The study of fungi in drinking water

The occurrence of fungi in drinking water has received increased attention in the last decades, and fungi are now generally accepted as drinking water contaminants. The knowledge about the occurrence and diversity of fungi in water has increased considerably from a low knowledge base. However, the relevance of waterborne fungi for water quality and human health is poorly understood and still conflicting. Scientific reports on effective treatment against fungi in water are also few. This article presents a review of the literature on fungal water studies, including some general results, and considerations of significance, limits, contradictions, precautions, and practical consequences.     

Case study of complaints on drinking water quality

Several families of Talca city, Chile complained to health authorities for what they attributed to consumption of copper (Cu)-contaminated drinking water. We assessed the situation 6–12 mo after the initiation of complaints by characterizing the symptoms reported, the chemistry of drinking water, and the Cu concentration in stagnant drinking water. After completing a census, 1778 households accepted participation and were categorized as follows: category 1, Cu plumbing for tap water and dwellers reporting health complaints (HC); category 2, Cu plumbing for tap water and dwellers reporting no HC; category 3, plastic plumbing for tap water and dwellers reporting no HC. Questionnaires recorded characteristics of households and symptoms presented by each member of the family in the last 3 mo. The Cu concentration in drinking water was measured in a subsample of 80 homes with Cu pipes. In category 1, participants presented significantly more abdominal pain, diarrhea, and/or vomiting (gastrointestinal [GI] symptoms) in comparison to category 3 and to categories 2 plus 3. The stagnant Cu concentrations measured in drinking water in all houses studied were below the US Environmental Protection Agency guideline value (<1.3 mg Cu/L). In summary, data obtained by interviews suggested that individuals in some areas of Talca city were suffering more GI symptoms potentially related to Cu excess, but measurement of Cu concentration in stagnant tap waters ruled out the association between Cu exposure and GI symptom reports at the time of this study. The dose-response curves for GI symptoms and Cu exposure now available were crucial in the analyses of results.     

Contaminated small drinking water supplies and risk of infectious intestinal disease: a prospective cohort study

Background

This study sought to identify whether elevated risk of infectious intestinal disease (IID) exists in contaminated small water supply consumers compared with consumers drinking from small supplies complying with current standards and whether this effect is modified by age.

Methodology and Principal Findings

A prospective cohort study of 611 individuals receiving small supplies in England was conducted. Water supplies received sanitary inspection and examination for indicator bacteria and participants maintained a daily record of IID. Regression modeling with generalized estimating equations that included interaction terms between age and indicators of fecal pollution was performed. Crude IID prevalence was 9·3 days with symptoms/1000 person days (95%CI: 8·4, 10·1) and incidence was 3·2 episodes/1000 person days (95%CI, 2·7, 3·7) or 1·2 episodes per person year. Although there was no overall association between IID risk and indicator presence, there was strong interaction between age and indicator presence. In children under ten, relative risk (RR) of IID in those drinking from enterococci contaminated supplies was 4.8 (95%CI: 1.5, 15.3) for incidence and 8.9 (95%CI: 2.8, 27.5) for prevalence. In those aged 10 to 59, IID risk was lower but not statistically significant.

Conclusions

Contaminated small water supplies pose a substantial risk of IID to young children who live in homes reliant on these supplies. By contrast older children and adults do not appear to be at increased risk. Health care professionals with responsibility for children living in homes provided by very small water supplies should make parents aware of the risk.     

Development of new renal scars: a collaborative study.

In a study of the factors surrounding the development of renal scars clinical data and serial radiographs were analysed in 74 infants and children (66 girls and eight boys) without duplex kidney or obstruction. The development of new scars was seen radiologically in 87 kidneys (74 previously normal and 13 previously scarred). New scarring was extensive in 16 kidneys. Thirty four children were aged 5 or over when scarring occurred. Urinary infection occurred in all the children. Diagnosis and effective treatment were delayed in 45 of them; 58 suffered further urinary infections between the baseline intravenous urogram and the first showing new scarring. Vesicoureteric reflux was seen in 67 of the children. Investigation and treatment varied widely, and few children received long term prophylaxis. Social problems interfered with the management of 22 children. Early diagnosis, prompt effective treatment, investigation, and long term supervision of children with urinary infection are essential if renal scarring is to be reduced; those over the age of 5 are still vulnerable.     

Compression-sclerotherapy for varicose veins: a Canadian study.

In recent years modifications and refinements in treating varicose veins by injecting a sclerosant have given this method an important place in the practitioner''s armamentarium. Specific indications and precise technique are essential. Compression-sclerotherapy has been used since 1975 in the vein clinic of Belleville General Hospital, Belleville, Ont. Some patients have also required limited ligation of veins that were deeper or more proximal, or both. A follow-up study of patients 2 or more years after treatment revealed no major complications and a high rate of patient acceptance and satisfaction. The costs of treatment were about one tenth those of conventional inpatient surgery.     

