Estrogenic compounds in drinking water: A systematic review and risk analysis.

Estrogenic compounds are the endocrine disruptors that receive major attention because of their ability to imitate the natural female hormone, 17ß-estradiol and cause adverse effects on the reproductive system of animals. The presence of estrogenic compounds in drinking water is a warning to assess the risks to which human beings are exposed. The present work has the objectives of carrying out a systematic review of studies that investigated estrogenic compounds in drinking water around the world and estimate the human health and estrogenic activity risks, based on the concentrations of each compound reported. The systematic review returned 505 scientific papers from the Web of Science®, SCOPUS® and PubMED® databases and after careful analysis, 45 papers were accepted. Sixteen estrogenic compounds were identified in drinking water, from the classes of hormones, pharmaceutical drugs and personal care products, plasticizers, corrosion inhibitors, pesticides and surfactants. Di-(2-ethylhexyl) phthalate (DEHP) was the compound found at the highest concentration, reaching a value of 1.43 mg/L. Non-carcinogenic human health risk was classified as high for 17α-ethynilestradiol and DEHP, medium for dibutyl phthalate, and low for bisphenol A. The estrogenic activity risks were negligible for all the compounds, except DEHP, with a low risk. None of the estrogenic compounds presented an unacceptable carcinogenic risk, due to estrogenic activity. However, the risk assessment did not evaluate the interactions between compounds, that occurs in drinking water and can increase the risks and adverse effects to human health. Nonetheless, this study demonstrates the need for improvement of drinking water treatment plants, with more efficient technologies for micropollutant removal.

An inexpensive paracetamol sensor based on an acid-activated carbon fiber microelectrode.

Paracetamol, a contaminant of emerging concern, has been detected in different bodies of water, where it can impact ecological and human health. To quantify this paracetamol, electroanalytical methods have gained support. Thus, the present study developed a simple, inexpensive, and environmentally friendly method for paracetamol quantification using a carbon fiber microelectrode based on commercial carbon fiber. To improve the carbon fiber microelectrode's paracetamol sensitivity and selectivity, it was subjected to an activation process via electrochemical oxidation in an acid medium (H2SO4 or HNO3), using 20 consecutive cycles of cyclic voltammetry. The treated (activated) carbon fiber microelectrode was characterized using scanning electron microscopy and electrochemical techniques, including chronoamperometry and electrochemical impedance spectroscopy. The H2SO4-activated carbon fiber microelectrode exhibited enhanced figures of merit, with a linear dynamic range of paracetamol detection from 0.5 to 11 µmol L-1 and a limit of detection of 0.21 µmol L-1 under optimized conditions. The method was optimized by quantifying paracetamol in commercial pharmaceutical tablets, spiked running tap water, and river water (Pita River, Quito, Ecuador, latitude -0.364955°, longitude -78.404538°); the respective recovery values were 102.89, 103.93, and 112.40%. The results demonstrated an acceptable level of accuracy and the promising applicability of this carbon fiber microelectrode as a sensor to detect paracetamol.

Calculation of the contribution of water to calcium intake in low- and middle-income countries.

Dietary calcium intake is low in many countries, particularly in low- and middle-income countries (LMICs). Water is often overlooked as a source of dietary calcium despite it being universally consumed and providing good calcium bioavailability. Our objective was to assess water distribution systems in LMICs and to develop a formula to simulate the contribution of different water sources to calcium availability. We calculated the contribution of drinking water considering different calcium concentration levels to estimate total calcium availability. We consider a country's households' access to drinking water sources and the distribution of the country's population by age and gender. Calcium availability could be increased by an average of 49 mg of calcium per person per day in the 62 countries assessed if calcium in drinking water was considered. In 22 (31%) of the countries studied, 80% of households are supplied by water sources that could increase calcium availability. Improving calcium concentration in water could be considered as a strategy in LMICs to slightly improve calcium availability.

Risk perceptions of drinking bottled vs. tap water in a low-income community on the US-Mexico Border.

