Nitrates in drinking water and methemoglobin levels in pregnancy: A longitudinal study

Deana M. Manassaram, Lorraine C. Backer, Rita Messing, Lora E. Fleming, Barbara Luke, Carolyn P. Monteilh

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Private water systems are more likely to have nitrate levels above the maximum contaminant level (MCL). Pregnant women are considered vulnerable to the effects of exposure to high levels of nitrates in drinking water due to their altered physiological states. The level of methemoglobin in the blood is the biomarker often used in research for assessing exposure to nitrates. The objective of this study was to assess methemoglobin levels and examine how various factors affected methemoglobin levels during pregnancy. We also examined whether differences in water use practices existed among pregnant women based on household drinking water source of private vs. public supply. Methods: A longitudinal study of 357 pregnant women was conducted. Longitudinal regression models were used to examine changes and predictors of the change in methemoglobin levels over the period of gestation. Results: Pregnant women showed a decrease in methemoglobin levels with increasing gestation although <1% had levels above the physiologic normal of 2% methemoglobin, regardless of the source of their drinking water. The multivariable analyses did not show a statistically significant association between methemoglobin levels and the estimated nitrate intake from tap water among pregnant women around 36 weeks gestation ( = 0.046, p = 0.986). Four women had tap water nitrate levels above the MCL of 10 mg/L. At enrollment, a greater proportion of women who reported using water treatment devices were private wells users (66%) compared to public system users (46%) (p < 0.0001). Also, a greater proportion of private well users (27%) compared to public system users (13%) were using devices capable of removing nitrate from water (p < 0.0001). Conclusion: Pregnant women potentially exposed to nitrate levels primarily below the MCL for drinking water were unlikely to show methemoglobin levels above the physiologic normal. Water use practices such as the use of treatment devices to remove nitrates varied according to water source and should be considered in the assessment of exposure to nitrates in future studies.

Original languageEnglish
Article number60
JournalEnvironmental Health: A Global Access Science Source
Volume9
Issue number1
DOIs
StatePublished - Oct 18 2010
Externally publishedYes

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Methemoglobin
Drinking Water
Nitrates
Longitudinal Studies
Pregnancy
Pregnant Women
Water
Equipment and Supplies
Water Purification
Drinking
Biomarkers

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Nitrates in drinking water and methemoglobin levels in pregnancy : A longitudinal study. / Manassaram, Deana M.; Backer, Lorraine C.; Messing, Rita; Fleming, Lora E.; Luke, Barbara; Monteilh, Carolyn P.

In: Environmental Health: A Global Access Science Source, Vol. 9, No. 1, 60, 18.10.2010.

Research output: Contribution to journalArticle

Manassaram, Deana M. ; Backer, Lorraine C. ; Messing, Rita ; Fleming, Lora E. ; Luke, Barbara ; Monteilh, Carolyn P. / Nitrates in drinking water and methemoglobin levels in pregnancy : A longitudinal study. In: Environmental Health: A Global Access Science Source. 2010 ; Vol. 9, No. 1.
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