Year: 2019
Type: article
Abstract: The study by Maki et al., 2019Maki G. McElmurry S. Kilgore P. Love N. Misikir H. Perri M. et al.Bacterial colonization of drinking water: implications for an aging U.S. water infrastructure.Int J Infect Dis. 2019; 79: 30-31Abstract Full Text Full Text PDF Google Scholar examined the effects of point-of-use (PoU) filters on bacterial infections in residents of Flint, Michigan homes. The authors noted that 12 pathogens (including Pseudomonas aeruginosa) were detected in PoU filters in 10 Flint homes and that residents of 70% of these homes had severe respiratory infections. Additionally alarming, the authors reported an astounding 50% mortality rate in their study sample. As researchers and clinicians based in Flint, MI and Newark, NJ, we have serious and genuine concerns regarding the methodology and conclusions of this research. The authors (Maki et al., 2019Maki G. McElmurry S. Kilgore P. Love N. Misikir H. Perri M. et al.Bacterial colonization of drinking water: implications for an aging U.S. water infrastructure.Int J Infect Dis. 2019; 79: 30-31Abstract Full Text Full Text PDF Google Scholar) suggest that the PoU filters may increase the risk of bacterial infection and death. This conclusion is based on a very small sample size. For example, the authors reported that only 10 Flint homes with PoU filters were studied, and of the Detroit controls, only one home had a filter. Furthermore, although the method of selecting the Flint homes for study is not disclosed, there appears to be a selection bias. Not knowing colonization rates in filters for Detroit makes it impossible to compare the populations of the two cities, much less to conclude that the use of the filters caused deaths. And finally, the study results do not appear to be peer-reviewed. The City of Flint provides water for a population of 96 448 (Anon., 2019bAnon City of Flint comprehensive annual financial report for the fiscal year ended June 30, 2018.2019: 6-20Google Scholar), and even a 5% mortality rate would result in the deaths of 4882 persons, leading to a call for immediate cessation of the use of PoU filters to prevent a catastrophe from filters colonized with lethal infectious organisms. We agree with the authors that properly installed PoU filters are effective in reducing lead exposure in drinking water (Maki et al., 2019Maki G. McElmurry S. Kilgore P. Love N. Misikir H. Perri M. et al.Bacterial colonization of drinking water: implications for an aging U.S. water infrastructure.Int J Infect Dis. 2019; 79: 30-31Abstract Full Text Full Text PDF Google Scholar) and can protect all populations including pregnant women and children (Bosscher et al., 2019Bosscher V. Lytle D.A. Schock M.R. Porter A. Del Toral M. POU water filters effectively reduce lead in drinking water: a demonstration field study in Flint, Michigan.J Environ Sci Health. 2019; 54: 484-493Crossref Scopus (15) Google Scholar). PoU filters are recommended for all households in Flint by the United States Environmental Protection Agency (Anon., 2019aAnon EPA—Flint drinking water FAQs.2019Google Scholar) and are currently provided free of charge to the community (Anon., 2019cAnon Get free water filters at these five locations.2019Google Scholar). As concerned scientists, we are alarmed that the ethical standards for proper scientific inquiry have not been met by the authors (Maki et al., 2019Maki G. McElmurry S. Kilgore P. Love N. Misikir H. Perri M. et al.Bacterial colonization of drinking water: implications for an aging U.S. water infrastructure.Int J Infect Dis. 2019; 79: 30-31Abstract Full Text Full Text PDF Google Scholar) and that their conclusions may reduce the use of PoU filters, thereby unnecessarily increasing the risk of lead exposure for the residents of Flint. Avoiding the use of filters may already be taking place given that the results of the study have been publicized on a Public Broadcasting Service (PBS) website (Pinchin, 2019Pinchin K. Flint’s deadly water: the EPA says Flint’s water is sate—scientists aren’t so sure.2019Google Scholar), in a companion PBS Frontline telecast (Anon., 2019cAnon Get free water filters at these five locations.2019Google Scholar), as well as national newspaper coverage (Bellware, 2019Bellware K. There may have been dozens more deaths linked to the Flint water crisis than previously known.2019Google Scholar). Not applicable. This is a letter—thus no funding was secured. The authors have no conflicts of interest to disclose. Active and syndromic surveillance for mass gatherings: BOOM festival 2018, PortugalInternational Journal of Infectious DiseasesVol. 79PreviewPurpose: To describe the implementation and results of an active syndromic surveillance team in a planned and recurrent international mass gathering (MG) allowing early detection of outbreaks, and thereby, allowing intervention by local, national and international authorities. Full-Text PDF Open Access
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $1,750
OpenAlex ID: W2990379951