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PubMed2003

Taking up binge drinking in college: the influences of person, social group, and environment.

PURPOSE: To identify person, social group, and environmental factors associated with uptake of binge drinking among a national sample of college students. METHODS: Using self-reported responses of students in the 1999 Harvard School of Public Health College Alcohol Study (CAS), we regressed conceptually important predictors of binge drinking onto a dichotomized variable describing uptake in the freshman year. This was a random sample of full-time undergraduates provided by the registrar at each participant school (n = 119). For this study, we analyzed data describing a subset of the total sample comprising first year students aged < or =19 years, excluding transfers (n = 1894). The student CAS is a 20-page voluntary, anonymous mailed questionnaire containing student reports about their alcohol and substance use, school activities, and background characteristics. Analyses included univariate and multivariate logistic regression adjusting for school response rate and using the Generalized Estimating Equations (GEE) in the Statistical Analysis Software package to handle the within-college clustering owing to the sampling scheme. RESULTS: College students who reported that they were exposed to "wet" environments were more likely to engage in binge drinking than were their peers without similar exposures. Wet environments included social, residential, and market surroundings in which drinking is prevalent and alcohol cheap and easily accessed. Findings held up in multivariate analyses that included variables describing person and social group characteristics. Students who picked up binge drinking in college also were more likely than their peers to report inflated definitions of binge drinking and more permissive attitudes about appropriate ages for legal consumption. CONCLUSIONS: Binge drinking can either be acquired or avoided in college among students who report they did not binge drink in high school. Reducing college binge uptake may require efforts to limit access/availability, control cheap prices, and maximize substance free environments and associations.

Adolescent↗
PubMed1996

The acidogenic potential of herbal baby drinks.

The acidogenic potential of a range of commonly available herbal baby drinks was assessed on the basis of their ability to depress plaque pH in vivo in 10 adult volunteers using the plaque harvesting technique. In addition the pH and inherent acidity of each drink was also analysed in vitro. Solutions of 10% sucrose was used as a positive control and full fat milk served as a negative control as it has traditionally been recommended as a safe drink. Three of the six test drinks had a low pH though most had a low titratable acidity. All drinks, except herbal tea, on rising led to a significant drop in the plaque pH to near critical pH value of 5.5. Most drinks were also more acidogenic than milk and some behaved essentially similar to a 10% sucrose solution. The area under the curve below the resting pH was highest for apple and raspberry herbal drink (20.51 +/- 3.66) and was the least for herbal tea (0.00) compared with the 10% sucrose control (22.01 +/- 2.87) and milk (0.07 +/- 0.14). It was concluded that most herbal drinks tested, especially those with added fruit, can lead to a significant acid production in the plaque and therefore have a potential to cause demineralisation of the enamel.

Adolescent↗
PubMed2005

Drinking deep-sea water restores mineral imbalance in atopic eczema/dermatitis syndrome.

OBJECTIVE: The effect of drinking deep-sea water on hair minerals was studied in patients with atopic eczema/dermatitis syndrome (AEDS). Study of hair minerals revealed an imbalance of essential minerals and an increase in toxic minerals in AEDS patients. DESIGN: After drinking deep-sea water (Amami no Mizu) for 6 months in AEDS patients, hair minerals (essential minerals and toxic minerals), clinical evaluation of the skin symptoms were compared before drinking with after drinking. SUBJECTS: After obtaining informed consent, 33 patients (mean age 26 y, range 1-50 y, 13 male and 20 female subjects) with mild to moderate AEDS were enrolled. RESULTS: After drinking deep-sea water, the levels of the essential mineral, potassium (K), were significantly decreased, while the levels of selenium (Se) increased. On the other hand, drinking deep-sea water significantly decreased the levels of the toxic minerals, mercury and lead. Moreover, after drinking deep-sea water, the skin symptoms were improved in 27 out of 33 patients. CONCLUSION: These results indicate that the mineral abnormalities/imbalance may be involved in the pathogenesis of AEDS, and that drinking deep-sea water may be useful in the treatment of AEDS.

Adolescent↗
PubMed2005

Prevention of childhood obesity by reducing soft drinks.

