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. 2000 Apr;108(4):363–366. doi: 10.1289/ehp.00108363

Recurrent acute respiratory tract infections in areas with high nitrate concentrations in drinking water.

S K Gupta 1, R C Gupta 1, A B Gupta 1, A K Seth 1, J K Bassin 1, A Gupta 1
PMCID: PMC1638033  PMID: 10753096

Abstract

A review of the literature indicated an association among high nitrate ingestion, methemoglobinemia, and pathologic changes in bronchi and lung parenchyma. The present study examined a possible correlation among drinking water nitrate concentration, methemoglobin levels, cytochrome b(5) reductase activity, and acute respiratory tract infection with a history of recurrence (RRTI). Our study was conducted in five village units in the state of Rajasthan, India, with nitrate concentrations of 26, 45, 95, 222, and 459 mg NO(3) ion/L. We randomly selected 88 children. The children were up to 8 years of age, age matched, and represented 10% of the total population of these areas. We obtained detailed RRTI histories and conducted medical examinations. Methemoglobin levels and cytochrome b(5) reductase activity were estimated biochemically. The data collected were statistically analyzed using spreadsheet software on a personal computer. We observed strong interdependence between methemoglobin levels and RRTI in children up to 8 years of age. Methemoglobin levels alone explained 80% of the variation in the RRTI cases. This study indicates that methemoglobinemia, secondary to high nitrate ingestion in drinking water, causes RRTI. Increased production of methemoglobin and free radicals of nitric oxide and oxygen due to nitrate metabolism in the body lead to alveolar damage and mismatching of ventilation and perfusion, which may be the reason for high mortality in children due to RRTI.

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Selected References

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  1. Craven P. A., DeRubertis F. R. Restoration of the responsiveness of purified guanylate cyclase to nitrosoguanidine, nitric oxide, and related activators by heme and hemeproteins. Evidence for involvement of the paramagnetic nitrosyl-heme complex in enzyme activation. J Biol Chem. 1978 Dec 10;253(23):8433–8443. [PubMed] [Google Scholar]
  2. Gupta S. K., Gupta R. C., Seth A. K., Gupta A. B., Bassin J. K., Gupta A. Adaptation of cytochrome-b5 reductase activity and methaemoglobinaemia in areas with a high nitrate concentration in drinking-water. Bull World Health Organ. 1999;77(9):749–753. [PMC free article] [PubMed] [Google Scholar]
  3. Hsia C. C. Respiratory function of hemoglobin. N Engl J Med. 1998 Jan 22;338(4):239–247. doi: 10.1056/NEJM199801223380407. [DOI] [PubMed] [Google Scholar]
  4. Li H., Duncan C., Townend J., Killham K., Smith L. M., Johnston P., Dykhuizen R., Kelly D., Golden M., Benjamin N. Nitrate-reducing bacteria on rat tongues. Appl Environ Microbiol. 1997 Mar;63(3):924–930. doi: 10.1128/aem.63.3.924-930.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Lowenstein C. J., Dinerman J. L., Snyder S. H. Nitric oxide: a physiologic messenger. Ann Intern Med. 1994 Feb 1;120(3):227–237. doi: 10.7326/0003-4819-120-3-199402010-00009. [DOI] [PubMed] [Google Scholar]
  6. Murray K. F., Christie D. L. Dietary protein intolerance in infants with transient methemoglobinemia and diarrhea. J Pediatr. 1993 Jan;122(1):90–92. doi: 10.1016/s0022-3476(05)83495-x. [DOI] [PubMed] [Google Scholar]
  7. Murray K. F., Christie D. L. Dietary protein intolerance in infants with transient methemoglobinemia and diarrhea. J Pediatr. 1993 Jan;122(1):90–92. doi: 10.1016/s0022-3476(05)83495-x. [DOI] [PubMed] [Google Scholar]
  8. Shuval H. I., Gruener N. Epidemiological and toxicological aspects of nitrates and nitrites in the environment. Am J Public Health. 1972 Aug;62(8):1045–1052. doi: 10.2105/ajph.62.8.1045. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Sutton H. C., Roberts P. B., Winterbourn C. C. The rate of reaction of superoxide radical ion with oxyhaemoglobin and methaemoglobin. Biochem J. 1976 Jun 1;155(3):503–510. doi: 10.1042/bj1550503. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Vane J. R. The Croonian Lecture, 1993. The endothelium: maestro of the blood circulation. Philos Trans R Soc Lond B Biol Sci. 1994 Jan 29;343(1304):225–246. doi: 10.1098/rstb.1994.0023. [DOI] [PubMed] [Google Scholar]
  11. Waldman S. A., Murad F. Cyclic GMP synthesis and function. Pharmacol Rev. 1987 Sep;39(3):163–196. [PubMed] [Google Scholar]
  12. Waldman S. A., Murad F. Cyclic GMP synthesis and function. Pharmacol Rev. 1987 Sep;39(3):163–196. [PubMed] [Google Scholar]
  13. Winterbourn C. C., McGrath B. M., Carrell R. W. Reactions involving superoxide and normal and unstable haemoglobins. Biochem J. 1976 Jun 1;155(3):493–502. doi: 10.1042/bj1550493. [DOI] [PMC free article] [PubMed] [Google Scholar]

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