Fluoride Action Network

Challenges for Safe and Healthy Drinking Water in China

Source: Water and Health [Epub ahead of print] | April 29th, 2020 | By Jianyong Wu
Location: China

Abstract

Purpose of Review
Rapid economic growth and its huge population are putting tremendous pressure on water sustainability in China. Ensuring clean drinking water is a great challenge for public health due to water shortage and pollution. This article reviews current scientific findings on health-related issues on drinking water and discusses the challenges for safe and healthy drinking water in China.

Recent Findings
From literature published since 2010, a variety of emerging contaminants were detected in drinking water, including disinfection byproducts (DBPs), pharmaceuticals and personal care products (PPCPs), endocrine-disrupting compounds (EDCs), antibiotic resistance genes, and pathogens. Arsenic and fluoride are still the two major contaminants in groundwater. Microcystins, toxins produced by cyanobacteria, were also frequently detected in surface water for drinking. Health effects of exposure to arsenic, fluoride, nitrates, DBPs, and noroviruses in drinking water have been reported in several epidemiological studies. According to literature, water scarcity is still a severe ongoing issue, and regional disparity affects the access to safe and healthy drinking water. In addition, urbanization and climate change have strong influences on drinking water quality and water quantity.

Summary
Multiple classes of contaminants of emerging concern have been detected in drinking water, while epidemiological studies on their health effects are still inadequate. Water scarcity, regional disparity, urbanization, and climate change are the major challenges for safe and healthy drinking water in China.

References


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance


1. • Hunter PR, MacDonald AM, Carter RC. Water supply and health. PLoS Med. 2010;7(11):e1000361. https://doi.org/10.1371/journal.pmed.1000361 The paper explained the relationship between water supply and health. PubMed

2. Schwarzenbach RP, Egli T, Hofstetter TB, Von Gunten U, Wehrli B. Global water pollution and human health. Annu Rev Environ Resour. 2010;35:109–36. Article

3. •• Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Basu NN, et al. The lancet commission on pollution and health. Lancet. 2018;391(10119):462–512. https://doi.org/10.1016/S0140-6736(17)32345-0 An excellent review about environmental pollution and human health. PubMed

4. Tao T, Xin K. Public health: a sustainable plan for China’s drinking water. Nature. 2014;511(7511):527–8. https://doi.org/10.1038/511527a.

5. •• Liu J, Yang W. Water management. Water sustainability for China and beyond. Science. 2012;337(6095):649–50. https://doi.org/10.1126/science.1219471 This paper provided some policy recommendations on water sustainability in China. PubMed

6. • Han D, Currell MJ, Cao G. Deep challenges for China’s war on water pollution. Environ Pollut. 2016;218:1222–33. https://doi.org/10.1016/j.envpol.2016.08.078 The paper illustrated the scale of groundwater pollution challenges in China and some factors driving groundwater quality degradation. PubMed

7. Ren H, Wan X, Yang F, Shi X, Xu J, Zhuang D, et al. Association between changing mortality of digestive tract cancers and water pollution: a case study in the Huai River basin, China. Int J Environ Res Public Health. 2014;12(1):214–26. https://doi.org/10.3390/ijerph120100214.

8. • Jiang Y. China’s water scarcity. J Environ Manag. 2009;90(11):3185–96. https://doi.org/10.1016/j.jenvman.2009.04.016 An important review paper on water scarcity in China.

9. Sauve S, Desrosiers M. A review of what is an emerging contaminant. Chem Cent J. 2014;8(1):15. https://doi.org/10.1186/1752-153X-8-15.

10. Villanueva CM, Cordier S, Font-Ribera L, Salas LA, Levallois P. Overview of disinfection by-products and associated health effects. Curr Environ Health Rep. 2015;2(1):107–15. https://doi.org/10.1007/s40572-014-0032-x.

11. Chang HH, Tung HH, Chao CC, Wang GS. Occurrence of haloacetic acids (HAAs) and trihalomethanes (THMs) in drinking water of Taiwan. Environ Monit Assess. 2010;162(1–4):237–50. https://doi.org/10.1007/s10661-009-0792-1.

