Poor Water Quality Can Increase Lung Infection Risk for CF Patients

Researchers at the National Institute of Allergy and Infectious Diseases (NIAID), a subset of the National Institutes of Health (NIH), recently published a study in Environmental Epidemiology evaluating the impacts of water quality on lung infections in patients with cystic fibrosis (CF). The study concluded that compounds in the water supply — including naturally occurring and anthropogenic compounds — can increase the risk of infection.

The population-based case-control study used data on nontuberculosis mycobacterial (NTM) pulmonary disease incidence from the Cystic Fibrosis Foundation Patient Registry. Two types of pulmonary infections were analyzed: Mycobacterium avium complex (MAC) infections and Mycobacterium abscessus infections.

Extrapolating information on patients from 2010 to 2019, researchers linked the incidences to patient zip codes. Zip codes were associated with county and surface water data from the Water Quality Portal.

Across 11 states, including Arizona, California, Colorado, Connecticut, Maine, Massachusetts, Nevada, New Mexico, Rhode Island, Utah, and Wyoming, the researchers collected information on 484 MAC cases and 222 M. abscessus cases. In addition, data from 2,816 cystic fibrosis patients without NTM were used as a reference.

Researchers in the study developed a model to understand the link between infections and trace metals and minerals in water, including sulfate, vanadium, and molybdenum. The infection rates were modeled as a function of the log concentration of each contaminant.

Each standardized unit sulfate concentration increase correlated with a 39% increased risk of MAC-infected CF patients. In addition, vanadium concentration increases contributed to a 21% elevated risk of MAC infections. Meanwhile, each standardized unit increase of molybdenum raised the odds of M. abscessus by 36%.

The data from this study emphasized that mineral and metal contamination can significantly impact the risk of lung infection in CF patients. The NIH press release notes, “Researchers said the study sheds light on how water-quality elements may increase the risk of bacteria-related pulmonary infections, but more studies are needed to establish a causal relationship between those conditions.”

Understanding the potential impacts of water contamination can provide insight into what guidelines or regulations should be enforced to minimize water contamination and subsequent infections.