Deposition of manganese in a drinking water distribution system

The deposition of manganese in a water distribution system with manganese-related "dirty water" problems was studied over a 1-year period. Four monitoring laboratories with Robbins biofilm sampling devices fitted to the water mains were used to correlate the relationship among manganese deposition, the level of manganese in the water, and the chlorination conditions. Manganese deposition occurred by both chemical and microbial processes. Chemical deposition occurred when Mn(II) not removed during water treatment penetrated the filters and entered the distribution system, where it was oxidized by chlorine and chlorine dioxide used for disinfection. Microbial deposition occurred in areas with insufficient chlorination to control the growth of manganese-depositing biofilm. At 0.05 mg of Mn(II) per liter, the chemical deposition rate was much greater than microbial deposition. Significant deposition occurred at 0.03 mg of manganese per liter, and dirty water complaints were not eliminated until manganese levels were continuously less than 0.02 mg/liter and chlorination levels were greater than 0.2 mg/liter. A guideline level of 0.01 mg of manganese per liter is recommended.     

Bacterial communities in sediments of a drinking water reservoir

Sediment microbial communities play crucial roles in biogeochemical cycles of aquatic systems. Knowledge of microbial community structure could aid in our understanding of these roles. In this study, the sediment bacterial community structure of a drinking water reservoir in China was investigated. A large difference in major bacterial groups was observed at different sampling sites. Proteobacteria was the largest bacterial phylum, with a marked shift in the proportions of its major subdivisions. Microorganisms within phylum Proteobacteria might play important roles in various biogeochemical processes.     

Virological study of a dengue type 1 epidemic at Rio de Janeiro

A dengue outbreak started in March, 1986 in Rio de Janeiro and spread very rapidly to other parts of the country. The great majority of cases presented classical dengue fever but there was one fatal case, confirmed by virus isolation. Dengue type 1 strains were isolated from patients and vectors (Aedes aegypti) in the area by cultivation in A. albopictus C6/36 cell line. The cytopathic effect (CPE) was studied by electron microscopy. An IgM capture test (MAC-ELISA) was applied with clear and reproducible results for diagnosis and evaluation of virus circulation; IgM antibodies appeared soon after start of clinical disease, and persisted for about 90 days in most patients. The test was type-specific in about 50% of the patients but high levels of heterologous response for type 3 were observed. An overall isolation rate of 46.8% (813 virus strains out of 1734 specimens) was recorded. The IgM test increased the number of confirmed cases to 58.2% (1479 out of 2451 suspected cases). The importance of laboratory diagnosis in all regions where the vectors are present is emphasized.     

Biofilms in drinking water systems: a possible reservoir for Helicobacter pylori

A laboratory model system was utilised to investigate the persistence of Helicobacter pylori in mixed-species heterotrophic biofilms. A single-stage continuous culture vessel was linked to a modified-Robbins device (mRD) incorporating removable stainless steel coupons. The system was innoculated with H. pylori (NCTC 11637) and the fate of the organism monitored by polymerase chain reaction (PCR) analysis. Helicobacter pylori was detected in biofilm material for a period of up to 192 h. Theoretical washout would have occurred at around 48 h thus detection of H. pylori for a prolonged period after theoretical washout suggested that the organism possessed the ability to persist in the mixed-species heterotrophic biofilm. Preliminary studies using heat-inactivated H. pylori showed that the organism was not detected in biofilm material at any time post-challenge suggesting that the persistence of H. pylori in such material was a phenomenon requiring the organism to be in a viable state. Further investigations to assess the biological basis for the association of H. pylori with drinking water biofilms and the risk that this may pose to public health are being undertaken.     

Development and structure of drinking water biofilms and techniques for their study

Drinking water systems are known to harbour biofilms, even though these environments are oligotrophic and often contain a disinfectant. Control of these biofilms is important for aesthetic and regulatory reasons. Study of full-scale systems has pointed to several factors controlling biofilm growth, but cause-and-effect relationships can only be established in controlled reactors. Using laboratory and pilot distribution systems, along with a variety of bacterial detection techniques, insights have been gained on the structure and behaviour of biofilms in these environments. Chlorinated biofilms differ in structure from non-chlorinated biofilms, but often the number of cells is similar. The number and level of cellular activity is dependent on the predominant carbon source. There is an interaction between carbon sources, the biofilm and the type of pipe material, which complicates the ability to predict biofilm growth. Humic substances, which are known to sorb to surfaces, appear to be a usable carbon source for biofilms. The finding offers an explanation for many of the puzzling observations in full scale and laboratory studies on oligotrophic biofilm growth. Pathogens can persist in these environments as well. Detection requires methods that do not require culturing.     

