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Water pollution and the brain
Fulvio A. Scorzaa,b,c, Feres Chaddad-Netoc,d, Larissa Beltramima,b, Josef Finsterere, Tomás de la Rosaf,g,h,
Corresponding author
tomas.rosa@uca.es

Corresponding author.
a Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
b Ministério do Desenvolvimento Agrário e Agricultura Familiar (MDA), São Paulo, SP, Brazil
c Unidade de Neurocirurgia do Hospital Beneficência Portuguesa, São Paulo, SP, Brazil
d Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, SP, Brazil
e Neurology and Neurophysiology Center, Vienna, Austria
f Neuroscience Department, Universidad de Cádiz, Facultad de Medicina 3 Planta, Cádiz, Spain
g Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain
h Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0001" class="elsevierStylePara elsevierViewall">Water is an essential nutrient&#46;<a class="elsevierStyleCrossRefs" href="#bib0001"><span class="elsevierStyleSup">1-3</span></a> Water is the main component of cells&#44; tissues&#44; and organs and accounts for 50 &#37;&#8210;70 &#37; of a young adult&#39;s body weight&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0004"><span class="elsevierStyleSup">4-6</span></a> For example&#44; a 70 kg human contains 42 liters of total body water&#44; of which 28 liters are intracellular water and 14 liters are extracellular fluids&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0004"><span class="elsevierStyleSup">4-7</span></a> In general&#44; water consumption is regulated by thirst&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> According to experts&#44; humans consume 20 &#37; to 30 &#37; of water in the form of solid food&#44; while 70 &#37; to 80 &#37; comes from drinks&#44; depending on the food choice and type of drink&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a> Current guidelines recommend that sedentary adults drink an average of 2 liters of water per day&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Total body water weight varies throughout life and is essential for cellular homeostasis &#40;the ability of cells to keep the organism in constant balance even in the face of external fluctuations&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0009"><span class="elsevierStyleSup">9</span></a> Consequently&#44; an adequate level of fluid intake is required for the optimal functioning of the systems of the human body such as the central and peripheral nervous system&#44; kidneys&#44; liver&#44; digestive tract&#44; reproductive system&#44; and respiratory and cardiovascular systems&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0009"><span class="elsevierStyleSup">9</span></a> Without going into detail&#44; the best source of liquids is&#44; surprisingly&#44; the water itself&#33; Although Brazil is privileged because the studied country contains approximately 12 &#37; of all fresh water on the planet&#44; the water sources are contaminated by a wide variety of factors&#44; such as the irregular disposal of industrial waste&#44; garbage&#44; and other urban waste&#44; waste from agriculture&#44; industrial or mining activities and deforestation&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> Catastrophically poor water quality has serious impacts on human health&#44; including our brains&#46; The human brain is considered the most complex system in our body&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> The brain&#44; which is responsible for our sensations&#44; emotions&#44; thinking&#44; language&#44; and consciousness&#44; consists of 86 billion neurons and weighs about 1&#46;5 kg&#46;<a class="elsevierStyleCrossRef" href="#bib0011"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0012"><span class="elsevierStyleSup">12</span></a> The human brain is in constant change throughout life and is therefore a plastic and adaptable organ&#46;<a class="elsevierStyleCrossRef" href="#bib0013"><span class="elsevierStyleSup">13</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0014"><span class="elsevierStyleSup">14</span></a> Unfortunately&#44; the negative consequences of environmental pollutants in drinking water are also associated with a deterioration in brain functions and the possible development of neuropsychiatric diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">15</span></a> In fact&#44; a number of industrial processes use large amounts of water&#44; and the wastewater produced by these processes has the potential to pollute residential water supplies&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> The chemicals that enter the water supply in this way primarily include inorganic salts and organic compounds&#44; which pose health risks and can have massive neurological effects&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> For example&#44; acrylamide in drinking water can cause neurotoxic side effects such as tremors&#44; peripheral neuropathy&#44; and sensory ataxia &#40;difficulty or inability to maintain motor coordination&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> Several epidemiological studies examining dietary intake of acrylamide and cancer risk have shown positive associations with the occurrence of endometrial&#44; ovarian&#44; and renal cell cancers&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> In animal studies&#44; the incidence of brain tumors increased when acrylamide was administered in drinking water&#44; and a similar trend was also evident in studies with humans&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> In addition&#44; cases of poisoning have been observed after drinking water from freshly plastered pipes or wells &#40;plaster made with acrylamide&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> In this way&#44; serious neurotoxic effects have been observed in these individuals&#44; including hallucinations and memory impairment&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0016"><span class="elsevierStyleSup">16-18</span></a> Additionally&#44; it is important to highlight that substances applied to agricultural crops &#40;e&#46;g&#46;&#44; pesticides&#41; often drain into water supply sources&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> In addition&#44; livestock activities can also introduce animal waste and bacteria into water runoff&#44; and the flow of chemical products from gardens can contribute to water contamination&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a> In fact&#44; it is well known that pesticide residues have serious