BACKGROUND: Previous studies have shown that low-income Latinos generally drink bottled water over tap water and might be at increased risks for cavities from unfluoridated bottled water. In order to better design interventions, it is important to understand the risk perceptions of this unique high-risk yet historically marginalized group. METHODS: We interviewed low-income Latino households (n = 90) from Nogales, Arizona who primarily drink bottled water and asked them to evaluate potential health risks of drinking tap water compared to 16 other voluntary activities. Unpaired t-tests were used to determine if statistically significant (α = 0.05) differences occurred in perceived risk by drinking-water source and differences among demographic groups in their level of (dis)agreement with statements regarding tap or bottled water safety. To assess significant differences (α = 0.05) in perceived risks and voluntariness to engage in a number of activities, including drinking local tap water and drinking water in different geographic regions, a one-way analysis of variance (ANOVA) followed by Scheffe's post-hoc test (a conservative post-hoc test) with adjustment for the number of pairwise comparisons was used. RESULTS: Participants viewed bottled water to be significantly safer to consume than tap water (p < 0.001). On a Likert scale from 1 (low risk) to 5 (high risk), "drinking tap water in Nogales, Arizona" received an average score of 4.7, which was significantly higher than the average perceived risk of drinking San Francisco, California tap water (µ = 3.4, p < 0.001), and as risky as drinking and driving (µ = 4.8, p = 1.00) and drinking Nogales, Sonora, Mexico tap water (µ = 4.8, p = 1.00). Ninety-eight percent of participants feared that drinking local tap water could result in illness, 79% did not drink their water because of fear of microbial and chemical contamination and 73% would drink their water if they knew it was safe regardless of taste. CONCLUSIONS: These results suggest that fear of illness from tap-water consumption is an important contributing factor to increased bottled water use. Future efforts should focus on the development of educational and outreach efforts to assess the safety and risks associated with tap-water consumption.

Using a Community-Based Participatory Mixed Methods Research Approach to Develop, Evaluate, and Refine a Nutrition Intervention to Replace Sugary Drinks with Filtered Tap Water among Predominantly Central-American Immigrant Families with Infants and Toddlers: The Water Up @Home Pilot Evaluation Study.

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.

Comparison of strontium isotope ratios in Mexican human hair and tap water as provenance indicators.

Deceased undocumented border crossers are some of the most difficult individuals to identify due to the inability to narrow down the region of origin and therefore to obtain family reference samples for DNA comparison. The isotopic compositions of various body tissues have been demonstrated to be useful biomarkers for tracking locations and movements to aid in the identification of human remains. This study closes the large spatial gap of available 87Sr/86Sr ratios from North America in tap water and presents the first 87Sr/86Sr human tissue-based ratios from Mexico. The 101 hair samples from 32 locations in Mexico range in 87Sr/86Sr ratios from 0.70424 to 0.71613 (ΔSrmax-min=0.01189). Furthermore, 151 tap water samples from 51 locations range between 0.70404 to 0.71385 (ΔSrmax-min=0.00981). Overall, small variations in the hair and tap water samples collected from individual locations were recorded (ΔSrmax-min=0.00041 and 0.00034 respectively). Despite the fact that Mexico is one of the largest bottled water consumers in the world, the 87Sr/86Sr ratios of human hair and tap water correlated strongly (R2=0.87 for location averages and R2=0.80 when using individual data points). These data represent a valuable resource for identifying the provenance of human remains.

Spatial Distributions of Oxygen Stable Isotope Ratios in Tap Water From Mexico for Region of Origin Predictions of Unidentified Border Crossers.

One of the many difficulties associated with identifying undocumented border crossers stems from an inability to narrow down the search area for the region of origin and family members to obtain family reference samples for DNA comparison. While the geography of regions of origins is wide, the biological profiles of the undocumented border crossers often show strong similarities, young and male. The isotopic composition of human bones, teeth, and hair has been demonstrated to be useful biomarkers for tracing locations and movements of individuals and for aiding in the identification of human remains. Data obtained from human remains can be compared to and aligned with various reference sources, such as soils and bedrock, archaeological remains, or cultural data. Here, the spatial deficiency in isotopic reference data for Mexico, specifically for oxygen (δ18 O) isotopes in tap water, is being addressed through the collection and analysis of over 150 water samples and explored with tooth enamel isotopic values from recently identified Mexican nationals. The isoscape was developed using a Spine with Barriers interpolation method and shows sufficient detail to narrow down the regions where specific isotopic values are represented. The individuals were plotted on the developed isoscape using conditional correlations. The methodology was successful in assigning the correct regions of origin for the two individuals, which shows the tremendous potential of the developed isoscape. Nonetheless, there is more research needed to further improve upon this geolocation method, including analysis of multiple isotopes in different tissues, and the development of new isotopic methods.

