The nitrate content of drinking water is rising at an alarming rate in several regions of NATO countries and elsewhere in the world. The increase is due to lack of proper sewage treatment, and primarily to excess fertilizer application. Also, eutrophication in several coastal areas is triggered by high nitrate concentrations. The main purpose of this book is to integrate scientific knowledge related to exposure assessment, health consequences and control of nitrate contamination in water. The motivation is related to the magnitude, the possible adverse health effects, and the high cost of control ling nitrate contamination. Future research tasks are defined by an interaction among hydro logists, toxicologists and environmental engineers in an integrated framework for nitrate risk management. The target readership of this book is a mix of university colleagues, practitioners from both the private and public sectors and advanced graduate students working with the hydrological, health science or environmental engineering aspects of nitrate contamination. The main conclusions include: 1. For risk assessment purposes, knowledge and sufficiently accurate models are available to predict nitrate load and its fate in water under changes in land use. 2. Once agricultural exposure controls are implemented, the response times in ground water may be so long as to make controls unrealistic. 3. It is still unknown whether agricultural best management practice is a compromise between nitrate risk reduction and agricultural revenue. 4. The current drinking water guidelines of 10 mg/L NOrN need not be changed.

Nitrite and Nitrate in Human Health and Disease delivers a comprehensive review of nitrite and nitrate biology, from basic biochemistry to the complex physiology and metabolism of these two naturally occurring molecules in the human body. Well-organized and well referenced chapters cover the rich history of nitrite and nitrate, sources of exposure, and the physiological effects when consumed through foods containing nitrite and nitrate. The chapters are written by leading experts, all of whom share their research and perspectives in order to help define the context for benefits vs. any potential risks associated with nitrite and nitrate use, either through dietary ingestion or therapeutic dosing. This diverse collection of authors includes vascular biologists, physiologists, physicians, epidemiologists, cancer biologists, registered dieticians, chemists, and public health experts from five countries in both academia and government. Nitrite and Nitrate in Human Health and Disease provides a balanced view of nitric oxide biochemistry, and nitrite and nitrate biochemistry in physiology and in the food sciences.

The quality of drinking water is paramount for public health. Despite important improvements in the last decades, access to safe drinking water is not universal. The World Health Organization estimates that almost 10% of the population in the world do not have access to improved drinking water sources. Among other diseases, waterborne infections cause diarrhea, which kills nearly one million people every year, mostly children under 5 years of age. On the other hand, chemical pollution is a concern in high-income countries and an increasing problem in low- and middle-income countries. Exposure to chemicals in drinking water may lead to a range of chronic non-communicable diseases (e.g., cancer, cardiovascular disease), adverse reproductive outcomes, and effects on children’s health (e.g., neurodevelopment), among other health effects. Although drinking water quality is regulated and monitored in many countries, increasing knowledge leads to the need for reviewing standards and guidelines on a nearly permanent basis, both for regulated and newly identified contaminants. Drinking water standards are mostly based on animal toxicity data, and more robust epidemiologic studies with accurate exposure assessment are needed. The current risk assessment paradigm dealing mostly with one-by-one chemicals dismisses the potential synergisms or interactions from exposures to mixtures of contaminants, particularly at the low-exposure range. Thus, evidence is needed on exposure and health effects of mixtures of contaminants in drinking water. Finally, water stress and water quality problems are expected to increase in the coming years due to climate change and increasing water demand by population growth, and new evidence is needed to design appropriate adaptation policies. This Special Issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the links between drinking water quality and human health.

Despite increasing knowledge of human nutrition, the dietary contribution to cancer remains a troubling question. Carcinogens and Anticarcinogens assembles the best available information on the magnitude of potential cancer riskâ€"and potential anticarcinogenic effectâ€"from naturally occurring chemicals compared with risk from synthetic chemical constituents. The committee draws important conclusions about diet and cancer, including the carcinogenic role of excess calories and fat, the anticarcinogenic benefit of fiber and other substances, and the impact of food additive regulation. The book offers recommendations for epidemiological and diet research. Carcinogens and Anticarcinogens provides a readable overview of issues and addresses critical questions: Does diet contribute to an appreciable proportion of human cancer? Are there significant interactions between carcinogens and anticarcinogens in the diet? The volume discusses the mechanisms of carcinogenic and anticarcinogenic properties and considers whether techniques used to evaluate the carcinogenic potential of synthetics can be used with naturally occurring chemicals. The committee provides criteria for prioritizing the vast number of substances that need to be tested. Carcinogens and Anticarcinogens clarifies the issues and sets the direction for further investigations into diet and cancer. This volume will be of interest to anyone involved in food and health issues: policymakers, regulators, researchers, nutrition professionals, and health advocates.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: "Is the tap water safe to drink?" "Is it safe to live near power lines?" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions. This book discusses six competency based learning objectives for all medical school students, discusses the relevance of environmental health to specific courses and clerkships, and demonstrates how to integrate environmental health into the curriculum through published case studies, some of which are included in one of the book's three appendices. Also included is a guide on where to obtain additional information for treatment, referral, and follow-up for diseases with possible environmental and/or occupational origins.