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Azotany w wodzie przeznaczonej do spożycia a zagrożenie dla zdrowia – współczesne poglądy (aktualny stan wiedzy)

Małgorzata Jamsheer-Bratkowska, Agnieszka Stankiewicz, Dorota Maziarka

Abstrakt


Streszczenie

Wśród następstw podwyższonych stężeń azotanów w wodzie przeznaczonej do spożycia methemoglobinemia i jej następstwa kliniczne u dzieci poniżej 3 miesiąca życia pozostają dotychczas jedynym bezspornym i przekonująco udokumentowanym skutkiem zdrowotnym. Mniej jasno przedstawia się ryzyko innych następstw zdrowotnych, dotyczących pozostałej populacji. Podejrzenie takie wysuwano w odniesieniu do szeregu innych chorób, ich ocenę utrudnia jednak fakt, że nie mają one charakteru ostrego, a ich ewentualne wystąpienie jest wynikiem długotrwałej, wieloletniej ekspozycji, przy możliwym współudziale innych czynników. Nie jest też jasne, czy najwyższe akceptowalne stężenie azotanów w wodzie do picia, chroniące przed wystąpieniem methemoglobinemii zapewnia zarazem ochronę przed innymi możliwymi następstwami zdrowotnymi narażenia na azotany poprzez wodę do picia, choć aspekt ten z puntu widzenia zdrowia publicznego ma istotne znaczenie. Najwięcej aktualnych danych sugeruje możliwy związek podwyższonych stężeń azotanów w wodzie do picia z powstawaniem w organizmie rakotwórczych N-nitrozozwiązków i występowaniem nowotworów złośliwych, zwłaszcza raka jelita grubego. Zależność ta jest jednak modyfikowana przez szereg czynników, w tym przez dostępność prekursorów N-nitrozozwiązków oraz inhibitorów reakcji nitrozowania. Wśród innych potencjalnych następstw zdrowotnych wymienia się powiększenie tarczycy (wole) i zaburzenia funkcji tego narządu oraz występowanie wad wrodzonych u dzieci, zwłaszcza dotyczących cewy nerwowej, choć należy wyraźnie stwierdzić, że dotychczasowe obserwacje nie dają podstaw do jednoznacznych wniosków.

 

Health aspects of nitrates in drinking water – current views

Abstract

Methaemoglobinaemia and its clinical consequences in children under 3 months of age remain the only convincingly documented health effect of an increased concentration of nitrates in drinking water. The risk of other health outcomes is less clear. A number of other diseases has been suspected , but their assessment is difficult due to the fact that their possible occurrence is the result of long-term exposure, with the possible involvement of other factors. It is also unclear whether the highest acceptable nitrate levels in drinking water that protects from methaemoglobinaemia provides protection against other possible health consequences. The largest number of current data suggests a possible relationship between elevated nitrate concentrations in drinking water and the formation of carcinogenic N-nitro compounds in the body and the occurrence of malignant neoplasms, especially colorectal cancer. However, this relationship is modified by a number of factors, including the availability of N-nitroso compound precursors and nitrosation inhibitors. Other potential health consequences include enlargement of the thyroid gland (goiter) and disturbances in the functions of this organ, as well as the occurrence of congenital defects in children, especially in the neural tube, although it should be stated that the current observations do not provide grounds for unambiguous conclusions in this regard.


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Bibliografia


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