Health Risk Assessment for Exposure to Nitrate in Drinking Water in Central Java, Indonesia.

Callum Lowe,Budi Laksono,Darren Gray,Ross Sadler,Johanna Kurscheid,Salvador Amaral,Aparna Lal,Matthew Kelly,Donald Stewart

doi:10.3390/ijerph18052368

Abstract

Since 2005, over 30 epidemiological studies have evaluated the association between nitrate in drinking water and adverse health outcomes. Conditions that lead to nitrate pollution in water, such as open defecation, the proximity of septic tanks to water sources, and the use of inorganic fertilizer, are rampant in Indonesia, which has experienced little research evaluating nitrate in drinking water. We conducted a health risk assessment for exposure to nitrate in drinking water and evaluated the nitrate concentration in key water sources in two villages of rural Central Java, Indonesia. The nitrate concentrations in the drinking water ranged from 3.55 mg/L to 26.75 mg/L as NO3−. Daily nitrate intake estimates, calculated at 50% and 95% exposure to the maximum nitrate concentration of the drinking water in both villages, were above the levels associated with birth defects, colorectal cancer, and thyroid conditions observed in other studies. There was a large variation in nitrate concentrations between and within the villages at different water sources. Further research into whether these health outcomes exist in rural Central Java, Indonesia will be required to better understand this risk.

Highlights

There is growing concern over the health risks of elevated levels of nitrate (NO3 - )in drinking water—more than 30 epidemiological studies have evaluated the association between nitrate in drinking water and adverse health outcomes since 2005 [1]
The majority of the land is used for farming in both villages; only data pertaining to the overarching territory of Topengan (Desa Sitiharjo) was available
This study found that estimates of daily nitrate intake from drinking water varied between households in Wonosobo, Indonesia

Summary

Introduction

There is growing concern over the health risks of elevated levels of nitrate (NO3 - ). In drinking water—more than 30 epidemiological studies have evaluated the association between nitrate in drinking water and adverse health outcomes since 2005 [1]. The ingestion of water with elevated nitrate concentrations is consistently associated with colorectal cancer, birth defects, and thyroid cancer. In Spain and Italy, Espejo-Herrera et al (2016) found that participants in a case-control study with a daily nitrate intake from water greater than 10 mg had higher odds (OR (odds ratio) 1.49, 95% CI (confidence interval) = 1.24–1.78) of colorectal cancer compared to those consuming < 5 mg nitrate per day [3]. Birth defects are reported to correlate with maternal nitrate intake.

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