12. Chen Z, Yang L, Huang Y, Spencer P, Zheng W, Zhou Y, et al. Carcinogenic risk of N-nitrosamines in Shanghai drinking water: indications for the use of ozone pretreatment. Environ Sci Technol. 2019;53(12):7007–18. https://doi.org/10.1021/acs.est.8b07363.

13.Huang H, Zhu H, Gan W, Chen X, Yang X. Occurrence of nitrogenous and carbonaceous disinfection byproducts in drinking water distributed in Shenzhen. China Chemosphere. 2017;188:257–64. https://doi.org/10.1016/j.chemosphere.2017.08.172.

14. Luo Q, Wang D, Wang Z. Occurrences of nitrosamines in chlorinated and chloraminated drinking water in three representative cities, China. Sci Total Environ. 2012;437:219–25. https://doi.org/10.1016/j.scitotenv.2012.08.023.

15. Pan S, An W, Li H, Su M, Zhang J, Yang M. Cancer risk assessment on trihalomethanes and haloacetic acids in drinking water of China using disability-adjusted life years. J Hazard Mater. 2014;280:288–94. https://doi.org/10.1016/j.jhazmat.2014.07.080.

16. Sang C, An W, Han M, Yang M. Health risk assessment on N-nitrosodimethylamine in drinking water and food in major cities of China with disability-adjusted life years (DALYs). Ecotoxicol Environ Saf. 2019;170:412–7. https://doi.org/10.1016/j.ecoenv.2018.11.128.

17. Wang W, Yu J, An W, Yang M. Occurrence and profiling of multiple nitrosamines in surface water and drinking water of China. Sci Total Environ. 2016;551–552:489–95. https://doi.org/10.1016/j.scitotenv.2016.0 1.175.

18. Wei X, Chen X, Wang X, Zheng W, Zhang D, Tian D, et al. Occurrence of regulated and emerging iodinated DBPs in the Shanghai drinking water. PLoS One. 2013;8(3):e59677. https://doi.org/10.1371/journal.pone.0059677.

19. Yao Z, Sun S, Wang M, Zhao Q, Jia R. The occurrence of THMs and AOX in drinking water of Shandong Province, China. Environ Sci Pollut Res Int. 2019;26(18):18583–92. https://doi.org/10.1007/s11356-019-05094-1.

20. Yin Y, Li T, Kuang D, Lu Y, Shen Y, Xu J, et al. Probabilistic health risk assessment of nitrosamines in drinking water of Shaoxing, Zhejiang, China. Environ Sci Pollut Res Int. 2019;26(6):5485–99. https://doi.org/10.1007/s11356-018-4026-3.

21. Yu Y, Ma X, Chen R, Li G, Tao H, Shi B. The occurrence and transformation behaviors of disinfection byproducts in drinking water distribution systems in rural areas of eastern China. Chemosphere. 2019;228:101–9. https://doi.org/10.1016/j.chemosphere.2019.04.095.

22. Zhang H, Chang S, Wang L, Wang W. Estimating and comparing the cancer risks from THMs and low-level arsenic in drinking water based on disability-adjusted life years. Water Res. 2018;145:83–93. https://doi.org/10.1016/j.watres.2018.08.012.

23. Zhao C, Lu Q, Gu Y, Pan E, Sun Z, Zhang H, et al. Distribution of N-nitrosamines in drinking water and human urinary excretions in high incidence area of esophageal cancer in Huai’an, China. Chemosphere. 2019;235:288–96. https://doi.org/10.1016/j.chemosphere.2019.06.124.

24. Zhou X, Zheng L, Chen S, Du H, Gakoko Raphael BM, Song Q, et al. Factors influencing DBPs occurrence in tap water of Jinhua region in Zhejiang Province, China. Ecotoxicol Environ Saf. 2019;171:813–22. https://doi.org/10.1016/j.ecoenv.2018.12.106.

25. Wei J, Ye B, Wang W, Yang L, Tao J, Hang Z. Spatial and temporal evaluations of disinfection by-products in drinking water distribution systems in Beijing. China Sci Total Environ. 2010;408(20):4600–6. https://doi.org/10.1016/j.scitotenv.2010.06.053.

