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R. O. Wright, W. J. Lewander and A. D. Woolf, “Methe- moglobinemia: Ethiology, Pharmacology, and Clinical Management,” Annals of Emergency Medicine, Vol. 34, No. 3, 1999, pp. 646-656. doi:10.1016/S0196-0644(99)70167-8

has been cited by the following article:

• TITLE: Does Exposure to Nitrate in Drinking Water Contribute Anything the Effect of Water Chlorination on Children Methemoglobin Levels?

  AUTHORS: Mina Sadeq, Redouane Abouqal, Benaissa Attarassi, Mohammed Lakranbi, Rajae ElAouad, Larbi Idrissi

  KEYWORDS: Methemoglobin; Drinking Water; Nitrate; Chlorine; Children

  JOURNAL NAME: Journal of Environmental Protection, Vol.3 No.2, February 24, 2012

  ABSTRACT: Previous studies showed contradictory findings regarding the relationship between nitrate in drinking well-water and abnormal methemoglobin (MetHb) level (>2%) among children. We studied the effect of water chlorination in this relationship in children aged up to 7. 240 subclinical children participated in this cross-sectional study. Water nitrate was analyzed for each participant, and so was blood MetHb. Analysis of two water nitrate exposure levels (50 mg/L as )-other extraneous factors (Breslow-Day-Test for interaction), bivariate and multivariate analyses were performed. Abnormal MetHb levels (up to 7.9%) were associated (p-value = 0.020) with exposure to drinking water nitrate. Only water chlorination was an effect modifier. Among those who do not disinfect water, the prevalence of ab- normal MetHb for those with nitrate level >50 mg/L was 4.95 (p-value = 0.001, 95% CI = [1.92 - 12.79]) times the prevalence for those with nitrate level