structure of children's diarrhea was monitored in outpatients at Mahosot Hospital, Vientiane, Lao PDR. Of the 191 children studied, 42% had stool specimens positive for enteropathogens; 22% had rotavirus, 21.5% enteropathogenic E. coli, 4.7% Shigella flexneri, 2.9% Campylobacter jejuni, 2.1% Shigella sonnei, and 0.5% each of Giardia intestinalis and Entamoeba histolytica. No Vibrio cholerae and Salmonella spp. was detected in this monitoring. In children under five years, rotaviruses were detected almost all round the year with a maximum prevalence in January in the dry season. Shigella species were highly detected in June to July in the rainy season.

Child↗
PubMed2000

A series of outbreaks of food poisoning?

A series of independently occurring episodes which were notified individually as 'food poisoning' were, after investigation, linked to a common source water supply.

Caliciviridae Infections↗
PubMed2000

Water, sanitation and diarrhoea.

Water, sanitation and health are inseparably linked. Diarrhoea and other water related diseases are the major causes of health problems in developing countries. Although the need for water and sanitation interventions for health promotion has been recognised, these are labeled as costly and are often neglected in the primary healthcare programmes. Lack of proper water and sanitation initiatives based on appropriate techniques, technologies, knowledge and/or implementation methods have hindered the expected achievements through water and sanitation interventions. Since water and sanitation initiatives include both availability of provisions and their effective use (which mean behavioral changes), they are technically and socially challenging. Disasters and emerging water quality problems, such as arsenic in groundwater, have further been complicating this situation. After reviewing relevant articles, several research issues are suggested in the context of developing country perspectives.

Developing Countries↗
PubMed2000

Challenges for health and water resources in the Birim districts of eastern Ghana.

In the late 1970s and early '1980s, the Ghana Water and Sewerage Corporation (GWSC) with assistance from the government of Germany (KfW through IGIP) drilled 144 wells in the Birim North and South Districts of the Eastern Region of Ghana. This was part of an overall provision of water to rural communities which later came to be known as the 3000 Wells Project. The wells were supply-driven and were centrally-maintained, without community involvement in planning and operation. Earlier in 1970, an agricultural development project was also promoted in the two otherwise deprived districts with the aim of increasing output of produce and thereby improving incomes of rural farmers with emphasis on cocoa, rice and oilpalm. In 1992, under a United Nations' Development Programme Rural Water and Sanitation Project with the GWSC, another 141 wells were drilled and assistance provided to households to build 750 Ventilated Improved Pit (VIP) latrines coupled with hygiene education under a demand-driven community management approach. (About 60% of the budget was allocated to water, another 30% to sanitation while some 10% was meant for hygiene education interventions). All the wells were fitted with modified Indian Mk II pumps. These measures together were meant to improve the health of rural communities and make them contribute more positively to national development. The paper looks at some of the possible factors of the two water projects and the agricultural development project that could impact negatively on the water resources and health of people in these two districts.

Agriculture↗
PubMed2000

Protecting drinking water: water quality testing and PHAST in South Africa.

The paper presents an innovative field-based programme that uses a simple total coliform test and the approach of PHAST (Participatory Hygiene And Sanitation Transformation) to help communities exploring possible water quality problems and actions that can be taken to address them. The Mvula Trust, a South African water and environmental sanitation NGO, has developed the programme. It is currently being tested throughout South Africa. The paper provides two case studies on its implementation in the field, and suggests ways in which the initiative can be improved in the future.

Colony Count, Microbial↗
PubMed2000

Conflict of technologies for water and sanitation in developing countries.

Borehole water supplies, in basement rock aquifers in the West Africa Sub-region, face potential pollution hazards as a result of their close location within the same geological environments as indiscriminately sited latrines, rubbish dumps, farms and animal watering points in the communities. The heterogeneous nature of the overburden and fractures in the bedrock constitute relatively fast flow paths for surface water contaminated mainly by bacteria and nitrates which enhance the pollution of the groundwater and boreholes. To improve the drinking water quality, some measures have been taken to minimize the hazards. Further studies are required to understand better the nature and scale of the problem and to avoid the apparent conflict of technologies. It is necessary to incorporate improvements in sanitation into rural water supply projects, if the otherwise good drinking water source should not be lost to society's wastes.

Conflict, Psychological↗
PubMed2000

Pit latrine effluent infiltration into groundwater: the Epworth case study.

Water can be a vehicle for the transmission of communicable diseases. Technologies have been developed to protect groundwater from external surface contamination. However, there is growing concern about the likelihood of pit latrine effluent infiltrating into groundwater reservoirs for well water supply systems. Investigations on seasonal variations and extent of pit latrine effluent infiltration into soil and groundwater have been carried out in Zimbabwe. Preliminary results show that groundwater flows in the direction of surface runoff, and that there is no lateral soil pollution above the groundwater surface. Pit latrine contents leach downwards and down slopes for distances that vary per season and soil type. The results also demonstrate the contribution of refuse pits and water collection methods to groundwater pollution.

Developing Countries↗
PubMed2000

Sanitation without pollution.

The most effective way of protecting drinking water resources from domestic sewage is to use technologies that do not produce sewage. This paper gives an overview of emerging alternatives in the form of ecological sanitation systems for urban and peri-urban areas. A key feature of ecological sanitation is that it regards human excreta as a resource to be recycled rather than as waste to be disposed of. Examples given include ecological sanitation systems based on dehydration and decomposition from Mexico, El Salvador, Sweden, India and Vietnam. These systems need neither water for flushing, nor pipelines for transport, nor treatment plants and arrangements for the disposal of toxic sludge. Large scale application of ecological sanitation would lead to less environmental pollution, reduced water consumption, considerable savings on sewers and treatment plants and increased employment. In addition it would provide valuable resources for food production and wasteland development.

Conservation of Natural Resources↗
PubMed2000

Reuse--the ultimate sink? Urine-diverting toilets to protect groundwater quality and fertilise urban agriculture.

People are concerned about water and food scarcity and the threats that faecal pollution and malnutrition pose to their health. Ecological sanitation systems open up for new, constructive options in sanitation, not least in poor periurban areas. The purpose of developing a no-mix excreta disposal system is to save water, to reduce wastewater treatment problems, and to protect groundwater quality as well as to recirculate nutrients from urine. In this paper all these aspects will be dealt with comprehensively.

Agriculture↗