AIMS: The increasing prevalence of childhood obesity is a global problem. There are a variety of environmental factors that may be contributing to this increase. One such factor may be the increased consumption of soft drinks. OBJECTIVE: This review will describe some of the latest research that has examined the association between obesity and the consumption of soft drinks. RESULTS: The association between the consumption of sugar-sweetened drinks and childhood obesity has been established in three separate American studies. It has been found that children who consume these drinks have a higher energy intake and are more likely to become overweight. In adult women, the consumption of sugar-sweetened soft drinks has been associated with an increased risk of developing diabetes. In the United Kingdom, a school-based initiative focusing on reducing the consumption of these drinks has also been effective in preventing a further increase in obesity. CONCLUSIONS: There is an association between obesity and consumption of soft drinks. Initiatives focusing on reducing the consumption of these drinks may help to prevent a further increase in childhood obesity.

Beverages↗
PubMed1998

Responses to televised alcohol advertisements associated with drinking behaviour of 10-17-year-olds.

AIMS: To examine the nature of the relationships between 10-17-year-old New Zealanders' responses to alcohol advertisements and their drinking behaviour and future drinking expectations, with consideration also being given to the role of positive and negative beliefs about drinking. DESIGN: Survey involving 500 face-to-face interviews, with selection based on random cluster sampling. SETTING: In respondents' homes in New Zealand's three largest urban areas. PARTICIPANTS: Ten-17-year-old New Zealanders. MEASUREMENTS: Response to specific alcohol advertisements was measured by recalled exposure (how often they recalled having seen the advertisements) and liking (a measure of positive response). FINDINGS: An exploratory structural equation model provided tentative support for the theory-based hypothesis that positive responses to beer advertisements increased the frequency of current drinking and expected future drinking, among this age group. There was no evidence for the hypothesized reciprocal effects; the frequency of drinking (including non-drinking) did not significantly affect the respondent's liking of beer advertisements. There was also no support for a hypothesis that linking of the beer advertisements was a product of a general liking for alcohol. Many of the young people themselves felt that alcohol advertising encouraged teenagers to drink. This was especially the case among 10-13-year-old males, who were the most likely to accept the portrayals in alcohol advertising as realistic. CONCLUSIONS: Although there are limitations on the confidence with which conclusions can be drawn, the findings are consistent with qualitative and quantitative research and different theoretical perspectives on advertising processes which suggest alcohol advertising is likely to have some influence on young people.

Adolescent↗
PubMed1998

Gender differences in alcohol-related problems: controlling for drinking behaviour.

AIMS: Two hypotheses were tested to explain a high prevalence of alcohol-related problems among women relative to their low prevalence of excessive drinking: (1) At a given level of drinking, women may report more problems of any type than do men. (2) At a given level of drinking, the number of problems or the severity of the reported problems may be lower among women than among men. DESIGN: General population survey. SETTING: Rotterdam, The Netherlands. PARTICIPANTS: 3537 Dutch respondents within the age range 16-69 years. MEASUREMENTS: Alcohol-related problems were measured in five problem areas: psychological dependence, symptomatic drinking, social problems, health problems/accidents and frequent drunkenness/hangovers. A problem index was formed by adding up the scores in the five separate problem areas. Alcohol use was measured by the Quantity-Frequency-Variability index. FINDINGS: For the same level of drinking, women were as likely as men to report alcohol-related problems except that women light drinkers were actually less likely to report problems than men. Men tended to have a greater accumulation of different types of problems within drinking categories than women. Overall problem severity, however, did not differ between men and women. The apparent excess prevalence of alcohol problems in women relative to drinking level appears to be due to presence of problems even among light drinkers and a greater preponderance of light drinkers in women than men. CONCLUSIONS: The first hypothesis was rejected; drinking levels being the same, the level of alcohol problems is the same or even lower for women than for men. As hypothesized, men tend to have a greater accumulation of different kinds of problems than women. However, the severity of the reported problems does not differ between men and women.

Adolescent↗
PubMed2002

Adolescent part-time work and heavy drinking in Finland.

