1. The health effects of contaminated water
Why this matters
The health effects of contaminated water
Joseph h kim, do faafp
Chairperson, Nanticoke health integrated alliance

2. Blue baby syndrome Multiple causes Increase in methemoglobin
Results in lack of oxygen
Tissue and organ death
treatable

3. Environ Health Perspective September 2013 | Volume 121 | Issue 9 Prenatal Nitrate Intake from Drinking Water and Selected Birth Defects in Offspring of Participants in the National Birth Defects Prevention Study
Conclusions: …Higher water nitrate intake was associated with several birth defects in offspring…
Reported Birth Defects include Spina Bifida, Limb Deficiency, Cleft Palate, Cleft Lip

5. Maternal Exposure to Nitrate from Drinking Water and Diet and Risk for Neural Tube Defects. American Journal of Epidemiology, Volume 153, Issue 4, 15 February 2001
Exposure to nitrate in drinking water at concentrations above
5 mg/liter was associated with increased risk for anencephaly.

7. Spontaneous abortions possibly related to ingestion of nitrate-contaminated well water--LaGrange County, Indiana, MMWR Morb Mortal Wkly Rep Jul 5;45(26):
This report summarizes the investigations of these reports by the health dept, which indicate the need for further assessment of a possible relation between ingesting nitrate-contaminated water and spontaneous abortion.

8. A review of nitrates in drinking water: maternal exposure and adverse reproductive and developmental outcomes. Environmental Health Perspectives, Mar 1, 2006
…some reports have suggested an association between exposure to nitrates in drinking water and spontaneous abortions, intrauterine growth restriction, and various birth defects…

9. RELATION TO CANCER

10. Municipal Drinking Water Nitrate Level and Cancer Risk in Older Women: The Iowa Women’s Health Study
Epidemiology: May Volume 12 - Issue 3 - p
Drinking Water Nitrate and the Risk of Non-Hodgkin's Lymphoma
Epidemiology: Vol. 7, No. 5 (Sep., 1996), pp
Calcium, Magnesium, and Nitrate in Drinking Water and Gastric Cancer Mortality
Cancer Science: First published: February 1998
Nitrate Intake and the Risk of Thyroid Cancer and Thyroid Disease
Epidemiology May; 21(3): 389–395.
Nitrate from Drinking Water and Diet and Bladder Cancer Among Postmenopausal Women in Iowa.
Environ Health Perspect Nov;124(11): Epub 2016 Jun 3
Nitrate and nitrite ingestion and risk of ovarian cancer among postmenopausal women in Iowa
Int J Cancer Jul 1;137(1): doi: /ijc Epub 2014 Dec 8.

11. National cancer institute cancer trends progress report nitrates
Studies have shown increased risks of colon, kidney, and stomach cancer among people with higher ingestion of water nitrate and higher meat intake…
….studies have shown modest evidence that higher nitrate intake can increase the risk of thyroid cancer and ovarian cancer among women.
Examination of nitrate is new to the Cancer Trends Progress Report. Last updated: feb 2018

12. Nitrates in Water and Food may Increase Thyroid Cancer Risks for Women Environmental Health News, June 29, 2010
the National Institute of Health studied 21,977 older women in Iowa who had used the same water supply for more than 10 years…
…nearly three-fold increase in thyroid cancer risk for women with more than five year's use of a public water supply that had nitrate levels of 5 mg/L or above….

13. OTHER HEALTH EFFECTS

14. Incidence of childhood diabetes mellitus in Yorkshire, northern England, is associated with nitrate in drinking water: an ecological analysis.
Diabetologia May;40(5):550-6.
Nitrate levels in community drinking waters and risk of IDDM. An ecological analysis.
Diabetes Care Nov;15(11):
Epidemilogical Trends Strongly Suggest Exposures as Etiologic Agents in the Pathogenesis of Sporadic Alzheimer's Disease, Diabetes Mellitus, and Non-Alcoholic Steatohepatitis
Journal of Alzheimer's Disease 17 (2009)
Nitrates May Be Environmental Trigger For Alzheimer’s, Diabetes And Parkinson's Disease
Lifespan, July 6, 2009

15. Delaware statistics Cancer mortality Cancer incidence Infant mortality
According to the CDC, the incidence of cancer for Delaware is 488 per 100,000, significantly higher than the U.S. rate of 454 per 100,000.
Delaware is 2nd highest in cancer incidence
The “Cancer Incidence and Mortality in Delaware” report stated there were deaths per 100,000 people between , making the mortality rate 5 percent higher than the U.S. rate of per 100,000
Delaware is 16th highest in total cancer deaths
According to Delaware division of public health, the incidence of birth defects is 372 per 10,000, significantly higher than the average U.S. rate of 300 per 100,000.
The rate of infant mortality in 2017 was 7.9 per compared to the U.S. rate of 5.9 per 1000.

16. “Access to safe water is a fundamental human need and, therefore, a basic human right. Contaminated water jeopardizes both the physical and social health of all people. It is an affront to human dignity.”
-Kofi Annan, UN Secretary-General