Screening of Nitrite Poisoning Among the Egyptian Children-Ismailia

Background: Water high in nitrate is potentially harmful to human and animal health. Bacteria that live in the digestive-tracts convert the ingested nitrate to nitrite (N02). Nitrite then reacts with hemoglobin, which carries oxygen in blood, to form methemoglobin. Methemoglobin cannot carry oxygen, thus the affected person suffers oxygen deficiency. The resulting condition is referred to as methemoglobinemia. Objectives: Determine the level of nitrite concentration in the water of Ismailia canal and screening for the presence of nitrite poisoning among the children living around the affected areas Study design: It is a cross section-descriptive study. The study samples: • Random samples were taken from Ismailia canal in different areas to examine the presence of nitrite in water. • Urine and blood samples were taken randomly from the children living around the tested areas to check for the presence of nitrite poisoning. Methodology:Kyeldhal method; for the detection of nitrites nitrates in the water. Griess reaction; for detection of nitrite in the urine and blood samples. Results: Water samples were taken from four areas along the Isamilia-canal (-tal-El Kabeer, Abousoir, Nefeshah And ismailia city). Samples were also taken from water treatment plan and tap water. The study of measurements of nitrites in water revealed that, the nitrites level was high in the four tested areas (12.6mg/L, 10.7mg/L, 11.2mg/L, 14.0mg/L respectively), exceed the Egyptian standards ((10mg/L) and the international standards (3mg/L). From 327 children, there is 16.5% of the children have excess nitrites in their urine which was confirmed by blood samples. The agreement between the urine and blood samples was 92.5%. The risk factors which accelerate the development of methemoglobuinemia in the presence of excess nitrite were apparent in the studied popu-lations as, anemia in 85.4%, repeated attacks of gastroenteritis in 46.4%, drinking underground water in 37% and exposure to nitrites-rich foods (e.g carrot, spinach), and the preserved food by sodium nitrites was in 81.4%. Exposure to drugs which increase nitrites in the body (e.g. sulpha) was in 44.4%. Conclusion: Nitrite poisoning is an alarming problem between the Egyptian children in Ismailia. Drinking unsafe water is criminated for such condition which is a threatened condition may seriously affect the health of our children. Urine assay for nitrite is an accurate, less invasive and less expensive tool for early detection of nitrite poisoning. Recommendation: Well organized program for the educa-tion of the physician about the dangers of nitrite poisoning, sign and symptoms and ideal treatment. Also we recommend health education program for the public about the importance of keeping our water sources clean. Regular testing of the water for excess nitrites and the children for methemoglobuiemia is recommended and an urgent action for treatment of such polluted water is highly recommended.