AIMS: To examine the relationship between part-time work and heavy drinking among Finnish adolescents. DESIGN, SETTING: The cross-sectional survey data (the School Health Promotion Survey, n = 47,568) were collected in classrooms in 2000. PARTICIPANTS: Finnish lower-level secondary school students from the 8th and 9th grades, aged 14-16 years. The response rate was 82%. MEASUREMENTS: Work intensity, work type and the frequency of heavy drinking obtained from self-administered questionnaires. The relationship between work and heavy drinking was studied using polychotomous logistic regression models. FINDINGS: Compared with non-workers, adolescents working more than 10 hours per week had an increased risk of heavy drinking, and also the frequency of heavy drinking was connected with this intensive working. When gender, grade level, parental education, the employment status of the parents, family structure, economic situation of the family, the degree of urbanisation, parental control, steady dating. GPA and disposable allowance were adjusted for, the odds of weekly drunkenness were almost three times the odds of not reporting drunkenness among intensive workers compared with non-workers. When adjusted for other factors, some typical children's jobs marginally decreased a likelihood of heavy drinking. CONCLUSIONS: Work does seem not protect adolescents from heavy drinking. Although many relevant factors were controlled for the effect may, however, be mediated through factors not covered in the survey. Therefore, further clarification of the causal chains linking adolescent working and drinking is needed.

Adolescent↗
PubMed2006

Perfluorinated surfactants in surface and drinking waters.

GOAL, SCOPE AND BACKGROUND: In this paper recent results are provided of an investigation on the discovery of 12 perfluorinated surfactants (PS) in different surface and drinking waters (Skutlarek et al. 2006 a, Skutlarek et al. 2006 b). In the last years, many studies have reported ubiquitous distribution of this group of perfluorinated chemicals, especially perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) in the environment, particularly in wildlife animal and human samples (Giesy and Kannan 2001, Houde et al. 2006, Prevedouros et al. 2006). Perfluorinated surfactants (e.g. PFOS and PFOA) have shown different potentials for reproductory interference and carcinogenity in animal experiments as well as partly long half-lives in humans (Guruge et al. 2006, FSA UK 2006a, FSA UK 2006b, 3M 2005, OECD 2002, Yao and Zhong 2005). They possess compound-dependent extreme recalcitrance against microbiological and chemical degradation and, in addition, they show variable potentials for bioaccumulation in animals and humans (Houde et al. 2006). METHODS: Surface and drinking water samples were collected from different sampling sites: Surface waters: samples taken from the rivers Rhine, Ruhr, Moehne and some of their tributaries. Further samples were taken from the Rhine-Herne-Canal and the Wesel-Datteln-Canal. Drinking waters: samples taken in public buildings of the Rhine-Ruhr area. After sample clean-up and concentration by solid-phase extraction, the perfluorinated surfactants were determined using HPLC-MS/MS. RESULTS: All measured concentrations (sum of seven mainly detected components) in the Rhine river and its main tributaries (mouths) were determined below 100 ng/L. The Ruhr river (tributary of the Rhine) showed the highest concentration (94 ng/L), but with a completely different pattern of components (PFOA as major component), as compared with the other tributaries and the Rhine river. Further investigations along the Ruhr river showed remarkably high concentrations of PS in the upper reaches of the Ruhr river and the Moehne river (tributary of the Ruhr) (Ruhr: up to 446 ng/L, Moehne: up to 4385 ng/L). The maximum concentration of all drinking water samples taken in the Rhine-Ruhr area was determined at 598 ng/L with the major component PFOA (519 ng/L). DISCUSSION: The surface water contaminations most likely stem from contaminated inorganic and organic waste materials (so-called 'Abfallgemisch'). This waste material was legally applied to several agricultural areas on the upper reaches of the Moehne. Perfluorinated surfactants could be detected in some suchlike soil samples. They contaminated the river and the reservoir belonging to it, likely by superficial run-off over several months or probably years. Downstream, dilution effects are held responsible for decreasing concentrations of PS in surface waters of the Moehne and the Ruhr river. In analogy to the surface water samples, PS (major component PFOA) can be determined in many drinking water samples of the Rhine-Ruhr area where the water supplies are mainly based on bank filtration and artificial recharge. CONCLUSIONS: The concentrations found in drinking waters decreased with the concentrations of the corresponding raw water samples along the flow direction of the Ruhr river (from east to west) and were not significantly different from surface water concentrations. This indicates that perfluorinated surfactants are at present not successfully removed by water treatment steps. RECOMMENDATIONS AND PERSPECTIVES: Because of their different problematic properties (persistence, mobility, toxicity, bioaccumulation), the concentrations of specific perfluorinated surfactants and their precursors in drinking waters and food have to be minimised. Therefore, it is of utmost importance to take the initiative to establish suitable legal regulations (limitations/ban) concerning the production and use of these surfactants and their precursors. Furthermore, it is indispensable to protect water resources from these compounds. A discussion on appropriate limit values in drinking water and foodstuffs is urgently needed. Concerning the assumed soil contamination, the corresponding regulation (Bioabfall-Verordnung 1998--Regulation on Organic Waste 1998) should be extended to allow the control of relevant organic pollutants.