Helicobacter Pylori Detected in Tap Water of Peruvian Patients with Gastric Cancer.

OBJECTIVE: To evaluate the correlation between the presence of H. pylori in paired samples of tap water and gastric cancer (GC) lesion in Lima city (Peru). MATERIAL AND METHODS: Gastric tissue and tap-water samples were prospectively collected from 82 Gastric Cancer who lived in Lima. HspA and ureA genes were evaluated by qPCR in the samples.  Results: The median age of patients with GC was 63 years, 52.4% were men and stage-II in 36.6%. A home-living time> 10 years was reported in 84.1% of patients. Boiling water treatment was indicated in 85.4% of cases. H. pylori was detected in 69.5% of gastric tissues and in 12.2% of analyzed tap-water. There was no differences in gastric infection rates among those with or without water contamination (70% vs. 69.4%, p=0.971). Conclusion & Impact: H. pylori was found in tap-water samples, however, detection rates were lower than in gastric cancer samples. Other sources of infection transmission should be investigated.

Arsenic species uptake and translocation in Elodea canadensis.

The capacity of Elodea canadensis to phytofiltrate arsenic species from water was evaluated. Plants were adapted to tap water and supplemented with 15 and 250 µg L-1 of As. Inorganic arsenic species (As III, As V), and organic arsenic compounds: monomethylarsonate (MMA) and dimethylarsinate (DMA) were analyzed. Sampling was carried out at different times after exposure in culture water and plant organs. Plants exposed to 15 µg L-1 of As concentration showed no significant difference on As concentration (95% confidence level) in their organs compared to controls. When plants were exposed to 250 µg L-1 of As concentration, a significant increase of As concentration in plant organs was observed. After 1 h exposure, plants reduce 63.16% the As concentration in the culture water, with a bioaccumulation factor (BF) of 4.3. Under these conditions, E. canadensis accumulate As V in roots and do not translocate it to stems (transfer factor <1). MMA was determined in stems and leaves. E. canadensis effectively phytofiltrate As from tap water of a city located in an arsenic endemic area from concentrations of 36 µg L-1 to undetectable levels (10 ng L-1).

Water system unreliability and diarrhea incidence among children in Guatemala.

OBJECTIVES: This article examines the effect of water system unreliability on diarrhea incidence among children aged 0-5 in Guatemala. METHODS: We use secondary data from a nationally representative sample of 7579 children to estimate the effects of uninterrupted and interrupted water services on diarrhea incidence. The national scope of this study imposes some methodological challenges due to unobserved geographical heterogeneity. To address this issue, we estimate mixed-effects logit models that control for unobserved heterogeneity by estimating random effects of selected covariates that can vary across geographical areas (i.e. water system reliability). RESULTS: Compared to children without access to piped water, children with uninterrupted water services have a lower probability of diarrhea incidence by approximately 33 percentage points. Conversely, there is no differential effect between children without access and those with at least one day of service interruptions in the previous month. Results also confirm negative effects of age, female gender, spanish language, and garbage disposal on diarrhea incidence. CONCLUSIONS: Public health benefits of piped water are realized through uninterrupted provision of service, not merely access. Policy implications are discussed.

Oxygen and Hydrogen Isotopes in Human Hair and Tap Water: Modeling Relationships in a Modern Mexican Population.

