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At least 55 records · Page 3Linked to original sources
USGS2024

Sero-epidemiology of Highly Pathogenic Avian Influenza viruses among wild birds in subarctic intercontinental transition zones

Background: The geographic expansion and evolution of A/Goose/Guangdong/1/1996(H5N1) (Gs/GD) lineage H5Nx highly pathogenic avian influenza (HPAI) viruses since 1996 have raised awareness of enzootic circulation among migratory birds and the potential for intercontinental transport and spread. Recent Pacific- and Atlantic-route introductions of HPAI to North America were facilitated by avian migration through subarctic zones, specifically Alaska and Iceland. This study aimed to identify recent historical patterns of exposure to HPAI viruses among birds within and migrating through both regions and evaluate how geographic, demographic, and taxonomic differences contribute to exposure risk at two intercontinental staging locations. Methods: During 2010-2019, blood samples were obtained from captured wild migratory seabirds and waterfowl in Alaska and Iceland. All live birds were released following completion of sampling. Sampling date, species, sampling location, and age class was documented for each bird, and sex was documented when possible. Lentiviral pseudoviruses that express the influenza hemagglutinin surface glycoprotein for H5Nx HPAI and H5 low-pathogenicity avian influenza (LPAI) were constructed for use in serological assays to screen for and quantify titers of antibodies against the latter viruses. Data were analyzed to compare (a) categorical baseline ecological traits between Iceland and Alaska, and (b) ecological traits between birds identified to be seropositive and suggestive/seronegative/fully cross-reactive birds to H5Nx HPAI in Iceland and Alaska. Factors associated with seroreactivity to H5Nx HPAI and H5 LPAI were assessed. Results: The seroprevalence of HPAI among birds in both locations was 7.3% (112/1526). Findings reveal variability in seroprevalence by year, higher rates of exposure to H5 LPAI than H5Nx HPAI overall, and significantly more seropositive and suggestive exposure of birds to H5Nx HPAI in Alaska as compared to Iceland. Geographic, demographic, and taxonomic differences contribute to exposure risk between Alaska and Iceland. Most tested birds were immuno-naïve to HPAI in both locations, which indicates many migratory birds in the subarctic are susceptible to HPAI infection, demonstrating substantial risk for intercontinental transmission between Asia, Europe, and North America. Conclusions: Our findings provide further justification for increased viral and serosurveillance in Alaska and Iceland to monitor subarctic movements of migratory birds and intercontinental transmission dynamics of currently circulating and new strains of HPAI globally.

Research Square↗
USGS2012

Role of bird movements in the epidemiology of West Nile and avian influenza virus

Avian influenza virus (AIV) is influenced by site fidelity and movements of bird hosts. We examined the movement ecology of American crows ( Corvus brachyrhynchos ) as potential hosts for West Nile virus (WNV) and greater white-fronted geese ( Anser albifrons frontalis ) as potential hosts for AIVs. Research was based on radio-telemetry studies conducted in the Central Valley of California, USA. While crows were restricted to a small area of only a few square kilometers, the distribution of the geese encompassed the northern Central Valley. The crows used 1.5 to 3.5 different roosting areas monthly from February through October, revealing lower roost fidelity than the geese that used 1.1 to 1.5 roosting areas each month from November through March. The crows moved a mean distance of 0.11 to 0.49 km/month between their roosting sites and 2.5 to 3.9 km/month between roosting and feeding sites. In contrast, the geese moved 4.2 to 19.3 km/month between roosting areas, and their feeding range varied from 13.2 to 19.0 km/month. Our comparison of the ecological characteristics of bird movements suggests that the limited local movements of crows coupled with frequent turnover of roosts may result in persistence of focal areas for WNV infection. In contrast, widespread areas used by geese will provide regular opportunities for intermixing of AIVs over a much greater geographic area.