Fluorocarbons↗
PubMed2003

Risk factors for increased urinary inorganic arsenic concentrations from low arsenic concentrations in drinking water.

A large number of drinking water supplies worldwide have greater than 50 microg l(- 1) inorganic arsenic in drinking water, and there is increasing pressure to reduce concentrations. Few studies have specifically considered low concentrations of arsenic in water supplies and the significance of other factors which may contribute to increased exposure. This study aimed to investigate risk factors for increased urinary inorganic arsenic concentrations, in a population exposed to 10 - 100 microg l(- 1) of arsenic in drinking water, as well as a control population with lower arsenic concentrations in their drinking water. Inorganic arsenic in urine was used as the measure of exposure. The median drinking water arsenic concentration in the exposed population was 43.8 microg l(- 1) (16.0 - 73 microg l(- 1)) and less than the analytical limit of detection of 1 microg l(- 1) (<DL) (range<DL-8.0 microg l(- 1)) in the control group. The geometric mean urinary inorganic arsenic concentration for the exposed group was 4.24 microg l(- 1) (range<DL-18.8 microg l(- 1)) and for the control group was 1.18 microg l(- 1) (<DL-4.49 microg l(- 1)). In a random effects linear regression model, drinking water was the significant predictor of urinary inorganic arsenic concentrations with factors such as age, season and drinking water consumption important risk factors. These results show that concentrations of arsenic in drinking water, even at lower concentrations, make an important contribution to exposure. Further work is required to define the potential for absorption at these lower levels.

Adolescent↗
PubMedDate not supplied

Drinking pattern and alcohol-related medical disorders.

Although heavy alcohol intake is known to be one of the most common causative factors of liver disease, pancreatitis, upper gastrointestinal and neurological disorders, the influence of the drinking pattern is largely unknown. The study investigated the relationship of alcohol-related medical disorders in alcoholics and their drinking pattern. Two hundred and forty-one chronic alcoholics were referred consecutively for detoxification and their drinking pattern was sufficient for them to be included in this study. History of alcohol abuse as well as drinking behaviour in the last 6 months were assessed by a semi-structured interview. Findings included intensive clinical examination with abdominal ultrasound in most subjects. Heavy drinking with frequent inebriation was most often found in our sample (44.4%), whereas continuous heavy alcohol consumption without intoxication (33.6%), and an episodic drinking style (22.0%) were less frequent. The heavy drinkers suffered more often from pancreatitis, oesophageal varices, polyneuropathy or erectile dysfunction than episodic drinkers. They also showed more upper gastrointestinal disorders, although the estimated life-time alcohol intake was comparable to continuous drinkers. No difference relating to withdrawal delirium or seizures could be found between the groups of alcoholics. Frequent heavy drinkers showed a trend to more alcohol-related medical disorders than alcoholics with a different drinking pattern, although they were younger and their estimated life-time alcohol intake was comparable to that of continuous drinkers. Thus, the drinking pattern, particularly frequent inebriation, has an influence on the occurrence of alcohol-related disorders.

Adult↗
PubMed1996

Detection of microcystins, a blue-green algal hepatotoxin, in drinking water sampled in Haimen and Fusui, endemic areas of primary liver cancer in China, by highly sensitive immunoassay.

