Comparison of nitrate levels in raw water and finished water from historical monitoring data on Iowa municipal drinking water supplies.

Nitrate contamination of water sources is a concern where large amounts of nitrogen fertilizers are regularly applied to soils. Ingested nitrate from dietary sources and drinking water can be converted to nitrite and ultimately to N-nitroso compounds, many of which are known carcinogens. Epidemiologic studies of drinking water nitrate and cancer report mixed findings; a criticism is the use of nitrate concentrations from retrospective drinking water data to assign exposure levels. Residential point-of-use nitrate data are scarce; gaps in historical data for municipal supply finished water hamper exposure classification efforts. We used generalized linear regression models to estimate and compare historical raw water and finished water nitrate levels (1960s-1990s) in single source Iowa municipal supplies to determine whether raw water monitoring data could supplement finished water data to improve exposure assessment. Comparison of raw water and finished water samples (same sampling date) showed a significant difference in nitrate levels in municipalities using rivers; municipalities using other surface water or alluvial groundwater had no difference in nitrate levels. A regional aggregation of alluvial groundwater municipalities was constructed based on results from a previous study showing regional differences in nitrate contamination of private wells; results from this analysis were mixed, dependent upon region and decade. These analyses demonstrate using historical raw water nitrate monitoring data to supplement finished water data for exposure assessment is appropriate for individual Iowa municipal supplies using alluvial groundwater, lakes or reservoirs. Using alluvial raw water data on a regional basis is dependent on region and decade.

The muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet): surveillance methodology.

BACKGROUND: This report focuses on the common protocol developed by the Muscular Dystrophy Surveillance Tracking and Research Network (MD STARnet) for population-based surveillance of Duchenne and Becker muscular dystrophy (DBMD) among 4 states (Arizona, Colorado, Iowa, and New York). METHODS: The network sites have developed a case definition and surveillance protocol along with software applications for medical record abstraction, clinical review, and pooled data. Neuromuscular specialists at each site review the pooled data to determine if a case meets the case criteria. Sources of potential cases of DBMD include neuromuscular specialty clinics, service sites for children with special healthcare needs, and hospital discharge databases. Each site also adheres to a common information assurance protocol. RESULTS: A population-based surveillance system for DBMD was created and implemented in participating states. CONCLUSIONS: The development and implementation of the population-based system will allow for the collection of information that is intended to provide a greater understanding of DBMD prevalence and health outcomes.