California↗
USGS2008

Molecular epidemiology of viral hemorrhagic septicemia virus in the Great Lakes region

Viral hemorrhagic septicemia virus (VHSV) is considered by many nations and international organizations to be one of the most important viral pathogens of finfish (Office International des Epizooties 2007). For several decades following its initial characterization in the 1950s, VHSV was thought to be limited to Europe where it was regarded as an endemic pathogen of freshwater fish that was especially problematic for farmed rainbow trout, an introduced species (Wolf 1988; Smail 1999). Subsequently, it was shown that VHSV was present among many species of marine and anadromous fishes in both the Pacific and Atlantic Oceans where it has been associated with substantial mortality among both wild and cultured fish (Meyers and Winton 1995; Skall et al. 2005).

Great Lakes↗
USGS2003

Preliminary geochemical, microbiological, and epidemiological investigations into possible linkages between lignite aquifers, pathogenic microbes, and kidney disease in northwestern Louisiana

In May 2002, 15 wells and four surface water sites were sampled, and in September 2002, those same wells and sites plus four additional surface sites were sampled in five parishes of northwestern Louisiana. A geographic information system (GIS) was used to select residential water wells for sampling. Well water samples were analyzed for pH, conductivity, organic compounds, and nutrient and anion concentrations. All samples were further tested for presence of fungi (maintained for up to 28 days and colonies counted and identified microscopically), and metal and trace element concentration by inductively-coupled plasma mass spectrometry and atomic emission spectrometry. Surface water samples were tested for dissolved oxygen and evidence of leptospiral bacterial presence. A polymerase chain reaction protocol was optimized for detection of pathogenic leptospires, and the sensitivity of the assay was determined. The Spearman correlation method was used to assess the association between the endpoints for these field/laboratory analyses and the incidence of cancer of the renal pelvis obtained from the Louisiana Tumor Registry. Significant associations were revealed between the cancer rate and the overall number of organic compounds, the fungi Zygomycetes, the nutrients PO4 and NH3, and thirteen chemical elements (As, B, Br, Cl, Cr, F, Li, Na, P, Rb, Se, Sr, W) from the well water as compared to the controls. Among the species of fungi from the total of 136 isolates were 12 Penicillium spp., at least two Aspergillus spp., a number of other genera (Alternaria sp., Eupenicillium lapidosum, Cladosporium sp., Epicoccum sp., Trichoderma sp., Paecilomyces sp., Chrysosporium sp., Chloridium sp.), and Zygomycetes, and Coelmycetes -- some of which are known mycotoxin producers. The two control wells yielded a mean of 6.5 (SD = 3.5355) individual isolates, while the mean number of isolates from all other sites was 7.6 (SD = 4.4866). Presence of human pathogenic leptospires was detected in 4/8 (50 percent) of the surface water sites sampled. These initial results suggest that additional investigation into these relationships is warranted.

Open-File Report↗
USGS2010

Kinetics of viral shedding provide insights into the epidemiology of viral hemorrhagic septicemia in Pacific herring

Losses from infectious diseases are an important component of natural mortality among marine fish species, but factors controlling the ecology of these diseases and their potential responses to anthropogenic changes are poorly understood. We used viral hemorrhagic septicemia virus (VHSV) and a laboratory stock of Pacific herring Clupea pallasii to investigate the kinetics of viral shedding and its effect on disease transmission and host mortality. Outbreaks of acute disease, accompanied by mortality and viral shedding, were initiated after waterborne exposure of herring to concentrations of VHSV as low as 101 plaque-forming units (pfu) ml–1. Shed virus in flow-through tanks was first detected 4 to 5 d post-exposure, peaked after 6 to 10 d, and was no longer detected after 16 d. Shedding rates, calculated from density, flow and waterborne virus titer reached 1.8 to 5.0 × 108 pfu fish–1 d–1. Onset of viral shedding was dose-dependent and preceded initial mortality by 2 d. At 21 d, cumulative mortality in treatment groups ranged from 81 to 100% and was dependent not on challenge dose, but on the kinetics and level of viral shedding by infected fish in the tank. Possible consequences of the viral shedding and disease kinetics are discussed in the context of epizootic initiation and perpetuation among populations of wild Pacific herring.