26.• Liu JL, Wong MH. Pharmaceuticals and personal care products (PPCPs): a review on environmental contamination in China. Environ Int. 2013;59:208–24. https://doi.org/10.1016/j.envint.2013.06.012 A good review on PPCPs contamination in China.

27. Cai MQ, Wang R, Feng L, Zhang LQ. Determination of selected pharmaceuticals in tap water and drinking water treatment plant by high-performance liquid chromatography-triple quadrupole mass spectrometer in Beijing, China. Environ Sci Pollut Res Int. 2015;22(3):1854–67. https://doi.org/10.1007/s11356-014-3473-8.

28. Xu C, Chen L, You L, Xu Z, Ren LF, Yew-Hoong Gin K, et al. Occurrence, impact variables and potential risk of PPCPs and pesticides in a drinking water reservoir and related drinking water treatment plants in the Yangtze estuary. Environ Sci Process Impacts. 2018;20(7):1030–45. https://doi.org/10.1039/c8em00029h

29. Jiang X, Qu Y, Zhong M, Li W, Huang J, Yang H, et al. Seasonal and spatial variations of pharmaceuticals and personal care products occurrence and human health risk in drinking water – a case study of China. Sci Total Environ. 2019;694:133711. https://doi.org/10.1016/j.scitotenv.2019.133711.

30. Leung HW, Jin L, Wei S, Tsui MMP, Zhou BS, Jiao LP, et al. Pharmaceuticals in tap water: human health risk assessment and proposed monitoring framework in China. Environ Health Perspect. 2013;121(7):839–46. https://doi.org/10.1289/ehp.1206244.

31. Li N, Ho KWK, Ying GG, Deng WJ. Veterinary antibiotics in food, drinking water, and the urine of preschool children in Hong Kong. Environ Int. 2017;108:246–52. https://doi.org/10.1016/j.envint.2017.08.014.

32. Lin YC, Lai WW, Tung HH, Lin AY. Occurrence of pharmaceuticals, hormones, and perfluorinated compounds in groundwater in Taiwan. Environ Monit Assess. 2015;187(5):256. https://doi.org/10.1007/s10661-015-4497-3.

33. Lv J, Zhang L, Chen Y, Ye B, Han J, Jin N. Occurrence and distribution of pharmaceuticals in raw, finished, and drinking water from seven large river basins in China. J Water Health. 2019;17(3):477–89.

34. Qin LT, Pang XR, Zeng HH, Liang YP, Mo LY, Wang DQ, et al. Ecological and human health risk of sulfonamides in surface water and groundwater of Huixian karst wetland in Guilin, China. Sci Total Environ. 2019;134552. https://doi.org/10.1016/j.scitotenv.2019.134552.

35. Yang GC, Yen CH, Wang CL. Monitoring and removal of residual phthalate esters and pharmaceuticals in the drinking water of Kaohsiung City. Taiwan J Hazard Mater. 2014;277:53–61. https://doi.org/10.1016/j.jhazmat.2014.03.005.

36. Ido A, Hiromori Y, Meng L, Usuda H, Nagase H, Yang M, et al. Occurrence of fibrates and their metabolites in source and drinking water in Shanghai and Zhejiang, China. Sci Rep. 2017;7:45931. https://doi.org/10.1038/srep45931.

37. Wen ZH, Chen L, Meng XZ, Duan YP, Zhang ZS, Zeng EY. Occurrence and human health risk of wastewater-derived pharmaceuticals in a drinking water source for Shanghai, East China. Sci Total Environ. 2014;490:987–93. https://doi.org/10.1016/j.scitotenv.2014.05.087.

38. Wang H, Wang N, Wang B, Zhao Q, Fang H, Fu C, et al. Antibiotics in drinking water in Shanghai and their contribution to antibiotic exposure of school children. Environ Sci Technol. 2016;50(5):2692–9. https://doi.org/10.1021/acs.est.5b05749.

39. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, et al. Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr Rev. 2009;30(4):293–342. https://doi.org/10.1210/er.2009-0002.

40. Chen HW, Liang CH, Wu ZM, Chang EE, Lin TF, Chiang PC, et al. Occurrence and assessment of treatment efficiency of nonylphenol, octylphenol and bisphenol-a in drinking water in Taiwan. Sci Total Environ. 2013;449:20–8. https://doi.org/10.1016/j.scitotenv.2013.01.038.