This study investigated the relationship between 18O and 2H isotopes in samples of Mexican hair and drinking water. The purpose of this study was twofold: to quantify the relationship between isotopes in Mexican hair and tap water, in order to understand the impact of water stress and differing socioeconomic status on accurate predictions of drinking water; and to determine whether currently existing semimechanistic models can accurately represent the relationship between hair and tap water. This study used a subset of paired samples of human hair (n = 62) and tap water (n = 76). Isotope values in tap water ranged from -11.4‰ to -4.3‰ and -79.1‰ to -22.5‰, and in hair from +9.5‰ to +16.1‰ and -90.8‰ to -53.7‰, for δ18O and δ2H, respectively. The most depleted δ18O and δ2H hair values came from individuals in the state of Morelos. For modern Mexican populations, positive correlations between isotopes in hair and water were not significant, with correlation coefficients r = 0.61 (p = 0.05) and r = 0.60 (p = 0.06) for 18O and 2H, respectively. Error-in-variables regression yielded linear fits that were somewhat better for 2H relative to 18O: δ18Oh = 0.183 [±0.132] δ18Otw + 15.7 [±0.9]‰ (r2 = 0.23); δ2Hh = 0.181 [±0.076] δ2Htw - 64.0 [±3.0]‰ (r2 = 0.34). In short, data from this Mexican population did not exhibit the strong relationships between isotope values of 18O and 2H in tap water and hair that have been characteristic of other populations studied to date. Given the economic stratification of this region and the poor correlation between hair and water samples, the authors considered the possibility that l, the fraction of the diet derived from local sources, and fs, the fraction of nonexchangeable H in keratin that was fixed in vivo, are local rather than global parameters for this population. The authors estimated different values of l and fs for each location. Given the anticipated importance of the nonlocal dietary contribution, they treated the isotopic content of nonlocal food and the offset parameters for predicting isotopes in locally derived food as tuning parameters and compared the results with parameters based on the American supermarket diet. They found that, although O and H isotopes in water and hair maintained similar geographic distributions, O and H isotopes in tap water explained only a small part of the variation observed in hair samples. Compared to the standard American supermarket diet, the Mexican estimates for nonlocal diet and local diet offsets predicted regional distributions of l and fs that cleanly segregated urban areas from rural towns.

Comparison of Fluoride Levels in Tap and Bottled Water and Reported Use of Fluoride Supplementation in a United States-Mexico Border Community.

BACKGROUND: Compared to the general United States (U.S.) population, Arizona counties along the U.S.-Mexico border have a higher prevalence of dental caries, which can be reduced with adequate fluoride exposure. Because of concern regarding local tap water quality, fluoride-free bottled water consumption is common in this region, raising concern that families are not receiving adequate fluoride to promote dental health. OBJECTIVE: To evaluate the levels of fluoride in tap and bottled water as well as the use of fluoride supplements in an Arizona border community. METHODS: Low-income Latino households (n = 90) who report use of bottled water as their primary source of water intake were recruited. Participants completed a questionnaire about their and their children's dental histories and use of fluoride supplements. Water samples (bottled and tap) were collected from a subset of households (n = 30) for analysis of fluoride. RESULTS: Fluoride detection levels were significantly greater (p = 0.02, Fisher's exact test) in tap water (average = 0.49 mg/dL) than in bottled water, yet, the majority (22/30) were below the range for optimal dental health (0.7-1.2 mg/L). Concentration of fluoride in the majority (29/30) of bottled water samples was below the quantitative detection limit of 0.4 mg/L. Children were significantly less likely to have dental caries if they received fluoride varnishing treatments (p = 0.01, Fisher's exact test), lived in households that reported using fluoridated mouthwash (p < 0.001, Fisher's exact test), their parents received fluoride education (p = 0.01, Fisher's exact test), and their parents reported visiting a dentist yearly (p < 0.001, Fisher's exact test). Furthermore, none of the participants reported receiving recommendations from health-care providers about fluoride supplementation or variance in content by the type of water consumed. CONCLUSION: Although fluoride was significantly more likely to be detected in tap than bottled water, neither water source in this border community is likely to provide enough fluoride for optimal dental health. Low-income children in this region may benefit from regular access to fluoride varnishing treatments and/or use of fluoridated mouthwash, interventions that could be tested in future well-designed trials.