Marine Ecology Progress Series↗
USGS2016

Bacterial genomics reveal the complex epidemiology of an emerging pathogen in arctic and boreal ungulates

Northern ecosystems are currently experiencing unprecedented ecological change, largely driven by a rapidly changing climate. Pathogen range expansion, and emergence and altered patterns of infectious disease, are increasingly reported in wildlife at high latitudes. Understanding the causes and consequences of shifting pathogen diversity and host-pathogen interactions in these ecosystems is important for wildlife conservation, and for indigenous populations that depend on wildlife. Among the key questions are whether disease events are associated with endemic or recently introduced pathogens, and whether emerging strains are spreading throughout the region. In this study, we used a phylogenomic approach to address these questions of pathogen endemicity and spread for Erysipelothrix rhusiopathiae , an opportunistic multi-host bacterial pathogen associated with recent mortalities in arctic and boreal ungulate populations in North America. We isolated E. rhusiopathiae from carcasses associated with large-scale die-offs of muskoxen in the Canadian Arctic Archipelago, and from contemporaneous mortality events and/or population declines among muskoxen in northwestern Alaska and caribou and moose in western Canada. Bacterial genomic diversity differed markedly among these locations; minimal divergence was present among isolates from muskoxen in the Canadian Arctic, while in caribou and moose populations, strains from highly divergent clades were isolated from the same location, or even from within a single carcass. These results indicate that mortalities among northern ungulates are not associated with a single emerging strain of E. rhusiopathiae , and that alternate hypotheses need to be explored. Our study illustrates the value and limitations of bacterial genomic data for discriminating between ecological hypotheses of disease emergence, and highlights the importance of studying emerging pathogens within the broader context of environmental and host factors.

Frontiers in Microbiology↗
USGS1987

Chalcopyrite disease in sphalerite: pathology and epidemiology.

This descriptive paper identifies three widely occurring textures designated as 'watermelon', 'dusting' and 'bimodal' that characterize the replacement of original Fe-bearing sphalerite by an aggregate of chalcopyrite and low-Fe sphalerite as an integral part of the mineralization process. Replacement probably predominates over alternative modes of origin for small chalcopyrite blebs in sphalerite from most vein and sea-floor massive sulphide deposits that formed in the 200-400oC temperature range and that have not been subsequently subjected to higher T. Sphalerite from the epithermal Ag-Pb-Zn deposit at Creede, Colorado, displays a rich variety of features ("bead chains') that are primary crystal dislocations decorated by exsolved chalcopyrite.-J.A.Z.

American Mineralogist↗
USGS2006

Spatial epidemiology of chronic wasting disease in Wisconsin white-tailed deer

Chronic wasting disease (CWD) is a fatal, emerging disease of cervids associated with transmissible protease-resistant prion proteins. The potential for CWD to cause dramatic declines in deer and elk populations and perceived human health risks associated with consuming CWD-contaminated venison have led wildlife agencies to embark on extensive CWD control programs, typically involving culling to reduce deer populations. We characterized the spatial distribution of CWD in white-tailed deer (Odocoileus virginianus) in Wisconsin to facilitate CWD management. We found that CWD prevalence declined with distance from a central location, was locally correlated at a scale of 3.6 km, and was correlated with deer habitat abundance. The latter result is consistent with patterns expected for a positive relationship between density and prevalence of CWD. We recommend management activities focused on culling in geographic areas with high prevalence to have the greatest probability of removing infected individuals. Further research is needed to elucidate the factors in envolved in CWD spread and infection rates, especially the role of density-dependent transmission. ?? Wildlife Disease Association 2006.

