Certified in Public Health (CPH) Practice Exam

Why are nitrates in groundwater particularly concerning for rural communities relying on well water?

1. Nitrates can cause Blue-Baby Syndrome in infants

2. Nitrates are potent carcinogens in adults

3. The well water will be undrinkable due to taste, odor, and color problems

4. The well water will form nitric acid and become corrosive to metal pipes in the water system

The correct answer is: Nitrates can cause Blue-Baby Syndrome in infants

Nitrates in groundwater are particularly concerning for rural communities relying on well water primarily because of the health risk they pose to infants, notably the risk of Blue-Baby Syndrome, or methemoglobinemia. This condition occurs when nitrates in the water are converted to nitrites in the body, which then interfere with the ability of blood to carry oxygen. Infants are especially vulnerable because their digestive systems convert nitrates to nitrites more effectively than those of older children and adults. High levels of nitrites can cause a significant reduction in the oxygen-carrying capacity of blood, leading to serious health implications, including cyanosis, which gives the skin a bluish color, hence the name "Blue-Baby Syndrome." Addressing the concern for well water quality is crucial in rural communities, where access to testing and treatment may be limited. Ensuring the safety of water supplies is vital for the health of vulnerable populations, particularly young children.