Abstract
Exposure to toxic metals and metalloids (TMs) such as arsenic and lead at levels of concern is associated with lifelong adverse health consequences. As exposure to TMs from paint, leaded gasoline, canned foods, and other consumer products has decreased in recent decades, the relative contribution of drinking water to environmental TM exposure and associated disease burdens has increased. We conducted a rapid review from June to September 2019 to synthesize information on the sources of TM contamination in small rural drinking water systems and solutions to TM contamination from these sources, with an emphasis on actionable evidence applicable to small rural drinking water systems worldwide. We reviewed publications from five databases (ProQuest, PubMed, Web of Science, Embase, and Global Health Library) as well as grey literature from expert groups including WHO, IWA, and others; findings from 61 eligible review publications were synthesized. Identified sources of TMs in included studies were natural occurrence (geogenic), catchment pollution, and corrosion of water distribution system materials. The review found general support for preventive over corrective actions. This review informs a useful planning and management framework for preventing and mitigating TM exposure from drinking water based on water supply characteristics, identified contamination sources, and other context-specific variables.
Highlights
Exposure to toxic metals and metalloids (TMs) such as arsenic, cadmium, lead, and mercury is detrimental to human health and can have serious, lifelong consequences
Most publications were excluded at the screening and the full-text review stages because they describe single studies rather than providing a review or synthesis of evidence, or because they were not directly relevant to toxic metals and metalloids (TMs) or drinking water
We produced a framework for the management of TM contamination by incorporating solutions to TM contamination identified in this review into the “framework for safe drinking-water” (Figure 2)
Summary
Exposure to toxic metals and metalloids (TMs) such as arsenic, cadmium, lead, and mercury is detrimental to human health and can have serious, lifelong consequences. Exposure to TMs occurs by dust inhalation; ingestion of contaminated food, water, or soil; and by absorption through the skin [2]. Paint, leaded gasoline, canned food, and other consumer products have historically been major sources of exposure to lead and other TMs. As regulatory actions and process improvements have brought these sources increasingly under control, the relative importance of drinking water as an exposure route has increased [3]. Improvements to analytical instruments have made it easier to measure and detect TMs in drinking water at concerning levels for health, leading to an increased identification of TM contamination [4]
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