41. Feng L, Yang G, Zhu L, Xu J, Xu X, Chen Y. Distribution and risk assessment of endocrine-disrupting pesticides in drinking water sources from agricultural watershed. Water Air Soil Pollut. 2016;227(1):23.

42. Li R-X, Wang C-M, Cao J-k, Cao W-X, Xu Q, Li J. Monitoring three typical phenol endocrine disrupting compounds in drinking water of Suzhou urban area–from raw water to tap water. Int J Environ Anal Chem. 2018;98(10):921–37.

43. Li Y, Li J, Zhang L, Huang Z, Liu Y, Wu N, et al. Perfluoroalkyl acids in drinking water of China in 2017: distribution characteristics, influencing factors and potential risks. Environ Int. 2019;123:87–95. https://doi.org/10.1016/j.envint.2018.11.036.

44. Pan EC, Sun H, Xu QJ, Zhang Q, Liu LF, Chen XD, et al. Polycyclic aromatic hydrocarbons concentrations in drinking water in villages along the Huai River in China and their association with high cancer incidence in local population. Biomed Res Int. 2015;2015:762832. https://doi.org/10.1155/2015/762832.

45. Zhang H, Zhang Y, Li J, Yang M. Occurrence and exposure assessment of bisphenol analogues in surface water and drinking water in China. Sci Total Environ. 2019;655:607–13. https://doi.org/10.1016/j.scitotenv.2018.11.053.

46. Zhang Y, Zhang L, Huang Z, Li Y, Li J, Wu N, et al. Pollution of polycyclic aromatic hydrocarbons (PAHs) in drinking water of China: composition, distribution and influencing factors. Ecotoxicol Environ Saf. 2019;177:108–16. https://doi.org/10.1016/j.ecoenv.2019.03.119.

47. Li J, He J, Li Y, Liu Y, Li W, Wu N, et al. Assessing the threats of organophosphate esters (flame retardants and plasticizers) to drinking water safety based on USEPA oral reference dose (RfD) and oral cancer slope factor (SFO). Water Res. 2019;154:84–93. https://doi.org/10.1016/j.watres.2019.01.035.

48. Liu X, Xiong L, Li D, Chen C, Cao Q. Monitoring and exposure assessment of organophosphorus flame retardants in source and drinking water, Nanjing, China. Environ Monit Assess. 2019;191(2):119. https://doi.org/10.1007/s10661-019-7239-0.

49. Li J, Yu N, Zhang B, Jin L, Li M, Hu M, et al. Occurrence of organophosphate flame retardants in drinking water from China. Water Res. 2014;54:53–61. https://doi.org/10.1016/j.watres.2014.01.031.

50. Yu N, Wang X, Zhang B, Yang J, Li M, Li J, et al. Distribution of perfluorooctane sulfonate isomers and predicted risk of thyroid hormonal perturbation in drinking water. Water Res. 2015;76:171–80. https://doi.org/10.1016/j.watres.2015.02.047.

51. Su HC, Liu YS, Pan CG, Chen J, He LY, Ying GG. Persistence of antibiotic resistance genes and bacterial community changes in drinking water treatment system: From drinking water source to tap water. Sci Total Environ. 2018;616–617:453–61. https://doi.org/10.1016/j.scitotenv.2017.10.318.

52. Li P, Wu Y, He Y, Zhang B, Huang Y, Yuan Q, et al. Occurrence and fate of antibiotic residues and antibiotic resistance genes in a reservoir with ecological purification facilities for drinking water sources. Sci Total Environ. 2019;707:135276. https://doi.org/10.1016/j.scitotenv.2019.135276.

53. Guo X, Li J, Yang F, Yang J, Yin D. Prevalence of sulfonamide and tetracycline resistance genes in drinking water treatment plants in the Yangtze River Delta, China. Sci Total Environ. 2014;493:626–31. https://doi.org/10.1016/j.scitotenv.2014.06.035.

