Evaluating the Potential for a Helicobacter pylori Drinking Water Guideline. Issue 9 (24th March 2014)

• Record Type: Journal Article
• Authors: Ryan, Michael; Hamilton, Kerry; Hamilton, Michael; Haas, Charles N.
• Is Part Of: Risk analysis. Volume 34:Issue 9(2014)
• Page Start: 1651
• Page End: 1662
• Publication Date: 2014-03-24
• Subjects: Technology -- Risk assessment -- Periodicals; 658.403
• DOI: 10.1111/risa.12190
• Languages: English
• ISSNs: 0272-4332

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Helicobacter pylori</italic> is a microaerophilic, gram‐negative bacterium that is linked to adverse health effects including ulcers and gastrointestinal cancers. The goal of this analysis is to develop the necessary inputs for a quantitative microbial risk assessment (QMRA) needed to develop a potential guideline for drinking water at the point of ingestion (e.g., a maximum contaminant level, or MCL) that would be protective of human health to an acceptable level of risk while considering sources of uncertainty. Using infection and gastric cancer as two discrete endpoints, and calculating dose‐response relationships from experimental data on humans and monkeys, we perform both a forward and reverse risk assessment to determine the risk from current reported surface water concentrations of <italic>H. pylori</italic> and an acceptable concentration of <italic>H. pylori</italic> at the point of ingestion. This approach represents a synthesis of available information on human exposure to <italic>H. pylori</italic> via drinking water. A lifetime risk of cancer model suggests that a MCL be set at <1 organism/L given a 5‐log removal treatment because we cannot exclude the possibility that current levels of <italic>H. pylori</italic> in environmental source waters pose a potential public health risk. Research gaps include pathogen occurrence in source and finished water, treatment removal rates, and determination of <italic>H. pylori</italic> risks from other water sources such as groundwater and recreational water.</p> </abstract>