An epidemiological survey for the causes of a high incidence of primary liver cancer (PLC) in Haimen city, Jian-Su province and Fusui county, Guangxi province in China, found a close correlation between the incidence of PLC and the drinking of pond and ditch water. With an aim to clarify whether microcystins (MC), a hepatotoxic peptide produced by water bloom algae, contaminate the drinking water in the endemic areas of PLC in China, a highly sensitive enzyme-linked immunosorbent assay with a detection limit of 50 pg/ml, was introduced to monitor the MC. Three trials to survey the drinking water were carried out in 1993-1994. Samples, 1135 in total, were collected from different sources such as: ponds, ditches, rivers, shallow wells and deep wells in Haimen city. The first survey in September 1993 found that three out of 14 ditch water specimens were positive for MC, with a range of 90-460 pg/ml. Several toxic algae such as Oscillatoria agardhii were present in some of the ditches. In the second trial, samples were collected from five ponds/ditches, two rivers, two shallow wells and two deep wells monthly for the whole year of 1994. These data showed that MC was highest in June to September, with a range of 62-296 pg/ml. A third trial on the 989 different water samples collected from the different types of water sources in July 1994 revealed that 17% of the pond/ditch water, 32% of the river water, and 4% of the shallow-well water were positive for MC, with averages of 101, 160 and 68 pg/ml respectively. No MC was detected in deep well water. A similar survey on 26 drinking water samples in Fusui, Guangxi province, demonstrated a high contamination frequency of MC in the water of ponds/ditches and rivers but no MC in shallow and deep wells. These data support a hypothesis that the blue-green algal toxin MC in the drinking water of ponds/ditches and rivers, or both, is one of the risk factors for the high incidence of PLC in China. Based on previous findings on the epidemiology of PLC and the present results from the mass screening of MC in the drinking water, an advisory level of MC in drinking water was proposed to below 0.01 microg/l. The combined effect of a potent hepatocarcinogen AFB1 and an intermittent intake of MC in drinking water in the summer season was discussed as an etiology of PLC.

Antibodies, Monoclonal↗
PubMed1989

Drinking and smoking patterns amongst women attending an antenatal clinic--II. During pregnancy.

This paper describes smoking and drinking patterns during pregnancy amongst a cohort of 2266 women who enrolled at a London antenatal clinic 1982-1983. Only 12% of mothers were non-drinkers before pregnancy, but 44% abstained in the first trimester, 38% in the second and 50% in the third. Before pregnancy 20% of mothers were drinking more than the recommended 10 units of alcohol per week. This dropped to 6% during pregnancy. Mean consumption at each of the three stages of pregnancy was highest amongst those mothers who were the heaviest drinkers before pregnancy. The heaviest pre-pregnancy drinkers were also the least likely to abstain at any point in pregnancy. Of those mothers who were drinking less than 10 units of alcohol per week before pregnancy, 3% increased during pregnancy. Wine was the most popular beverage choice but heavier drinkers were more likely to drink beers and spirits in addition. Before pregnancy 29% of mothers smoked. This dropped to 23% in pregnancy. Consumption levels fell amongst those who continued smoking. The heaviest pre-pregnancy smokers were the most likely to reduce but the least likely to stop. Smoking was positively associated with the level of both pre-pregnancy and pregnancy drinking. The most commonly cited reasons for changes in drinking and smoking habits in pregnancy were concern for the child, concern for self or concern for both. Feeling sick or ill was a more commonly stated reason for reduction of drinking than smoking. Social pressures were important in reducing smoking, but the mass media were quoted as a more important influence in reducing drinking. Mothers who drank more than 10 units of alcohol per week during pregnancy were more likely to be older, of higher social status and primiparous. In contrast those who smoked in pregnancy were more likely to be younger, of lower social status and multiparous. This has important implications for planning antenatal health education.

Adolescent↗
PubMed2002

Binge drinking in Jewish and non-Jewish white college students.

BACKGROUND: In the United States, religious commitment, as measured by service attendance, has an inverse relationship with alcohol consumption, heavy use, and problem use. This association, however, has not been found consistently in Jewish Americans. The present study examined the relationship between religious variables and binge drinking in Jewish and non-Jewish white college students. In addition, the association among genetic, cultural, and religious variables and binge drinking was examined in the Jewish sample alone. METHODS: Participants were 132 Jewish and 147 non-Jewish white college students. All participants completed the Time-Line Follow-Back, had blood drawn for genotyping at the alcohol dehydrogenase locus ADH2, and reported their religious affiliation and the number of religious services attended in the past year. Jewish subjects also completed the Jewish Identity Scale. RESULTS: As hypothesized, more frequent religious service attendance related to lower rates of binge drinking in non-Jews but was not related to binge drinking in Jews. Within the Jewish sample, individuals who were religiously affiliated had approximately one third the risk of binge drinking as those who were secularly affiliated, but identification with Jewish culture was not related to binge drinking. In the total sample, individuals who possessed a variant alcohol dehydrogenase allele ADH2*2 were approximately half as likely to binge drink as those who did not possess this allele. CONCLUSIONS: These results are consistent with previous studies that find an inverse relationship between religious service attendance and heavy alcohol use in Christian but not Jewish college students. Findings within the Jewish sample support theories that suggest religious, not just cultural, Jewish affiliation relates to lower levels of alcohol behavior. More research is needed to identify additional factors, including other religious, cultural, genetic, and biological influences, that protect Jewish Americans from heavy drinking.