54. Jiang L, Hu X, Xu T, Zhang H, Sheng D, Yin D. Prevalence of antibiotic resistance genes and their relationship with antibiotics in the Huangpu River and the drinking water sources, Shanghai, China. Sci Total Environ. 2013;458–460:267–72. https://doi.org/10.1016/j.scitotenv.2013.04.038.

55. Ma L, Li B, Jiang XT, Wang YL, Xia Y, Li AD, et al. Catalogue of antibiotic resistome and host-tracking in drinking water deciphered by a large scale survey. Microbiome. 2017;5(1):154. https://doi.org/10.1186/s40168-017-0369-0.

56. Ma L, Li B, Zhang T. New insights into antibiotic resistome in drinking water and management perspectives: a metagenomic based study of small-sized microbes. Water Res. 2019;152:191–201. https://doi.org/10.1016/j.watres.2018.12.069

57. Stange C, Yin D, Xu T, Guo X, Schafer C, Tiehm A. Distribution of clinically relevant antibiotic resistance genes in Lake Tai, China. Sci Total Environ. 2019;655:337–46. https://doi.org/10.1016/j.scitotenv.2018.11.211

58. Xu L, Ouyang W, Qian Y, Su C, Su J, Chen H. High-throughput profiling of antibiotic resistance genes in drinking water treatment plants and distribution systems. Environ Pollut. 2016;213:119–26. https://doi.org/10.1016/j.envpol.2016.02.013.

59. Chen Z, Yu D, He S, Ye H, Zhang L, Wen Y, et al. Prevalence of antibiotic-resistant Escherichia coli in drinking water sources in Hangzhou City. Front Microbiol. 2017;8:1133. https://doi.org/10.3389/fmicb.2017.01133.

60. Ding M, Li J, Liu X, Li H, Zhang R, Ma J. Exploring links between water quality and E. coli O157:H7 survival potential in well waters from a rural area of southern Changchun City, China. J Water Health. 2018;16(2):300–10. https://doi.org/10.2166/wh.2017.162.

61. Li J, Ding M, Han Z, Ma J. Persistence of Salmonella Typhimurium in well waters from a rural area of Changchun City, China. Int J Environ Res Public Health. 2018;15(6). https://doi.org/10.3390/ijerph15061090.

62. Wu Q, Ye Y, Li F, Zhang J, Guo W. Prevalence and genetic characterization of Pseudomonas aeruginosa in drinking water in Guangdong Province of China. LWT-Food Sci Technol. 2016;69:24–31.

63.Xiao G, Qiu Z, Qi J, Chen JA, Liu F, Liu W, et al. Occurrence and potential health risk of Cryptosporidium and Giardia in the three gorges reservoir, China. Water Res. 2013;47(7):2431–45. https://doi.org/10.1016/j.watres.2013.02.019.

64. Xiao S, An W, Chen Z, Zhang D, Yu J, Yang M. The burden of drinking water-associated cryptosporidiosis in China: the large contribution of the immunodeficient population identified by quantitative microbial risk assessment. Water Res. 2012;46(13):4272–80. https://doi.org/10.1016/j.watres.2012.05.012.

65. Qin B, Zhu G, Gao G, Zhang Y, Li W, Paerl HW, et al. A drinking water crisis in Lake Taihu, China: linkage to climatic variability and lake management. Environ Manag. 2010;45(1):105–12. https://doi.org/10.1007/s00267-009-9393-6.

66. Yu G, Jiang Y, Song G, Tan W, Zhu M, Li R. Variation of Microcystis and microcystins coupling nitrogen and phosphorus nutrients in Lake Erhai, a drinking-water source in southwest plateau, China. Environ Sci Pollut Res Int. 2014;21(16):9887–9898. doi:https://doi.org/10.1007/s11356-014-2937-1.

67. Zhang L, Liu J, Zhang D, Luo L, Liao Q, Yuan L, et al. Seasonal and spatial variations of microcystins in Poyang Lake, the largest freshwater lake in China. Environ Sci Pollut Res Int. 2018;25(7):6300–7. https://doi.org/10.1007/s11356-017-0967-1.

68. Guo JX, Hu L, Yand PZ, Tanabe K, Miyatalre M, Chen Y. Chronic arsenic poisoning in drinking water in Inner Mongolia and its associated health effects. J Environ Sci Health A Tox Hazard Subst Environ Eng. 2007;42(12):1853–8. https://doi.org/10.1080/10934520701566918.