A preliminary nationwide survey of the presence of emerging contaminants in drinking and source waters in Brazil.

This is the first nationwide survey of emerging contaminants in Brazilian waters. One hundred drinking water samples were investigated in 22 Brazilian state capitals. In addition, seven source water samples from two of the most populous regions of the country were evaluated. Samples were collected from June to September of 2011 and again during the same period in 2012. The study covered emerging contaminants of different classes, including hormones, plasticizers, herbicides, triclosan and caffeine. The analytical method for the determination of the compounds was based on solid-phase extraction followed by analysis via liquid chromatography electrospray triple-quadrupole mass spectrometry (LC-MS/MS). Caffeine, triclosan, atrazine, phenolphthalein and bisphenol A were found in at least one of the samples collected in the two sampling campaigns. Caffeine and atrazine were the most frequently detected substances in both drinking and source water. Caffeine concentrations in drinking water ranged from 1.8ngL-1 to values above 2.0µgL-1 while source-water concentrations varied from 40ngL-1 to about 19µgL-1. For atrazine, concentrations were found in the range from 2.0 to 6.0ngL-1 in drinking water and at concentrations of up to 15ngL-1 in source water. The widespread presence of caffeine in samples of treated water is an indication of the presence of domestic sewage in the source water, considering that caffeine is a compound of anthropogenic origin.

Novel method for determination of zinc traces in beverages and water samples by solid surface fluorescence using a conventional quartz cuvette.

A new method for zinc pre-concentration/separation and determination by molecular fluorescence is proposed. The metal was complexed with o-phenanthroline and eosin at pH 7.5 in Tris; a piece of filter paper was used as a solid support and solid fluorescent emission measured using a conventional quartz cuvette. Under optimal conditions, the limits of detection and quantification were 0.36 × 10(-3) and 1.29 × 10(-3) µg L(-1), respectively, and the linear range from 1.29 × 10(-3) to 4.50 µg L(-1). This method showed good sensitivity and selectivity, and it was applied to the determination of zinc in foods and tap water. The absence of filtration reduced the consumption of water and electricity. Additionally, the use of common filter papers makes it a simpler and more rapid alternative to conventional methods, with sensitivity and accuracy similar to atomic spectroscopies using a typical laboratory instrument.

Sequential determination of lead and cobalt in tap water and foods samples by fluorescence.

In this work, a new procedure was developed for the separation and preconcentration of lead(II) and cobalt(II) in several water and foods samples. Complexes of metal ions with 8-hydroxyquinolein (8-HQ) were formed in aqueous solution. The proposed methodology is based on the preconcentration/separation of Pb(II) by solid-phase extraction using paper filter, followed by spectrofluorimetric determination of both metals, on the solid support and the filtered aqueous solution, respectively. The solid surface fluorescence determination was carried out at λem=455 nm (λex=385 nm) for Pb(II)-8-HQ complex and the fluorescence of Co(II)-8-HQ was determined in aqueous solution using λem=355 nm (λex=225 nm). The calibration graphs are linear in the range 0.14-8.03×10(4) µg L(-1) and 7.3×10(-2)-4.12×10(3) µg L(-1), for Pb(II) and Co(II), respectively, with a detection limit of 4.3×10(-2) and 2.19×10(-2) µg L(-1) (S/N=3). The developed methodology showed good sensitivity and adequate selectivity and it was successfully applied to the determination of trace amounts of lead and cobalt in tap waters belonging of different regions of Argentina and foods samples (milk powder, express coffee, cocoa powder) with satisfactory results. The new methodology was validated by electrothermal atomic absorption spectroscopy with adequate agreement. The proposed methodology represents a novel application of fluorescence to Pb(II) and Co(II) quantification with sensitivity and accuracy similar to atomic spectroscopies.

