health effects of nitrate in drinking water

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Health Effects of Nitrate in Drinking Water Sarah Yang, Ph.D. Groundwater Toxicologist February 26, 2020

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Page 1: Health Effects of Nitrate in Drinking Water

Health Effects of Nitrate in Drinking Water

Sarah Yang, Ph.D.

Groundwater Toxicologist

February 26, 2020

Page 2: Health Effects of Nitrate in Drinking Water

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High levels of nitrate can affect everyone’s health.

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Nitrate is one of the most common contaminants in Wisconsin's groundwater.

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Our major source of nitrate depends on age.

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When we eat or drink nitrate, it goes through our body to our small intestine.

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Most nitrate is absorbed in our blood.

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While most nitrate in our blood leaves our body when we urinate, about 25% goes into our saliva.

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Intestines Blood

Stomach

In saliva, most nitrate goes back through the intestines, but some is turned into nitrite and moves to the stomach.

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Blood Beneficial substances

Harmful substances

In the stomach, nitrite can move into the blood or be turned into other substances.

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Nitrite in the blood can affect the body’s ability to transport oxygen.

Nitrite

Hemoglobin

Fe2+

Methemoglobin

Fe3+

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Page 11: Health Effects of Nitrate in Drinking Water

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High levels of methemoglobincan cause health problems.

3 Skin discoloration10 Weakness, excess heart rate

20 Headache, dizziness, fatigue, nausea

70 Death (very rare)

1 Normal

% methemoglobin in the blood

Adapted from Shihana, F. et al (2010)

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High levels of nitrate can cause blue baby syndrome (methemoglobenemia) in infants.

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Infants are at a greater risk for blue baby syndrome because of their size and how their bodies work.

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The drinking water standard for nitrate is 10 mg/L.

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0

5

36

81

92

51–100

≤ 10 0

11–20

21–50

> 100

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Level of nitrate-nitrogen in formula (mg/L)

Cases of blue baby syndrome

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Nitrate-Nitrogen Nitrate

United States 10 mg/L

Europe 50 mg/L

The United States uses a different measure of nitrate than other countries.

45 mg/L

11 mg/L

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High levels of nitrate can also affect women who are or may become pregnant.

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High levels of nitrate in drinking water may increase the incidence of neural tube defects.

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Neural tube defects can occur in the first 3 weeks of pregnancy.

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High levels of nitrate in drinking water can cause long-term health effects in everyone.

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Strongest Evidence

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Recent studies among people have evaluated the health effects of high nitrate in drinking water.

Thyroid disease Colon cancer

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High levels of nitrate may affect the thyroid by blocking iodine uptake.

Iodine(from diet)

Hypothyroidism

Thyroid

T3

(hormone)

T4

(hormone)

Nitrate

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Harmful substances

Nitrite can form N-nitrosocompounds in the stomach –some of which have been shown to cause cancer in research animals.

(N-nitroso compounds)

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Take action to protect yourself and your family

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Test your well for nitrate at least once a year.

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When nitrate levels are high:

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Do not give water to babies less than 6 months old or used to make infant formula.

Women who are or may become pregnant should immediately stop using the water for drinking and preparing foods that use a lot of water.

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Everyone should avoid long-term use of the water for drinking and preparing foods that use a lot of water.

Page 28: Health Effects of Nitrate in Drinking Water

Thanks!

Sarah Yang, Ph.D.

Groundwater ToxicologistBureau of Environmental and Occupational Health

Division of Public HealthWisconsin Department of Health Services

[email protected]

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