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Vol. LXI, No. 12
June 12, 2009
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Digest

  Private well water should be tested yearly, and in some cases more often, according to new guidance offered by the American Academy of Pediatrics.  
  Private well water should be tested yearly, and in some cases more often, according to new guidance offered by the American Academy of Pediatrics.  

Well Water Should Be Tested Annually to Reduce Health Risks to Children

Private well water should be tested yearly, and in some cases more often, according to new guidance offered by the American Academy of Pediatrics (AAP). Researchers at NIEHS took a lead role in working with AAP to develop the recommendations and draft a new AAP policy statement about things parents should do if their children drink well water. The recommendations call for annual well testing, especially for nitrate and microorganisms such as coliform bacteria, which can indicate that sewage has contaminated the well. The guidelines point out circumstances when additional testing should occur, including testing when there is a new infant in the house or if the well is subjected to structural damage.

“Children are especially vulnerable to waterborne illnesses that may come from contaminated wells,” said Dr. Walter Rogan, an NIEHS epidemiologist and lead author on the policy statement and technical report in the June issue of Pediatrics. The statement offers recommendations for inspection, testing and remediation of wells providing drinking water for children. Private wells are not subject to federal regulations and are only minimally regulated by states. With proper care, well water is safe; however, wells can become contaminated by chemicals or pathogenic organisms. Nitrate, which comes from sewage or fertilizer, is the most common contaminant in wells. The presence of nitrates can be a problem particularly for infants under 3 months who cannot metabolize nitrate.

Combination of Aspirin, Anti-Clotting Drug Reduces Risk of Dialysis Access Failure

For the first time, a combination of aspirin and the anti-platelet drug dipyridamole has been shown to significantly reduce blockages and extend the useful life of new artery-vein access grafts used for hemodialysis, according to a study by the Dialysis Access Consortium (DAC). The study, supported by NIDDK, was published in the May 21 New England Journal of Medicine.

Artery-vein access grafts, called arteriovenous (AV) grafts, fail most often due to narrowing of blood vessels (stenosis) at the graft site and subsequent clotting, which block the flow of blood. A blocked graft cannot be used for dialysis and is a major cause of worsening health in dialysis patients.

The DAC trial found that the combination treatment decreased the rate of loss of primary unassisted graft patency—the useful life of a graft before it becomes blocked the first time—by 18 percent and the rate of developing significant stenosis by 28 percent, compared to placebo. Previous smaller clinical trials of anti-clotting therapies failed to show that these drugs improve AV graft patency or that they could be used safely in dialysis patients.

Enrollment Stopped in Study of Concentrated Saline for Patients with Traumatic Brain Injury

NHLBI has stopped enrollment into a clinical trial testing the effects of highly concentrated (hypertonic) saline solutions on patients with severe traumatic brain injury (TBI) when given as soon as possible after the injury—that is, before the patient arrives at the hospital or emergency room. After reviewing data on more than 1,000 participants, the study’s monitoring board and NHLBI determined that the hypertonic saline solutions were no better than the standard treatment of normal saline and that it is unlikely that continuing to enroll new patients would change the outcome of the study. There were no concerns about safety. Previously enrolled participants who have not yet completed their 6-month follow-up visits will continue to be monitored according to the study design. The TBI study is the largest randomized clinical trial ever conducted in this severely injured patient population. Typically, in the crucial early minutes before blood transfusions can be safely administered in the hospital, trauma patients receive normal saline solution intravenously in the field to compensate for blood loss and to buy time. Compared to normal saline, concentrated saline solution was believed to compensate for blood loss more effectively, lessen excessive inflammatory responses and prevent brain swelling.

Researchers Identify Key Proteins Needed for Ovulation

Researchers from NIH and other institutions have identified in mice two proteins essential for ovulation to take place. The finding has implications for treating infertility resulting from a failure of ovulation to occur as well as for developing new means to prevent pregnancy by preventing the release of the egg. The proteins, called ERK1 and ERK2, appear to bring about the maturation and release of the egg. The study appeared in the May 15 issue of Science and was funded in part by NICHD and NCI.—compiled by Carla Garnett

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