The occurrence of Aeromonas in drinking water, tap water and the Porsuk River

The occurrence of Aeromonas spp. in the Porsuk River, public drinking water and tap water in the City of Eskisehir (Turkey) was monitored. Fresh water samples were collected from several sampling sites during a period of one year. Total 102 typical colonies of Aeromonas spp. were submitted to biochemical tests for species differentiation and of 60 isolates were confirmed by biochemical tests. Further identifications of isolates were carried out first with the VITEK system (BioMeÿrieux) and then selected isolates from different phenotypes (VITEK types) were identified using the DuPont Qualicon RiboPrinter® system. Aeromonas spp. was detected only in the samples from the Porsuk River. According to the results obtained with the VITEK system, our isolates were 13 percent Aeromonas hydrophila, 37 percent Aeromonas caviae, 35 percent Pseudomonas putida, and 15 percent Pseudomonas acidovorans. In addition Pseudomonas sp., Pseudomonas maltophila, Aeromonas salmonicida, Aeromonas hydrophila, and Aeromonas media species were determined using the RiboPrinter® system. The samples taken from the Porsuk River were found to contain very diverse Aeromonas populations that can pose a risk for the residents of the city. On the other hand, drinking water and tap water of the City are free from Aeromonas pathogens and seem to be reliable water sources for the community.

The occurrence of Aeromonas in drinking water, tap water and the porsuk river.

The occurrence of Aeromonas spp. in the Porsuk River, public drinking water and tap water in the City of Eskisehir (Turkey) was monitored. Fresh water samples were collected from several sampling sites during a period of one year. Total 102 typical colonies of Aeromonas spp. were submitted to biochemical tests for species differentiation and of 60 isolates were confirmed by biochemical tests. Further identifications of isolates were carried out first with the VITEK system (BioMe˜rieux) and then selected isolates from different phenotypes (VITEK types) were identified using the DuPont Qualicon RiboPrinter® system. Aeromonas spp. was detected only in the samples from the Porsuk River. According to the results obtained with the VITEK system, our isolates were 13% Aeromonas hydrophila, 37% Aeromonas caviae, 35% Pseudomonas putida, and 15% Pseudomonas acidovorans. In addition Pseudomonas sp., Pseudomonas maltophila, Aeromonas salmonicida, Aeromonas hydrophila, and Aeromonas media species were determined using the RiboPrinter® system. The samples taken from the Porsuk River were found to contain very diverse Aeromonas populations that can pose a risk for the residents of the city. On the other hand, drinking water and tap water of the City are free from Aeromonas pathogens and seem to be reliable water sources for the community.

The occurrence of Aeromonas in drinking water, tap water and the Porsuk River

The occurrence of Aeromonas spp. in the Porsuk River, public drinking water and tap water in the City of Eskisehir (Turkey) was monitored. Fresh water samples were collected from several sampling sites during a period of one year. Total 102 typical colonies of Aeromonas spp. were submitted to biochemical tests for species differentiation and of 60 isolates were confirmed by biochemical tests. Further identifications of isolates were carried out first with the VITEK system (BioMe˜rieux) and then selected isolates from different phenotypes (VITEK types) were identified using the DuPont Qualicon RiboPrinter® system. Aeromonas spp. was detected only in the samples from the Porsuk River. According to the results obtained with the VITEK system, our isolates were 13% Aeromonas hydrophila, 37% Aeromonas caviae, 35% Pseudomonas putida, and 15% Pseudomonas acidovorans. In addition Pseudomonas sp., Pseudomonas maltophila, Aeromonas salmonicida, Aeromonas hydrophila, and Aeromonas media species were determined using the RiboPrinter® system. The samples taken from the Porsuk River were found to contain very diverse Aeromonas populations that can pose a risk for the residents of the city. On the other hand, drinking water and tap water of the City are free from Aeromonas pathogens and seem to be reliable water sources for the community.

Spontaneous cytokine production in children according to biological characteristics and environmental exposures.

