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HEALTH CONSULTATION

NITRATE IN GROUNDWATER AND METHEMOGLOBINEMIA

LABORATORY FOR ENERGY RELATED HEALTH RESEARCH
DAVIS, YOLO COUNTY, CALIFORNIA


CONCLUSIONS

There does not appear to have been a diagnosed case of infant methemoglobinemia requiring hospitalization in the LEHR vicinity in the time period 1983-1995. It is possible that methemoglobinemia occurred without hospital admission, or that methemoglobinemia occurred but was not diagnosed.

Nevertheless, elevated levels of nitrate in private drinking wells in the vicinity of the LEHR site pose a health hazard to infants under 6 months of age who ingest this water, either directly or mixed with formula. This hazard exists for several reasons: 1) there are private drinking water wells in the area; 2) levels of nitrate in the area have often exceeded the MCL; 3) contaminants in well water may be concentrated by boiling, and; 4) certain illnesses could increase an infant's susceptibility. Also, because of fluctuations in water nitrate levels, a nitrate reading on a particular day may not be representative of the range of levels that may occur.

We believe it is important to ensure that well water users in the LEHR vicinity are aware of the risk to infants of drinking well water. Currently CDHS is completing a fact sheet on nitrate/nitrite, which can be used at LEHR as well as other locations throughout the state.


RECOMMENDATIONS

1. Nitrate/nitrite testing.

Private well owners in the Yolo/Solano county areas, especially parents and care givers of infants, should be aware of the nitrate and nitrite levels in the water. Regular testing for nitrate/nitrite from a reliable laboratory is strongly recommended.

2. Infants under 6 months of age.

If a well has a measured level of nitrate/nitrite contamination at or above the MCL, water from this well should not be given to infants under 6 months of age. Because a nitrate/nitrite reading on a particular day may not be representative of levels on all other days, to be cautious, parents and care givers may wish to avoid giving water to infants if there is nitrate/nitrite contamination at levels close to the MCL.

3. Boiling concentrates nitrate.

Well water for infants should not be boiled, as this concentrates the nitrate/nitrite. If there is bacterial contamination in the well water, an alternative water source (e.g. bottled water) should be used.


FOLLOW-UP PUBLIC HEALTH ACTIONS
1. CDHS will complete and distribute a fact sheet regarding risks of nitrate/nitrite to area well water users and to local county environmental health officers.
Note: The interpretation and recommendations provided are based on the data and the information referenced. Additional data could alter the advice presented. Conclusionsand recommendations are situation-specific, and should not be considered applicableto other situations. ATSDR/CDHS is committed to review or respond to additional requests if received.


PREPARERS OF REPORT

ENVIRONMENTAL AND HEALTH EFFECTS ASSESSORS:

Sumi Hoshiko, M.P.H.
Epidemiologist
Impact Assessment, Inc., Contractor to
Environmental Health Investigations Branch
California Department of Health Services

Marilyn C. Underwood, Ph.D.
Staff Toxicologist
Environmental Health Investigations Branch
California Department of Health Services

COMMUNITY RELATIONS COORDINATOR:

Jane Riggan, M.S.W.
Public Health Social Work Consultant
Environmental Health Investigations Branch
California Department of Health Services

ATSDR REGIONAL REPRESENTATIVES

William Nelson
Dan Strausbaugh
Gwendolyn Eng
Regional Representatives, Region IX
Agency for Toxic Substances and Disease Registry

ATSDR TECHNICAL PROJECT OFFICER

William J. Greim, M.S., M.P.H.
Environmental Health Scientist
Division of Health Assessment and Consultation
Superfund Site Assessment Branch, State Programs Section

ATSDR FEDERAL FACILITIES ASSESSMENT BRANCH
Brenda Weis, Ph.D.
Toxicologist

Burt Cooper
Chief, Energy Section.
Division of Health Assessment and Consultation


CERTIFICATION

The Laboratory For Energy-Related Health Research, Nitrate In Groundwater and Methemoglobinemia Health Consultation was prepared by the California Department of Health Services under a cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR). It is in accordance with approved methodology and procedures existing at the time the health consultation was initiated.

William Greim
Technical Project Officer, SPS, SSAB, DHAC

The Division of Health Assessment and Consultation, ATSDR, has reviewed this health consultation and concurs with its findings.

Lisa C. Hayes
for Chief, SPS, SSAB, DHAC, ATSDR

Burt J. Cooper
Chief, ESB, FFAB, DHAC, ATSDR


REFERENCES

1) University of California, Davis. LEHR Newsletter. April 1996.

2) United States Department of Energy, Environment, Safety and Health Office of Environmental Audit. Environmental Survey Preliminary Report: Laboratory for Energy-Related Health Research, Davis, California. March 1988.

3) Agency for Toxic Substances and Disease Registry. Laboratory for Energy-Related Health Research, Davis, California. Site Summary. December 1995.

4) National Research Council. Nitrate and nitrite in drinking water. Washington (DC): National Academy Press, 1995.

5) Agency for Toxic Substances and Disease Registry. Letter to Dr. Marilyn Underwood, California Department of Health Services, from William H. Taylor, concerning private well monitoring data. August 8, 1996.

6) University of California, Davis. Letter to "LEHR RPMs," from Brian Oatman, LEHR Project Manager, concerning analytical results from the Neighbor's Well Sampling Program. August 21, 1996.

7) Bruning-Fann CS, Kaneene JB. The effects of nitrate, nitrite and n-nitroso compounds on human health: a review. Vet Human Toxicol 1993;35:521-538.

8) Fan AM, Willhite CC, Book SA. Evaluation of the nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity. Regul Toxicol Pharmacol 1987;7:135-148.

9) Fan AM, Steinberg VE. Health implications of nitrate and nitrite in drinking water: an update on methemoglobinemia occurrence and reproductive and developmental toxicity. Regul Toxicol Pharmacol 1996;23:35-43.

10) Johnson CJ, Kross BC. Continuing importance of nitrate contamination of groundwater and wells in rural areas. Am J Indust Med 1990;18:449-456.

11) National Academy of Sciences, Environmental Studies Board. Nitrates: an environmental assessment. Washington (DC): National Academy of Sciences, 1978.

12) US Bureau of the Census. 1990 Census of Population and Housing, Summary Tape File 1A.

13) Methemoglobinemia attributable to nitrite contamination of potable water through boiler fluid additives -- New Jersey, 1992 and 1996. MMWR 1997;46:202-204.

14) Methemoglobinemia in an infant -- Wisconsin, 1992. MMWR 1993;42:217--219.

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