Adult↗
PubMed2006

Identifying risk drinking in expectant fathers.

BACKGROUND: Identification of risk drinking in expectant fathers may be helpful as an important part of efforts to minimize maternal alcohol use, and as an opportunity to inform them about a problematic practice during a critical developmental stage for the couple. The purpose of this study was to evaluate the T-ACE screening questionnaire, which asks about tolerance to alcohol, being annoyed by other's comments about drinking, attempts to cut down, and having a drink first thing in the morning ("eye-opener"), in the male partners of pregnant women who themselves were T-ACE positive. METHODS: Two hundred fifty-four male partners were asked to complete the T-ACE embedded in a health survey, the Alcohol Use Disorders Identification Test (AUDIT), and other questions about their alcohol use in the past 30 days when their pregnant partners had a median gestation of 11.5 weeks (T1). After delivery, male partners again completed the T-ACE and quantity-frequency questions (T2). The predictive ability of the T-ACE and AUDIT was compared, using risk drinking (>4 drinks/day or >14 drinks/week) as the criterion standard. RESULTS: A substantial minority of male partners had risk drinking, 31 percent at T1 and 25 percent at T2. Although the AUDIT was better than the T-ACE as an independent predictor of risk drinking, the latter was most accurate when the tolerance threshold exceeded 2 drinks, the same established for pregnant women. The sensitivity (T1= 84.6%, T2= 82.8%) and specificity (T1= 43.8%, T2= 51.1%) of the T-ACE at this threshold compared favorably with those of the AUDIT at the standard cut point of 8. CONCLUSIONS: The T-ACE may be a practical way for clinicians to identify risk drinking in both pregnant women and expectant fathers.

Adolescent↗
PubMed1987

Fluid balance in food-deprived lactating goats drinking saline.

Fluid balance was studied in four lactating goats during two 3 week periods, which included 30 h periods of food deprivation. In one period the goats were given 0.9% NaCl to drink, and in the other they were given water. Prior to food deprivation, fluid intake and urinary flow were similar in the two groups, but urinary Na+ excretion was higher in the saline-drinking goats. The plasma renin activity was depressed in saline-drinking goats, while the plasma aldosterone concentration was the same both in saline-drinking and water-drinking animals. Food deprivation depressed fluid intake and urine flow in all goats, but the reduction was more pronounced in goats drinking saline. The urinary Na+ and K+ excretion also decreased, in both groups, as did plasma Na+ concentration and osmolality. The plasma protein concentration increased in both groups, indicating that hypovolaemia had developed. The renin-angiotensin-aldosterone system (r.a.a.s.) became activated in goats drinking water, but not in the group drinking saline. It is suggested that sodium retention may have attenuated the activation of the r.a.a.s. in the latter group. The results of this study show that hyponatraemic hypovolaemia develops during starvation in lactating goats, regardless of the sodium state of the animals. The possibility that the hyponatraemic hypovolaemia is secondary to an impeded Na+ and fluid absorption from the rumen reticulum is discussed.

Aldosterone↗
PubMed2005

Toenail arsenic concentrations, GSTT1 gene polymorphisms, and arsenic exposure from drinking water.