BACKGROUND: Environmental factors are likely to have profound effects on the development of host immune responses, with serious implications for infectious diseases and inflammatory disorders such as asthma. OBJECTIVE: This study was designed to investigate the effects of environmental exposures on the cytokine profile of children. METHODS: The study involved measurement of T helper (Th) 1 (interferon-gamma), 2 [interleukin (IL)-5 and IL-13], and the regulatory cytokine IL-10 in unstimulated peripheral blood leukocytes from 1,376 children 4-11 years of age living in a poor urban area of the tropics. We also assessed the impact of environmental exposures in addition to biological characteristics recorded at the time of blood collection and earlier in childhood (0-3 years before blood collection). RESULTS: The proportion of children producing IL-10 was greater among those without access to drinking water [p < 0.05, chi-square test, odds ratio (OR) = 1.67]. The proportion of children producing IL-5 and IL-10 (OR = 10.76) was significantly greater in households that had never had a sewage system (p < 0.05, trend test). CONCLUSIONS: These data provide evidence for the profound effects of environmental exposures in early life as well as immune homeostasis in later childhood. Decreased hygiene (lack of access to clean drinking water and sanitation) in the first 3 years of life is associated with higher spontaneous IL-10 production up to 8 years later in life.

A Comparison of the Effect of Chlorhexidine, Tap Water and Normal Saline on Healing Wounds / Comparación del Efecto de Clorhexidina, Agua Corriente y Suero Salino en Curación de Heridas

Many researchers have advocated in recent times that antiseptic use in healing wounds should be discouraged. Antiseptics have been found to retard healing of wounds. Innocuous solutions like normal saline and tap water are being considered as better alternatives to antiseptics. Chlorhexidine, a commonly used antiseptic, is known to be less toxic on granulation cells. We decided to compare the effect of chlorhexidine, normal saline and tap water on healing wounds. Three groups of wistar rats had 2 by 2cm full thickness wounds made on their right dorsolateral flanks. The wounds were dressed with either chlorhexidine, normal saline or tap water. Wounds were examined at three-day intervals and measurements of area covered were taken on the first day of study and the ninth day. Wound contraction on the ninth day and number of days for healing to take place in the different groups was taken and statistical analysis using student t-test was done to compare the values. Gross morphology of the wounds was also observed. The result showed an inhibitory effect of chlorhexidine on healing wounds. The wound contraction in the antiseptic group was less than the tap water and saline group on day nine. The average number of days for wound healing to be completed in the antiseptic group was more than the other two. These results were statistically significant when compared with the other two groups. There was no statistical difference in the wound contraction values and rate of healing of the saline and tap water dressed wounds. Grossly, all the wounds dressed with antiseptic also had greenish exudates on their surface by day nine with pale looking granulation tissue, and there was greater mortality in this group.

En la actualidad, diversos investigadores han propagado que el uso de antisépticos en heridas en cicatrización debería, ser abandonado. Se ha encontrado que los antisépticos retardan la cicatrización. Soluciones inocuas, tales como, suero salino y agua corriente, están siendo consideradas como mejores alternativas para efectos antisépticos. La clorhexidina, un antiséptico comúnmente usado, es conocida por ser menos tóxica sobre las células granulares. Basado en lo anterior, comparamos los efectos de la clorhexidina, suero salino y agua corriente en heridas en cicatrización. A tres grupos de ratas Wistar se les infirió heridas de 2 x 2 cm de grosor, en su flanco dorsolateral derecho. La heridas fueron cubiertas (pinceladas) con clorhexidina, solución salina o agua corriente, según el caso. Estas heridas fueronn examinadas cada tres días y las mediciones del área cubierta fueron registradas desde el primero al noveno día. La contracción de la herida al noveno día y el número de días que llevó para cicatrizar se regsitraron en los diversos grupos, analizando los resultados esatadísticamente, usando el test t- student para comparar los valores. La morfología macroscópica también fue observada. Los resultados mostraron un efecto inhibidor de la clorhexidina sobre la cicatrización. La contracción de la herida en el grupo con antiséptico fue menor que en los grupos con suero salino y agua corriente. El promedio de días para cicatrizar, fue mayor en el grupo con antiséptico. Estos resultados fueron estadísticamente significativos al compararlos con los otros dos grupos. No hubo diferencias estadísticamente significativas en los valores de contracción de la herida y rango de cicatrización en el grupo tratado con suero salino normal y en el con agua corriente. Desde el punto de vista macroscópico, las heridas tratadas con el antiséptico también tuvieron un exudado verdoso sobre su superficie al día noveno con un tejido granular pálido y hubo mayor ...