69. Rodriguez-Lado L, Sun G, Berg M, Zhang Q, Xue H, Zheng Q, et al. Groundwater arsenic contamination throughout China. Science. 2013;341(6148):866–8. https://doi.org/10.1126/science.1237484.

70. He J, Charlet L. A review of arsenic presence in China drinking water. J Hydrol. 2013;492:79–88. https://doi.org/10.1016/j.jhydrol.2013.04.007.

71. Cheng PS, Weng SF, Chiang CH, Lai FJ. Relationship between arsenic-containing drinking water and skin cancers in the arseniasis endemic areas in Taiwan. J Dermatol. 2016;43(2):181–6. https://doi.org/10.1111/1346-8138.13058.

72. Cheng TJ, Ke DS, Guo HR. The association between arsenic exposure from drinking water and cerebrovascular disease mortality in Taiwan. Water Res. 2010;44(19):5770–6. https://doi.org/10.1016/j.watres.2010.05.040.

73. Cheng YY, Chang YT, Cheng HL, Shen KH, Sung JM, Guo HR. Associations between arsenic in drinking water and occurrence of end-stage renal disease with modifications by comorbidities: a nationwide population-based study in Taiwan. Sci Total Environ. 2018;626:581–91. https://doi.org/10.1016/j.scitotenv.2018.01.043.

74. Cheng YY, Huang NC, Chang YT, Sung JM, Shen KH, Tsai CC, et al. Associations between arsenic in drinking water and the progression of chronic kidney disease: a nationwide study in Taiwan. J Hazard Mater. 2017;321:432–9. https://doi.org/10.1016/j.jhazmat.2016.09.032.

75. Wade TJ, Xia Y, Mumford J, Wu K, Le XC, Sams E, et al. Cardiovascular disease and arsenic exposure in Inner Mongolia, China: a case control study. Environ Health. 2015;14:35. https://doi.org/10.1186/s12940-015-0022-y.

76. Chung YL, Liaw YP, Hwang BF, Cheng YY, Lin MS, Kuo YC, et al. Arsenic in drinking and lung cancer mortality in Taiwan. J Asian Earth Sci. 2013;77:327–31. https://doi.org/10.1016/j.jseaes.2013.04.038.

77. Chen J, Wu H, Qian H, Gao Y. Assessing nitrate and fluoride contaminants in drinking water and their health risk of rural residents living in a semiarid region of Northwest China. Exposure Health. 2017;9(3):183–95.

78. Wen D, Zhang F, Zhang E, Wang C, Han S, Zheng Y. Arsenic, fluoride and iodine in groundwater of China. J Geochem Explor. 2013;135:1–21.

79. Lu C, Lu Z, Lin S, Dai W, Zhang Q. Neonicotinoid insecticides in the drinking water system – fate, transportation, and their contributions to the overall dietary risks. Environ Pollut. 2019;258:113722. https://doi.org/10.1016/j.envpol.2019.113722.

80. Wu Q, Zhang T, Sun H, Kannan K. Perchlorate in tap water, groundwater, surface waters, and bottled water from China and its association with other inorganic anions and with disinfection byproducts. Arch Environ Contam Toxicol. 2010;58(3):543–50. https://doi.org/10.1007/s00244-010-9485-6.

81. Bi E, Liu Y, He J, Wang Z, Liu F. Screening of emerging volatile organic contaminants in shallow groundwater in East China. Ground Monit Remediat. 2012;32(1):53–8.

82. Zhang L, Qin J, Zhang Z, Li Q, Huang J, Peng X, et al. Concentrations and potential health risks of methyl tertiary-butyl ether (MTBE) in air and drinking water from Nanning, South China. Sci Total Environ. 2016;541:1348–54. https://doi.org/10.1016/j.scitotenv.2015.10.038.

83. Wei B, Ye B, Yu J, Jia X, Zhang B, Zhang X, et al. Concentrations of asbestos fibers and metals in drinking water caused by natural crocidolite asbestos in the soil from a rural area. Environ Monit Assess. 2013;185(4):3013–22. https://doi.org/10.1007/s10661-012-2768-9.