Protection of waterborne pathogens by higher organisms in drinking water: a review

Higher organisms are ubiquitous in surface waters, and some species can proliferate in granular filters of water treatment plants and colonize distribution systems. Meanwhile, some waterborne pathogens are known to maintain viability inside amoebae or nematodes. The well-documented case of Legionella replication within amoebae is only one example of a bacterial pathogen that can be amplified inside the vacuoles of protozoa and then benefit from the protection of a resistant structure that favours its transport and persistence through water systems. Yet the role of most zooplankton organisms (rotifers, copepods, cladocerans) in pathogen transmission through drinking water remains poorly understood, since their capacity to digest waterborne pathogens has not been well characterized to date. This review aims at (i) evaluating the scientific observations of diverse associations between superior organisms and pathogenic microorganisms in a drinking water perspective and (ii) identifying the missing data that impede the establishment of cause-and-effect relationships that would permit a better appreciation of the sanitary risk arising from such associations. Additional studies are needed to (i) document the occurrence of invertebrate-associated pathogens in relevant field conditions, such as distribution systems; (ii) assess the fate of microorganisms ingested by higher organisms in terms of viability and (or) infectivity; and (iii) study the impact of internalization by zooplankton on pathogen resistance to water disinfection processes, including advanced treatments such as UV disinfection.     

DNA methylation levels and long-term trihalomethane exposure in drinking water: an epigenome-wide association study

Trihalomethanes (THM) are undesired disinfection byproducts (DBPs) formed during water treatment. Mice exposed to DBPs showed global DNA hypomethylation and c-myc and c-jun gene-specific hypomethylation, while evidence of epigenetic effects in humans is scarce. We explored the association between lifetime THM exposure and DNA methylation through an epigenome-wide association study. We selected 138 population-based controls from a case-control study of colorectal cancer conducted in Barcelona, Spain, exposed to average lifetime THM levels ≤85 μg/L vs. >85 μg/L (N = 68 and N = 70, respectively). Mean age of participants was 70 years, and 54% were male. Average lifetime THM level in the exposure groups was 64 and 130 µg/L, respectively. DNA was extracted from whole blood and was bisulphite converted to measure DNA methylation levels using the Illumina HumanMethylation450 BeadChip. Data preprocessing was performed using RnBeads. Methylation was compared between exposure groups using empirical Bayes moderated linear regression for CpG sites and Gaussian kernel for CpG regions. ConsensusPathDB was used for gene set enrichment. Statistically significant differences in methylation between exposure groups was found in 140 CpG sites and 30 gene-related regions, after false discovery rate <0.05 and adjustment for age, sex, methylation first principal component, and blood cell proportion. The annotated genes were localized to several cancer pathways. Among them, 29 CpGs had methylation levels associated with THM levels (|Δβ|≥0.05) located in 11 genes associated with cancer in other studies. Our results suggest that THM exposure may affect DNA methylation in genes related to tumors, including colorectal and bladder cancers. Future confirmation studies are required.     

Lung function in Canadian Inuit: a follow-up study.

To assess the impact of acculturation on lung function, the forced vital capacity (FVC) and the 1-second forced expiratory volume (FEV1) of 341 Inuit at Igloolik, NWT were measured. The same observers had used the same equipment to test 196 subjects in 1970-71. Cross-sectional analysis suggested that, relative to the previous decade, younger subjects had larger lung volumes (with gains of about 10% in FVC and 5% in FEV1), while the elderly had smaller volumes (with losses of about 22% in FVC and 25% in FEV1). Longitudinal analysis confirmed an accelerating loss of lung function in the older subjects: from age 25 to 35 years men and women had a loss in FVC of 13 and 11 mL/yr respectively, whereas from age 45 to 55 years the corresponding figures were 70 and 38 mL/yr. Cigarette smoking had increased substantially among the Inuit over the decade: the proportion of males and females smoking rose from 64% to 81% and from 85% to 93% respectively. Daily cigarette consumption per smoker increased from 11.8 to 20.2 and from 7.4 to 12.0 among men and women respectively. Nevertheless, the main explanation for the shape of the ageing curve is the survival of a small cohort of elderly Inuit with advanced tuberculosis. With control of this disease future cohorts of the elderly will have better lung function.     

Deposition of manganese in a drinking water distribution system.

The deposition of manganese in a water distribution system with manganese-related "dirty water" problems was studied over a 1-year period. Four monitoring laboratories with Robbins biofilm sampling devices fitted to the water mains were used to correlate the relationship among manganese deposition, the level of manganese in the water, and the chlorination conditions. Manganese deposition occurred by both chemical and microbial processes. Chemical deposition occurred when Mn(II) not removed during water treatment penetrated the filters and entered the distribution system, where it was oxidized by chlorine and chlorine dioxide used for disinfection. Microbial deposition occurred in areas with insufficient chlorination to control the growth of manganese-depositing biofilm. At 0.05 mg of Mn(II) per liter, the chemical deposition rate was much greater than microbial deposition. Significant deposition occurred at 0.03 mg of manganese per liter, and dirty water complaints were not eliminated until manganese levels were continuously less than 0.02 mg/liter and chlorination levels were greater than 0.2 mg/liter. A guideline level of 0.01 mg of manganese per liter is recommended.