Wisconsin↗
USGS2013

Chapter A: Summary and findings

The Agency for Toxic Substances and Disease Registry (ATSDR) is conducting epidemiological studies to evaluate the potential for health effects from exposures to volatile organic compounds (VOCs) in finished water supplied to family housing units at U.S. Marine Corps Base Camp Lejeune, North Carolina (USMCB Camp Lejeune). The core period of interest for the epidemiological studies is 1968– 1985. VOCs of major interest to the epidemiological studies include tetrachloroethylene (PCE), trichloroethylene (TCE), trans -1,2-dichloroethylene (1,2-tDCE), vinyl chloride (VC), and benzene. Eight water-distribution systems have supplied or currently (2013) are supplying finished water to family housing and other facilities at USMCB Camp Lejeune. The three distribution systems of interest to this study—Tarawa Terrace, Hadnot Point, and Holcomb Boulevard—have historically supplied finished water to the majority of family housing units at the Base. Historical exposure data needed for the epidemiological studies are limited or unavailable. To obtain estimates of historical exposure, water-modeling methods are used to quantify concentrations of particular contaminants in finished water and to compute the level and duration of human expo- sure to contaminated finished water. During 2007–2009, ATSDR published historical reconstruction results for contaminants delivered in finished water to Tarawa Terrace family housing areas and vicinity. Corresponding results for Hadnot Point and Holcomb Boulevard family housing areas and vicinity are presented here as a series of reports supporting ATSDR’s health studies at USMCB Camp Lejeune. These reports and associated supplements provide comprehensive descriptions of information, data analyses and interpretations, and modeling results used to reconstruct historical contaminant concentration levels in finished water delivered within the service areas of the Hadnot Point and Holcomb Boulevard water treatment plants (WTPs) and vicinities. This report, Chapter A: Summary and Findings, summarizes analyses and results of reconstructed VOC concentrations in groundwater, in water-supply wells, and in finished water delivered by the Hadnot Point WTP (HPWTP) and Holcomb Boulevard WTP (HBWTP) to family housing areas and vicinities. Methods and approaches to complete the historical reconstruction process for the Hadnot Point–Holcomb Boulevard study area included (1) information discovery and data mining, (2) three-dimensional, steady-state (predevelopment) and transient groundwater-flow modeling using MODFLOW-2005 and objective parameter estimation using PEST-12, (3) deter- mining historical water-supply well scheduling and operations using TechWellOp, (4) three-dimensional contaminant fate and transport modeling for VOCs dissolved in groundwater using MT3DMS-5.3, (5) estimating the volume of light nonaqueous phase liquid (LNAPL) released to the subsurface at the Hadnot Point Industrial Area using TechNAPLVol, (6) analysis of LNAPL and dissolved phase fate and transport using TechFlowMP, (7) reconstruction of water-supply well concentrations at the Hadnot Point landfill using the linear control theory model (LCM) TechControl, (8) computation of flow-weighted average concentrations of VOCs assigned to finished water delivered by the HPWTP using a materials mass balance (simple mixing) model, (9) extended period simulation of hydraulics and water quality of the Holcomb Boulevard water-distribution system using EPANET 2, (10) sensitivity analysis of hydraulic, fate and transport, and numerical-model parameter values, (11) uncertainty analysis by coupling Kalman filtering with Monte Carlo simulation within the LCM methodology, and (12) probabilistic analysis of intermittent connections (1972–1985) of the Hadnot Point and Holcomb Boulevard water-distribution systems using the TechMarkov-Chain model. The end result of the historical reconstruction process was the estimation of monthly mean concentrations of selected VOCs in finished water distributed to housing areas served by the HPWTP and HBWTP. Historical reconstruction results summarized herein provide considerable evidence that concentrations of several contaminants of interest in finished water delivered by the HPWTP substantially exceeded current maximum contaminant levels (MCLs) during all or much of the epidemiological study period of 1968–1985. Reconstructed concentrations of TCE exceeded the current MCL of 5 micrograms per liter (μg/L) prior to and during the entire epidemiological study period and reached a maximum reconstructed concentration of 783 μg/L during November 1983. The most likely date that TCE first exceeded its current MCL is during August 1953; however, this exceedance could have been as early as November 1948. Corresponding finished-water concentrations of PCE exceeded the current MCL of 5 μg/L during most of the period 1975–1985 and also reached a maximum concentration of 39 μg/L during November 1983. Similar results for 1,2-tDCE and VC were also noted during the period 1975–1985. The maximum reconstructed concentrations of 1,2-tDCE and VC were 435 and 67 μg/L, respectively, and also occurred during November 1983. The respective current MCLs for these contaminants are 100 and 2.0 μg/L. Substantial volumes of liquid hydrocarbon fuels were lost due to leakage to the subsurface within the Hadnot Point Industrial Area. This area contained as many as 10 active water-supply wells. Despite the large volumes lost, finished- water concentrations of benzene only slightly exceeded the current MCL of 5 μg/L during the period 1980–1985. The maximum reconstructed concentration of 12 μg/L of benzene occurred during April 1984. Within the HBWTP service area, only TCE routinely exceeded its current MCL during intermittent periods (1972–1985). The TCE resulted from transfers of finished water from the Hadnot Point water-distribution system to the Holcomb Boulevard water-distribution system. The maximum reconstructed TCE concentration of 51 μg/L occurred during June 1978 at the Berkeley Manor housing area. During the 8-day period of January 28 through February 4, 1985, the HBWTP was out of service, and the HPWTP continuously supplied finished water to the Holcomb Boulevard housing area. During this period, the maximum reconstructed TCE concentration at the HPWTP was 324 μg/L, which resulted in a maximum reconstructed monthly mean concentration of 66 μg/L within the Paradise Point housing area.

