You see a shallow well next to an agricultural plot of land. You think, “hmmm, a shallow well - that’s probably susceptible to contamination and unprotected.” What we often cannot see, thus not think about, is the percolation of chemicals from pesticides, manure, and fertilizer from distant to nearby farming practices into the well’s groundwater. In many parts of Africa, households that surround high-intensity agricultural land may suffer from high nitrate levels in their water sources. Normal levels of nitrate in water usually fall around 1-2 mg/liter but households near farmed land can see levels of up to 50 mg/l. For reference, the U.S. Public Health Services set the maximum nitrate level at 10 mg/l.
High levels of nitrate in water can cause methemoglobinemia, a condition that can best be described as oxygen starvation. In a healthy body, oxygen taken in from the lungs diffuse into the capillaries and are bound to hemoglobin. The oxygen is then transported to the rest of the body for ATP production. In the presence of nitrites, or reduced forms of nitrates, the hemoglobin binding affinity towards oxygen decreases significantly since the binding sites are inhibited by nitrites. Nitrite bounded hemoglobin are called methemoglobin and when more than 6% of hemoglobin become methemoglobin, the body goes into a state of oxygen starvation. When hemoglobin to methemoglobin conversion rates reach 50%, death usually occurs. Infants are especially susceptible to this occurrence since they produce less of the enzyme that unbinds nitrate from methemoglobin, hence why it’s called Blue Baby Syndrome.
Since the 1980’s, over 4,000 cases of methemoglobinemia have been reported but unfortunately, there were very few from the tropics and especially sub-Saharan Africa. On the World Health Organization’s website, it says that efforts are currently being made to estimate the extent of methemoglobinemia in developing nations. However, it is generally known that resource-poor countries have high levels of nitrate in their water. In a survey conducted across several parts of Africa, 20 - 50% of wells contained nitrate levels that exceeded 50 mg/l.
In one study conducted in Namibia on 500 infants under the age of 1, 8% were found to have methemoglobin levels of over 5%. Chronic exposure to nitrates can also induce diarrhea, weakness, and gastroenteritis and can impair cognitive development. In one particular subject, the infant had a methemoglobin level of over 35% and was found to be consuming water with nitrate levels over 250 mg/l. Infants who are bottle-fed are at the greatest risk to nitrate exposure and unfortunately, boiling water does remove nitrates from water.
Securing drinking water to avoid nitrate exposure is easy in developed nations; we simply install a piping system. But for rural communities, the task is immensely challenging. Unfortunately, very little literature exists for what is currently being done on the field to address high nitrate levels in water sources. Some potential solutions I can see as viable on a short-term scale can be limiting the use of agricultural inputs, relocating wells away from farmland, and administering nitrate filters throughout communities with high levels until a more sustainable solution is implemented. Since the early 70’s, consumption of nitrogen-based products such as fertilizers has increased rapidly and in light of this growing demand, the research community must work towards constructing a sustainable model for providing safe-drinking water for rural communities.
In one study conducted in Namibia on 500 infants under the age of 1, 8% were found to have methemoglobin levels of over 5%. Chronic exposure to nitrates can also induce diarrhea, weakness, and gastroenteritis and can impair cognitive development. In one particular subject, the infant had a methemoglobin level of over 35% and was found to be consuming water with nitrate levels over 250 mg/l. Infants who are bottle-fed are at the greatest risk to nitrate exposure and unfortunately, boiling water does remove nitrates from water.
Securing drinking water to avoid nitrate exposure is easy in developed nations; we simply install a piping system. But for rural communities, the task is immensely challenging. Unfortunately, very little literature exists for what is currently being done on the field to address high nitrate levels in water sources. Some potential solutions I can see as viable on a short-term scale can be limiting the use of agricultural inputs, relocating wells away from farmland, and administering nitrate filters throughout communities with high levels until a more sustainable solution is implemented. Since the early 70’s, consumption of nitrogen-based products such as fertilizers has increased rapidly and in light of this growing demand, the research community must work towards constructing a sustainable model for providing safe-drinking water for rural communities.
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