84. Guo HM, Wen DG, Liu ZY, Jia YF, Guo Q. A review of high arsenic groundwater in mainland and Taiwan, China: distribution, characteristics and geochemical processes. Appl Geochem. 2014;41:196–217. https://doi.org/10.1016/j.apgeochem.2013.12.016.

85. Chen CL, Chiou HY, Hsu LI, Hsueh YM, Wu MM, Wang YH, et al. Arsenic in drinking water and risk of urinary tract cancer: a follow-up study from northeastern Taiwan. Cancer Epidemiol Biomark Prev. 2010;19(1):101–10. https://doi.org/10.1158/1055-9965.EPI-09-0333.

86. Hsu LI, Hsieh FI, Wang YH, Lai TS, Wu MM, Chen CJ, et al. Arsenic exposure from drinking water and the incidence of CKD in low to moderate exposed areas of Taiwan: a 14-year prospective study. Am J Kidney Dis. 2017;70(6):787–97. https://doi.org/10.1053/j.ajkd.2017.06.012.

87. Lin HJ, Sung TI, Chen CY, Guo HR. Arsenic levels in drinking water and mortality of liver cancer in Taiwan. J Hazard Mater. 2013;262:1132–8. https://doi.org/10.1016/j.jhazmat.2012.12.049.

88. Wei Y, Jia C, Lan Y, Hou X, Zuo J, Li J, et al. The association of tryptophan and phenylalanine are associated with arsenic-induced skin lesions in a Chinese population chronically exposed to arsenic via drinking water: a case-control study. BMJ Open. 2019;9(10):e025336. https://doi.org/10.1136/bmjopen-2018-025336.

89. Liu H, Gao Y, Sun L, Li M, Li B, Sun D. Assessment of relationship on excess fluoride intake from drinking water and carotid atherosclerosis development in adults in fluoride endemic areas, China. Int J Hyg Environ Health. 2014;217(2–3):413–20. https://doi.org/10.1016/j.ijheh.2013.08.001.

90. Sun L, Gao Y, Liu H, Zhang W, Ding Y, Li B, et al. An assessment of the relationship between excess fluoride intake from drinking water and essential hypertension in adults residing in fluoride endemic areas. Sci Total Environ. 2013;443:864–9. https://doi.org/10.1016/j.scitotenv.2012.11.021.

91. Wang C, Gao Y, Wang W, Zhao L, Zhang W, Han H, et al. A national cross-sectional study on effects of fluoride-safe water supply on the prevalence of fluorosis in China. BMJ Open. 2012;2(5). https://doi.org/10.1136/bmjopen-2012-001564.

92. Weng HH, Tsai SS, Wu TN, Sung FC, Yang CY. Nitrates in drinking water and the risk of death from childhood brain tumors in Taiwan. J Toxicol Environ Health A. 2011;74(12):769–78. https://doi.org/10.1080/15287394.2011.567951.

93. Chang CC, Tsai SS, Wu TN, Yang CY. Nitrates in municipal drinking water and non-Hodgkin lymphoma: an ecological cancer case-control study in Taiwan. J Toxicol Environ Health A. 2010;73(4):330–8. https://doi.org/10.1080/15287390903421243.

94. Zhang N, Yu C, Wen D, Chen J, Ling Y, Terajima K, et al. Association of nitrogen compounds in drinking water with incidence of esophageal squamous cell carcinoma in Shexian, China. Tohoku J Exp Med. 2012;226(1):11–7. https://doi.org/10.1620/tjem.226.11.

95. Zeng Q, Chen YZ, Xu L, Chen HX, Luo Y, Li M, et al. Evaluation of exposure to trihalomethanes in tap water and semen quality: a prospective study in Wuhan, China. Reprod Toxicol. 2014;46:56–63. https://doi.org/10.1016/j.reprotox.2014.03.005.

96. Zeng Q, Wang YX, Xie SH, Xu L, Chen YZ, Li M, et al. Drinking-water disinfection by-products and semen quality: a cross-sectional study in China. Environ Health Perspect. 2014;122(7):741–6. https://doi.org/10.1289/ehp.1307067.