North Carolina↗
USGS2025

Spatiotemporal causal inference with mechanistic ecological models: Evaluating targeted culling on chronic wasting disease dynamics in cervids

Spatiotemporal causal inference methods are needed to detect the effect of interventions on indirectly measured epidemiological outcomes that go beyond studying spatiotemporal correlations. Chronic wasting disease (CWD) causes neurological degeneration and eventual death to white-tailed deer ( Odocoileus virginianus ) in Wisconsin. Targeted culling involves removing deer after traditional hunting seasons in areas with high CWD prevalence. The evaluation of the causal effects of targeted culling in the spread and growth of CWD is an important unresolved research and CWD management question that can guide surveillance efforts. Reaction–diffusion partial differential equations (PDEs) can be used to mechanistically model the underlying spatiotemporal dynamics of wildlife diseases, like CWD, allowing researchers to make inference about unobserved epidemiological quantities. These models indirectly regress spatiotemporal covariates on diffusion and growth rates parameterizing such PDEs, obtaining associational conclusions. In this work we develop an innovative method to obtain causal estimators for the effect of targeted culling interventions on CWD epidemiological processes using an inverse-probability-of-treatment-weighted technique by means of marginal structural models embedded in the PDE fitting process. Additionally we establish a novel scheme for sensitivity analysis under unmeasured confounder for testing the hypothesis of a significant causal effect in the indirectly measured epidemiological outcomes. Our methods can be broadly used to study the impact of spatiotemporal interventions and treatment exposures in the epidemiological evolution of infectious diseases that can help to inform future efforts to mitigate public health implications and wildlife disease burden.

