According to a new study, the change from free chlorine to chloramines as a public drinking water disinfection agent may be responsible for increased levels of lead in humans. The study, "Changes in Blood Lead Levels Associated with Use of Chloramines in Water Treatment Systems" was published in the November issue of Environmental Health Perspectives, a monthly peer-reviewed journal of the National Institute of Environmental Health Sciences (NIEHS).

Chloramines are a combination of chlorine and ammonia being used more frequently by public water utilities as an alternative to conventional chlorine to comply with the U.S. Environmental Protection Agency's (EPA) Stage 1 Disinfection Byproducts Rule. The federal guidelines were developed as a means of reducing public exposure to disinfection byproducts (DBPs). DBPs are substances created when chlorine reacts with naturally occurring compounds that have been linked to potential health risks.

In a widely-reported story from 2004, the Washington DC public water utility discovered that lead levels spikes in the District's in-home drinking water coincided with the switch from free chlorine to chloramines as a water disinfection method. Water officials found that chloramines caused corrosion in many of the lead distribution pipes, leading to the leach of lead into public drinking water after it left the treatment plant.

The NIEHS-published research reports on the potential effect of switching from chlorine to chloramines on childhood blood-lead levels, using Wayne County, North Carolina data. Findings of the study recommend the following to limit the health impact of chloramines use:

• Expand lead level screening of children after chloramines are introduced by a water utility
• Target lead level screening on children living in housing built before 1975 when chloramines are being used
• Focus lead level screening for blood-lead levels on children living in housing built before 1950 when chloramines are not being used
• Provide more intensive outreach and education to residents of older housing, including techniques such as running water to flush out lead before drinking it.

For a copy of "Changes in Blood Lead Levels Associated with Use of Chloramines in Water Treatment Systems", please go to http://www.ehponline.org/members/2006/9432/9432.pdf

In a report issued last week, the United Nations Development Program (UNDP) called on the international community to spearhead the creation of an emergency Global Action Plan to combat the lack of proper sanitation and access to clean water that has reached crisis proportions around the world. The UNDP 2006 Human Development Report , Beyond Scarcity: Power, Poverty and the Global Water Crisis, urges the Group of 8 (G-8) nations to work to resolve the public health issue considered to be a major factor impeding development of third world nations.

Global statistics highlighted in the report include the following:

· 1.2 billion people live without access to safe water · 2.6 billion people live without access to sanitation · 1.8 million children die each year from diarrheal disease that could be prevented with access to clean water and safe sanitation facilities.

UNDP findings also show that at any given time approximately one-half of all people in developing countries suffer from a health problem caused by a lack of water and sanitation.

The report also highlights the sizeable discrepancy in both water usage and in the prices people pay for water globally. According to the report, U.S. and British populations use an average of 13.2 gallons of water each day merely on toilet flushes, while many of the world's impoverished survive on a total of approximately 1 gallon of contaminated water per day. In addition, statistics show that those living in urban slums typically pay five to 10 times more per liter of water than people living in high-income areas. Included is the surprising fact that residents in the poorest parts of cities such as Accra, Ghana and Manila pay more for drinking water than residents of New York, London and Paris.

The UNDP report, "Beyond Scarcity: Power, Poverty and the Global Water Crisis" is available at http://hdr.undp.org/hdr2006

The U.S. Centers for Disease Control and Prevention (CDC) reports that 41 states and the District of Columbia have confirmed a total of 3,830 cases of West Nile virus (WNV) infection so far in 2006. The statistics, published in the November 10 issue of Morbidity and Mortality Weekly Report, represent monitoring between January 6 and October 22. The WNV cases included 1,339 involving neurologic disease such as encephalitis, meningitis, or myelitis.

A total of 119 deaths have been attributed to complications from the infection in 2006.

These data indicate an up-tick from 2005, when CDC reported a total of 3,000 WNV cases, including 119 fatalities. However, 2006 will not be a record year for WNV. In 2003, infections in the U.S. reached 9,862 cases, including 264 deaths.

Idaho has been hit hardest so far this year with 824 WNV cases. Other states with significant case numbers include Colorado (310); Texas (305); California (266); and Nebraska (217). Fifty-five percent of the cases reported occurred in men. The median age of WNV patients is 51 years old.

In addition to the human cases, CDC reports 3,214 dead corvids and 745 other miscellaneous dead birds with WNV infection have been confirmed in 42 states and New York City during 2006.

For a brief overview of the report from the CDC, please go to
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5544a5.htm

CDC's West Nile Virus annual surveillance data can be found at
http://www.cdc.gov/ncidod/dvbid/westnile/surv&controlCaseCount06_detailed.htm

Dr. Margaret Chan, a former Hong Kong health official who lead efforts against severe acute respiratory syndrome (SARS) and spearheaded the World Health Organization's (WHO) fight against bird flu, was confirmed as the new Director-General of the global health organization. Dr. Chan becomes the first Chinese to win election to a high-profile United Nations post.

Chan said her top goals will be to improve the health of Africans and of women around the world.

While Hong Kong's director of health in 1997, Chan led the city's effort to stop the first major H5N1 outbreaks in poultry and the first human cases. Her decision to promptly slaughter all 1.5 million poultry in the district has been credited with stopping the outbreak and possibly preventing a major international health crisis.

Recently China has been charged by the global public health community with being slow to share H5N1 avian flu data and virus samples. With her confirmation, Chan has promised to spur Beijing to cooperate more fully with global avian flu efforts.

Chan's term as Director General will run until June 2012.

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