97. Cao WC, Zeng Q, Luo Y, Chen HX, Miao DY, Li L, et al. Blood biomarkers of late pregnancy exposure to trihalomethanes in drinking water and fetal growth measures and gestational age in a Chinese cohort. Environ Health Perspect. 2016;124(4):536–41. https://doi.org/10.1289/ehp.1409234.

98. Wang X, Mao Y, Tang S, Yang H, Xie YF. Disinfection byproducts in drinking water and regulatory compliance: a critical review. Front Environ Sci Eng. 2015;9(1):3–15.

99. He Y-Q, Ma H-W, Yao X-J, Bu Q-L, Yang H, Huang W, et al. Norovirus gastroenteritis outbreak is associated with contaminated drinking water in South China. Food Environ Virol. 2010;2(4):207–10.

100. Shang X, Fu X, Zhang P, Sheng M, Song J, He F, et al. An outbreak of norovirus-associated acute gastroenteritis associated with contaminated barrelled water in many schools in Zhejiang, China. PLoS One. 2017;12(2):e0171307. https://doi.org/10.1371/journal.pone.0171307.

101. Yang Z, Wu X, Li T, Li M, Zhong Y, Liu Y, et al. Epidemiological survey and analysis on an outbreak of gastroenteritis due to water contamination. Biomed Environ Sci. 2011;24(3):275–83. https://doi.org/10.3967/0895-3988.2011.03.011.

102. Chen YJ, Cao NX, Xie RH, Ding CX, Chen EF, Zhu HP, et al. Epidemiological investigation of a tap water-mediated hepatitis E virus genotype 4 outbreak in Zhejiang Province, China. Epidemiol Infect. 2016;144(16):3387–99. https://doi.org/10.1017/S0950268816001898.

103. Lv S, Zhao J, Xu D, Chong Z, Jia L, Du Y, et al. An epidemiological survey of children’s iodine nutrition and goitre status in regions with mildly excessive iodine in drinking water in Hebei Province, China. Public Health Nutr. 2012;15(7):1168–73. https://doi.org/10.1017/S1368980012000146.

104. Zhou Y, Khu S-T, Xi B, Su J, Hao F, Wu J, et al. Status and challenges of water pollution problems in China: learning from the European experience. Environ Earth Sci. 2014;72(4):1243–54.

105. Stelmach RD, Clasen T. Household water quantity and health: a systematic review. Int J Environ Res Public Health. 2015;12(6):5954–74. https://doi.org/10.3390/ijerph120605954.

106. Bei E, Wu X, Qiu Y, Chen C, Zhang X. A tale of two water supplies in China: finding practical solutions to urban and rural water supply problems. Acc Chem Res. 2019;52(4):867–75. https://doi.org/10.1021/acs.accounts.8b00605.

107. • Gong P, Liang S, Carlton EJ, Jiang Q, Wu J, Wang L, et al. Urbanisation and health in China. Lancet. 2012;379(9818):843–52. https://doi.org/10.1016/S0140-6736(11)61878-3 An influential review paper on Urbanization and health in China.

108. Ebenstein A. The consequences of industrialization: evidence from water pollution and digestive cancers in China. Rev Econ Stat. 2012;94(1):186–201.

109. Wen D, Zou W, Wen X, Yang Y, Chen Y, He Y, et al. Urban–rural disparity in colorectal cancer incidence and increasing trend in relation to socioeconomic development and urbanization in China. J Int Med Res. 2018;46(10):4181–96.

110. Wu J, Yunus M, Islam MS, Emch M. Influence of climate extremes and land use on fecal contamination of shallow tubewells in Bangladesh. Environ Sci Technol. 2016;50(5):2669–76. https://doi.org/10.1021/acs.est.5b05193.

111. Wang H, Yu X, editors. A review of the protection of sources of drinking water in China. Natural Resources Forum; 2014: Wiley Online Library.

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Wu, J. Challenges for Safe and Healthy Drinking Water in China. Curr Envir Health Rpt (2020). https://doi.org/10.1007/s40572-020-00274-5

Keywords

  • Emerging contaminants
  • Water sustainability
  • Water scarcity
  • Epidemiology
  • Public health

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