effects on human health&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0019"><span class="elsevierStyleSup">19</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">20</span></a> From a neurological perspective&#44; it has been demonstrated that some types of pesticides &#40;e&#46;g&#46;&#44; carbamates&#44; organochlorines&#44; and organophosphates&#41; can cause serious irreversible damage to the brain and are considered potential risk factors for the development of neurodegenerative diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRefs" href="#bib0019"><span class="elsevierStyleSup">19-21</span></a> In parallel&#44; several pesticides have harmful neurological effects and indirectly unbalance the cellular mechanisms that maintain brain activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0019"><span class="elsevierStyleSup">19-21</span></a> Additionally&#44; exposure of agricultural workers to pesticides increases the incidence of anxiety and depression&#44; which has a major impact on mental health&#46;<a class="elsevierStyleCrossRefs" href="#bib0019"><span class="elsevierStyleSup">19-21</span></a> Suicide cases among these individuals rose twice as high as the national average&#46;<a class="elsevierStyleCrossRefs" href="#bib0019"><span class="elsevierStyleSup">19-21</span></a> Ironically&#44; another threat to the quality of water reservoirs lies in the practices to improve drinking water quality&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0022"><span class="elsevierStyleSup">22</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0023"><span class="elsevierStyleSup">23</span></a> Alumina&#44; a harmful material for bleaching and precipitating organic matter&#44; can increase aluminum levels in water&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0022"><span class="elsevierStyleSup">22</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0023"><span class="elsevierStyleSup">23</span></a> Accordingly&#44; epidemiological evidence clearly demonstrates that aluminum levels in drinking water are associated with the occurrence of Alzheimer&#39;s disease and that these patients have excessive accumulation of aluminum in the brain tissue&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0022"><span class="elsevierStyleSup">22</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0023"><span class="elsevierStyleSup">23</span></a> At the same time&#44; as many people in the world are exposed to other toxic metals in drinking water&#44; there is also great concern in the scientific community about the toxic effects of arsenic&#44; lead&#44; and cadmium on the human brain&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0024"><span class="elsevierStyleSup">24</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">25</span></a> In fact&#44; several studies have shown that chronic consumption of these metals through drinking water leads to changes in cognitive abilities and impaired sensory and motor functions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0024"><span class="elsevierStyleSup">24</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">25</span></a> Another important aspect is the contamination of water by pharmaceutical waste&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0026"><span class="elsevierStyleSup">26</span></a> According to health authorities&#44; about half of the population takes at least one prescribed medication every thirty days&#44; and some of these chemicals gradually leak into waterways&#44;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0026"><span class="elsevierStyleSup">26</span></a> having undesirable consequences on human health&#46; In fact&#44; recent studies have shown that the presence of drug residues in the environment &#40;e&#46;g&#46;&#44; food and water for consumption&#41; can have negative effects on brain development and pose a serious threat to the health and lives of current and future generations&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0026"><span class="elsevierStyleSup">26</span></a> Although each of the environmental pollutants present in water has a distinctive neurotoxicity profile&#44; inflammatory and oxidative mechanisms play a role important in the brain changes caused by most of these chemicals&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0027"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0028"><span class="elsevierStyleSup">28</span></a> In this sense&#44; the introduction of therapeutic strategies that reduce absorption&#44; increase excretion and prevent or minimize the harmful effects of environmental pollutants present in water or tissues and organs is fundamental today&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0029"><span class="elsevierStyleSup">29</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">30</span></a> In general&#44; water pollution must be viewed as a serious public health problem and ensuring the supply of safe drinking water for all is a challenging task&#46;<a class="elsevierStyleCrossRef" href="#bib0031"><span class="elsevierStyleSup">31</span></a> In that regard&#44; the appropriate and effective implementation of public policies to deal with water pollution problems is important&#46; In addition&#44; the development of educational campaigns is extremely necessary to provide our population with accurate and up-to-date information that water is a scarce resource and that consuming or ingesting contaminated water causes serious harm to our mental and organic health&#46;</p><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Authors&#8217; contributions</span><p id="para0002" class="elsevierStylePara elsevierViewall">All authors contributed equally to the conceptualization&#44; writing&#44; and reviewing of the present manuscript&#46;</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Funding</span><p id="para0003" class="elsevierStylePara elsevierViewall">Our studies are supported by the following grants&#58; FAPESP &#40;Funda&#231;&#227;o de Amparo &#224; Pesquisa do Estado de S&#227;o Paulo&#41;&#59; CNPq &#40;Conselho Nacional de Desenvolvimento Cient&#237;fico e Tecnol&#243;gico&#41;&#44; Coordena&#231;&#227;o de Aperfei&#231;oamento de Pessoal de N&#237;vel Superior &#40;CAPES&#41; and &#8216;Juan de la Cierva&#8217; grant financed by &#40;MICIU&#47;AEI&#47;10&#46;13039&#47;501100011033&#41; and by European Social Fund &#40;FSE&#43;&#41;</p></span></span>"
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Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos