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Chemical and microbiological drinking water contaminants pose risks to child health but are not often evaluated concurrently. At two consecutive visits to 96 households in Piura, Peru, we collected drinking water samples, administered health and exposure questionnaires, and collected infant stool samples. Standard methods were used to quantify heavy metals/metalloids, pesticides, and Escherichia coli concentrations in water samples. Stool samples were assayed for bacterial, viral, and parasitic enteropathogens. The primary drinking water source was indoor piped water for 70 of 96 households (73%); 36 households (38%) stored drinking water from the primary source in containers in the home. We found high prevalence of chemical and microbiological contaminants in household drinking water samples: arsenic was detected in 50% of 96 samples, ≥ 1 pesticide was detected in 65% of 92 samples, and E. coli was detected in 37% of 319 samples. Drinking water samples that had been stored in containers had higher odds of E. coli detection (adjusted odds ratio [aOR]: 4.50; 95% CI: 2.04–9.95) and pesticide detection (OR: 6.55; 95% CI: 2.05–21.0) compared with samples collected directly from a tap. Most infants (68%) had ≥ 1 enteropathogen detected in their stool. Higher odds of enteropathogen infection at the second visit were observed among infants from households where pesticides were detected in drinking water at the first visit (aOR: 2.93; 95% CI: 1.13–7.61). Results show concurrent risks of exposure to microbiological and chemical contaminants in drinking water in a low-income setting, despite high access to piped drinking water.
Financial support: This work was supported by the HERCULES: Exposome Research Center [grant number NIEHS: P30 ES0197767] at Emory University and by the National Institute for Allergy and Infectious Diseases [grant numbers K01AI103544 and 5T32ES12870] at the US National Institutes of Health. AGL and CC are sponsored by the training grant D43 TW007393 awarded by the Fogarty International Center of the US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Disclaimer: No authors had financial disclosures to report.
Authors’ addresses: Miranda J. Delahoy, Sydney Hubbard, and Mia Mattioli, Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, E-mails: email@example.com, firstname.lastname@example.org, and email@example.com. Carlos Culquichicón, Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, and School of Health Sciences, Universidad Nacional de Piura, Piura, Peru, E-mail: firstname.lastname@example.org. Jackie Knee, Disease Control Department, London School of Hygiene & Tropical Medicine, London, UK, E-mail: email@example.com. Joe Brown, Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, E-mail: firstname.lastname@example.org. Lilia Cabrera, Asociación Benéfica PRISMA, Lima, Peru, E-mail: email@example.com. Dana Boyd Barr and P. Barry Ryan, Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, E-mails: firstname.lastname@example.org and email@example.com. Andres G. Lescano, Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: firstname.lastname@example.org. Robert H. Gilman, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: email@example.com. Karen Levy, Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, and Department of Environmental, and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, E-mail: firstname.lastname@example.org.