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Sunil Kumar Gupta,¹ R.C. Gupta,² A.B. Gupta,³ A.K. Seth,⁴ J.K. Bassin,⁴ and Alka Gupta²

¹Satellite Hospital Banipark, Jaipur, India
²Department of Physiology, SMS Medical College, Jaipur, India
³Malaviya Regional Engineering College, Jaipur, India
⁴Jaipur Zonal Laboratory, National Environmental Engineering Research Institute, Jaipur, India

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 b₅ 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 NO₃ 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 b₅ 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. Key words: cytochrome b₅ reductase, drinking water, methemoglobinemia, nitrate, recurrent acute respiratory infection (RRTI) . Environ Health Perspect 108:363-366 (2000) . [Online 6 March 2000]

http://ehpnet1.niehs.nih.gov/docs/2000/108p363-366gupta/ abstract.html

Address correspondence to S.K. Gupta, A 31-B, Anita Colony, Bajaj Nagar, Jaipur 302 015, India. Telephone: 91 141 510045. Fax: 91 141 518001. E-mail: krass@jp1.dot.net.in

This study was carried out in collaboration with the National Environmental Engineering Research Institute, Nagpur, India. We thank the director of the institute and S.P. Sharma for all of the help and support. We acknowledge the Sookshm Vikas Sansthan, Jawanpura, Viratnagar, Rajasthan, India, for help in conducting the field studies.

This study was conducted at the Department of Physiology, SMS Medical College, Jaipur, and Zonal Laboratory, National Environmental Engineering Research Institute, Jaipur. The study was partially funded by a grant from the Department of Human Resource Development Group and Extramural Research, Council of Scientific and Industrial Research, New Delhi, India.

Received 1 September 1999 ; accepted 10 November 1999.