DISEASES ASSOCIATED TO

CHEMICAL AND BACTERIAL

CONTAMINATION OF DRINKING
WATER.
HEALTH AND CARIES PROTECTIVE
PROPHYLAXIS
The importance of the water factor in the morbidity of
the population is connected to the chemical
composition, the radioactivity of water and its role in
the epidemiological spread of agents of bacterial,
viral and parasitic diseases.

The chemical composition of water affect the morbidity

of the population in three ways:
1. Diseases associated with deficiency or excess of
certain trace elements in water
Endemic (biogeochemical) diseases - dental caries
(low fluorine content in the 0,4 mg / l), fluorosis
(fluoride at concentrations above 1,5 mg / l), endemic
goiter (low content of iodine in water, soil and food)
Endemic fluorosis

The main source of fluoride is drinking water which provides up

to 85% of the body daily needs of this trace element. Optimal
levels of fluoride in drinking water is 0,7-1 mg / l. The amount
of fluoride in natural waters is different. The waters of the
open resources (rivers, dams, lakes) that are frequently used
for central water supply are characterized by low fluoride
content (less than 0,5 mg / l).
Fluoride has a toxicity which occurs when the water content
exceed 1,5 mg / l. Chronic toxicity or fluorosis, present with
symptoms of teeth, skeletal and parenchymatous organs,
depending on the concentration of fluoride in drinking water.
Caries

At low concentration of fluoride in drinking water (less than 0,5 mg / l),

and presence of other factors such as unhealthy diet, is developing
dental caries.

The mechanism of anti caries effect of fluorine lies in the fact that in its
interaction with the mineral components of bone and teeth to form
poorly soluble compounds. Fluoride contributes to precipitation of
calcium phosphate from saliva, which determines the process of
remineralization in initial caries process.

Systematic introduction of fluoride in prophylactic doses reduced to

60% caries; reduces the number of persons with dental caries, the
proportion of carious teeth caries activity and extraction of teeth due
to decay. Prophylactic doses of fluoride have a positive effect on
periodontal status, have an indirect positive effect on the proportion
of tooth-jaw deformities.

In 85% of all water sources in Bulgaria fluoride concentration is below

0,6 mg / l. In Varna region about 97% of the population use drinking
water with low fluoride (less than 0,5 mg / l).
Endemic goiter

Disease that occurs among the population of regions

with low iodine content in soil, water and foodstuffs.
Endemic goiter is widespread. According to WHO
particularly affects about 200 million people. It
occurs mainly in mountainous areas. The daily
intake of iodine for normal functioning of the thyroid
gland is 200-220 μg.

The reason for endemic goitre is the low content of

iodine in the diet.Its low content in the soil and
concentration in water is only an indicator of its
contents into the environment.
2. Diseases associated with deficiency or excess of
certain salts of macroelements in the water
(magnesium, sodium, nitrates, chlorides, sulfates).
Has been shown that drinking water with both high and
low content of mineral salts are biologically inferior.
 soft water with low magnesium and sodium
and chloride above the acceptable health
standards predisposes to the occurrence of
atherosclerosis and hypertension
 increased total water hardness (12 mgEqv / l)
is one of risk factors for nephrolithiasis and
urolithiasis
 water with high nitrate levels (above 50mg / l)
caused water-nitrate methemoglobinemia in
infants fed
Severe form of disease expression in toxic cyanosis
(10% lethality) was observed only in infants.

Mild forms of methemoglobinemia associated with the

use of water overweight nitrate levels were found in
children of all ages. Affects the following symptoms:
weakness, pallor, increased fatigue.

In this mechanism excess nitrate levels in drinking

water is dangerous for elderly people suffering from
coronary insufficiency and anemia. In thisthis
connection certain health standard for nitrate in
drinking water is 50 mg / l.
3. Diseases related to exposure to toxic and
radioactive substances at concentrations in the
water above the acceptable health standards

 Minamata disease - in excessive concentrations of mercury

in water
 Disease "itai, itai - in excessive concentrations of cadmium
in water
 Fertilizers and pesticides (chlorine, phosphorus, mercury-
organic compounds) cause disturbances in metabolism,
liver, kidney, central nervous system and others.
 Malignancies caused by certain toxic substances with
carcinogenic effects
  Radioactive substances - cause mutagenic,
teratogenic, carcinogenic abnormalities on human
health and its progeny.

This requires development and implementation of complex of

measures for radiation protection. The danger of radioactive
contamination of the water increases due to the ability of
aquatic organisms (mollusks, algae, plankton, fish, etc..)
accumulate radioactive substances which thus included in
biological and food chain and can accumulate in elevated
levels in the human organism.

The influence of chemical components of drinking water on the

health status of the population is demonstrated by
epidemiological transverse (momentary health status) and
longitudinal (health status dynamics) studies.
3. Condition: agents of infectious diseases come with
drinking water in the human body.
This is possible under the following conditions:
 distortion of the technology of purification and
disinfection of water treatment plants;
 secondary contamination of disinfected water into
the mains;
 bathing, swimming.
3. Zoonoses - tularemia, brucellosis, Q fever, leptospirosis.
Leptospires enter the body through mucous membranes
and small sores on the skin for wading, bathing, use of
contaminated irrigation water and washing. They fall in
reservoirs in the urine of rodents, cattle, pigs. For
leptospirosis is characterized by summer-autumn
season, when the contact of humans with reservoirs is
greater.

4. Parasitic (amoeba dysentery, askaridoza, lamblioza etc.)..

Producers of parasitoses incl. eggs of intestinal parasites
and mosquitoes may enter the body with untreated and
disinfected drinking water. Incidence of parasitism is
higher in warmer countries (tropics and the equator) in
comparison with the temperate climate zone.

When bathing, wading, washing, etc.. contact with

contaminated water through broken skin can penetrate
the maggots of schistosomas causing Schistosomiasis
(from this disease affected 200 million people worldwide).
Thank you for your attention.