Wisconsin↗
USGS2011

Estimating water supply arsenic levels in the New England bladder cancer study

Background: Ingestion of inorganic arsenic in drinking water is recognized as a cause of bladder cancer when levels are relatively high (≥ 150 μg/L). The epidemiologic evidence is less clear at the low-to-moderate concentrations typically observed in the United States. Accurate retrospective exposure assessment over a long time period is a major challenge in conducting epidemiologic studies of environmental factors and diseases with long latency, such as cancer. Objective: We estimated arsenic concentrations in the water supplies of 2,611 participants in a population-based case–control study in northern New England. Methods: Estimates covered the lifetimes of most study participants and were based on a combination of arsenic measurements at the homes of the participants and statistical modeling of arsenic concentrations in the water supply of both past and current homes. We assigned a residential water supply arsenic concentration for 165,138 (95%) of the total 173,361 lifetime exposure years (EYs) and a workplace water supply arsenic level for 85,195 EYs (86% of reported occupational years). Results: Three methods accounted for 93% of the residential estimates of arsenic concentration: direct measurement of water samples (27%; median, 0.3 μg/L; range, 0.1–11.5), statistical models of water utility measurement data (49%; median, 0.4 μg/L; range, 0.3–3.3), and statistical models of arsenic concentrations in wells using aquifers in New England (17%; median, 1.6 μg/L; range, 0.6–22.4). Conclusions: We used a different validation procedure for each of the three methods, and found our estimated levels to be comparable with available measured concentrations. This methodology allowed us to calculate potential drinking water exposure over long periods.

Environmental Health Perspectives↗
USGS2006

The fitting of general force-of-infection models to wildlife disease prevalence data

Researchers and wildlife managers increasingly find themselves in situations where they must deal with infectious wildlife diseases such as chronic wasting disease, brucellosis, tuberculosis, and West Nile virus. Managers are often charged with designing and implementing control strategies, and researchers often seek to determine factors that influence and control the disease process. All of these activities require the ability to measure some indication of a disease's foothold in a population and evaluate factors affecting that foothold. The most common type of data available to managers and researchers is apparent prevalence data. Apparent disease prevalence, the proportion of animals in a sample that are positive for the disease, might seem like a natural measure of disease's foothold, but several properties, in particular, its dependency on age structure and the biasing effects of disease-associated mortality, make it less than ideal. In quantitative epidemiology, the a??force of infection,a?? or infection hazard, is generally the preferred parameter for measuring a disease's foothold, and it can be viewed as the most appropriate way to a??adjusta?? apparent prevalence for age structure. The typical ecology curriculum includes little exposure to quantitative epidemiological concepts such as cumulative incidence, apparent prevalence, and the force of infection. The goal of this paper is to present these basic epidemiological concepts and resulting models in an ecological context and to illustrate how they can be applied to understand and address basic epidemiological questions. We demonstrate a practical approach to solving the heretofore intractable problem of fitting general force-of-infection models to wildlife prevalence data using a generalized regression approach. We apply the procedures to Mycobacterium bovis (bovine tuberculosis) prevalence in bison (Bison bison) in Wood Buffalo National Park, Canada, and demonstrate strong age dependency in the force of infection as well as an increased mortality hazard in positive animals.

Ecology↗
USGS2024

Scenario design for infectious disease projections: Integrating concepts from decision analysis and experimental design

Across many fields, scenario modeling has become an important tool for exploring long-term projections and how they might depend on potential interventions and critical uncertainties, with relevance to both decision makers and scientists. In the past decade, and especially during the COVID-19 pandemic, the field of epidemiology has seen substantial growth in the use of scenario projections. Multiple scenarios are often projected at the same time, allowing important comparisons that can guide the choice of intervention, the prioritization of research topics, or public communication. The design of the scenarios is central to their ability to inform important questions. In this paper, we draw on the fields of decision analysis and statistical design of experiments to propose a framework for scenario design in epidemiology, with relevance also to other fields. We identify six different fundamental purposes for scenario designs (decision making, sensitivity analysis, situational awareness, horizon scanning, forecasting, and value of information) and discuss how those purposes guide the structure of scenarios. We discuss other aspects of the content and process of scenario design, broadly for all settings and specifically for multi-model ensemble projections. As an illustrative case study, we examine the first 17 rounds of scenarios from the U.S. COVID-19 Scenario Modeling Hub, then reflect on future advancements that could improve the design of scenarios in epidemiological settings.