Toenail arsenic (As) concentrations were evaluated as a biomarker of inorganic As (As(in)) exposure in a population residing in an As-endemic region of Bangladesh. Drinking water and toenail samples were collected from 48 families (n = 223) every 3 months for 2 years and analyzed for As using inductively coupled plasma-mass spectrometry. Drinking water collected 3, 6, and 9 months before each toenail sample collection was combined into a weighted lagged exposure variable. The contribution of each water sample to the measured toenail As concentration was estimated using maximum likelihood that accounted for fluctuations in drinking water exposure and toenail growth. The best model attributed 69%, 14%, and 17% of the toenail As content to drinking water exposures that occurred 3, 6, and 9 months before toenail collection [95% confidence intervals (95% CI), 0.46-0.97, 0.00-0.31, and 0.03-0.35, respectively]. Generalized additive mixed models using penalized regression splines were employed to model the data. Below a drinking water concentration of 2 mug As/L, no relationship between drinking water As and toenail As concentrations was observed. Above this concentration, toenail As content increased in a dose-dependent fashion as drinking water As increased. Age was a significant effect modifier of drinking water As exposure on toenail As (beta = 0.01; 95% CI, 0.002-0.02). Individuals possessing GSTT1-null genotypes had significantly more As in their toenails in contrast to GSTT1 wild-type individuals (beta = 0.11; 95% CI, 0.06-0.2). Therefore, it seems that GSTT1 modifies the relationship between As(in) exposure and toenail As(in) content.

Adolescent↗
PubMed2006

A review of nitrates in drinking water: maternal exposure and adverse reproductive and developmental outcomes.

In this review we present an update on maternal exposure to nitrates in drinking water in relation to possible adverse reproductive and developmental effects, and also discuss nitrates in drinking water in the United States. The current standard for nitrates in drinking water is based on retrospective studies and approximates a level that protects infants from methemoglobinemia, but no safety factor is built into the standard. The current standard applies only to public water systems. Drinking water source was related to nitrate exposure (i.e., private systems water was more likely than community system water to have nitrate levels above the maximum contaminant limit). Animal studies have found adverse reproductive effects resulting from higher doses of nitrate or nitrite. The epidemiologic evidence of a direct exposure-response relationship between drinking water nitrate level and adverse reproductive effect is still not clear. However, some reports have suggested an association between exposure to nitrates in drinking water and spontaneous abortions, intrauterine growth restriction, and various birth defects. Uncertainties in epidemiologic studies include the lack of individual exposure assessment that would rule out confounding of the exposure with some other cause. Nitrates may be just one of the contaminants in drinking water contributing to adverse outcomes. We conclude that the current literature does not provide sufficient evidence of a causal relationship between exposure to nitrates in drinking water and adverse reproductive effects. Future studies incorporating individual exposure assessment about users of private wells--the population most at risk--should be considered.

Abortion, Spontaneous↗
PubMed1999

Drinking water disinfection byproducts: review and approach to toxicity evaluation.

There is widespread potential for human exposure to disinfection byproducts (DBPs) in drinking water because everyone drinks, bathes, cooks, and cleans with water. The need for clean and safe water led the U.S. Congress to pass the Safe Drinking Water Act more than 20 years ago in 1974. In 1976, chloroform, a trihalomethane (THM) and a principal DBP, was shown to be carcinogenic in rodents. This prompted the U.S. Environmental Protection Agency (U.S. EPA) in 1979 to develop a drinking water rule that would provide guidance on the levels of THMs allowed in drinking water. Further concern was raised by epidemiology studies suggesting a weak association between the consumption of chlorinated drinking water and the occurrence of bladder, colon, and rectal cancer. In 1992 the U.S. EPA initiated a negotiated rulemaking to evaluate the need for additional controls for microbial pathogens and DBPs. The goal was to develop an approach that would reduce the level of exposure from disinfectants and DBPs without undermining the control of microbial pathogens. The product of these deliberations was a proposed stage 1 DBP rule. It was agreed that additional information was necessary on how to optimize the use of disinfectants while maintaining control of pathogens before further controls to reduce exposure beyond stage 1 were warranted. In response to this need, the U.S. EPA developed a 5-year research plan to support the development of the longer term rules to control microbial pathogens and DBPs. A considerable body of toxicologic data has been developed on DBPs that occur in the drinking water, but the main emphasis has been on THMs. Given the complexity of the problem and the need for additional data to support the drinking water DBP rules, the U.S. EPA, the National Institute of Environmental Health Sciences, and the U.S. Army are working together to develop a comprehensive biologic and mechanistic DBP database. Selected DBPs will be tested using 2-year toxicity and carcinogenicity studies in standard rodent models; transgenic mouse models and small fish models; in vitro mechanistic and toxicokinetic studies; and reproductive, immunotoxicity, and developmental studies. The goal is to create a toxicity database that reflects a wide range of DBPs resulting from different disinfection practices. This paper describes the approach developed by these agencies to provide the information needed to make scientifically based regulatory decisions.

Acetates↗