Epidemics↗
USGS2020

Modeling pathogen dispersal in marine fish and shellfish

Bio-physical models are a useful tool for understanding dispersal and transmission of marine pathogens. While utilized for larval dispersal models, they are only recently being used in epidemiological studies and are currently underutilized by the marine epidemiology field. Bio-physical models are useful for spatial planning and coastal management. For example, they have been used for spatial planning of salmon farm site locations, and to establish early warning networks. Bio-physical modeling can be used to test hypotheses, rather than simply develop them. Model resolution and computation demands must be balanced when making decisions about model parameters. Epidemiological bio-physical models are in their infancy. While they have proven useful so far, future applications of these models can incorporate more aspects of disease dynamics and address many additional questions.

Trends in Parasitology↗
USGS2011

Development of an aquatic pathogen database (AquaPathogen X) and its utilization in tracking emerging fish virus pathogens in North America

The AquaPathogen X database is a template for recording information on individual isolates of aquatic pathogens and is freely available for download (http://wfrc.usgs.gov). This database can accommodate the nucleotide sequence data generated in molecular epidemiological studies along with the myriad of abiotic and biotic traits associated with isolates of various pathogens (e.g. viruses, parasites and bacteria) from multiple aquatic animal host species (e.g. fish, shellfish and shrimp). The cataloguing of isolates from different aquatic pathogens simultaneously is a unique feature to the AquaPathogen X database, which can be used in surveillance of emerging aquatic animal diseases and elucidation of key risk factors associated with pathogen incursions into new water systems. An application of the template database that stores the epidemiological profiles of fish virus isolates, called Fish ViroTrak, was also developed. Exported records for two aquatic rhabdovirus species emerging in North America were used in the implementation of two separate web-accessible databases: the Molecular Epidemiology of Aquatic Pathogens infectious haematopoietic necrosis virus (MEAP-IHNV) database (http://gis.nacse.org/ihnv/) released in 2006 and the MEAP- viral haemorrhagic septicaemia virus (http://gis.nacse.org/vhsv/) database released in 2010.

Journal of Fish Diseases↗
USGS2005

Workgroup report: Drinking-water nitrate and health - Recent findings and research needs

Human alteration of the nitrogen cycle has resulted in steadily accumulating nitrate in our water resources. The U.S. maximum contaminant level and World Health Organization guidelines for nitrate in drinking water were promulgated to protect infants from developing methemoglobinemia, an acute condition. Some scientists have recently suggested that the regulatory limit for nitrate is overly conservative; however, they have not thoroughly considered chronic health outcomes. In August 2004, a symposium on drinking-water nitrate and health was held at the International Society for Environmental Epidemiology meeting to evaluate nitrate exposures and associated health effects in relation to the current regulatory limit. The contribution of drinking-water nitrate toward endogenous formation of N-nitroso compounds was evaluated with a focus toward identifying subpopulations with increased rates of nitrosation. Adverse health effects may be the result of a complex interaction of the amount of nitrate ingested, the concomitant ingestion of nitrosation cofactors and precursors, and specific medical conditions that increase nitrosation. Workshop participants concluded that more experimental studies are needed and that a particularly fruitful approach may be to conduct epidemiologic studies among susceptible subgroups with increased endogenous nitrosation. The few epidemiologic studies that have evaluated intake of nitrosation precursors and/or nitrosation inhibitors have observed elevated risks for colon cancer and neural tube defects associated with drinking-water nitrate concentrations below the regulatory limit. The role of drinking-water nitrate exposure as a risk factor for specific cancers, reproductive outcomes, and other chronic health effects must be studied more thoroughly before changes to the regulatory level for nitrate in drinking water can be considered.

Environmental Health Perspectives↗