The Association between Drinking Water Quality and Inflammatory Bowel Disease—A Study in Eastern Croatia

Dubravka Holik, Atila Bezdan, Monika Marković, Želimir Orkić, Andrea Milostić-Srb, Štefica Mikšić and Aleksandar Včev
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Dubravka Holik: Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Atila Bezdan: Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia
Monika Marković: Faculty of Agrobiotechnical Sciences, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Želimir Orkić: Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Andrea Milostić-Srb: Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Štefica Mikšić: Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Aleksandar Včev: Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia

IJERPH, 2020, vol. 17, issue 22, 1-16

Abstract: The incidence rate of inflammatory bowel disease (IBD) is becoming a global health problem that could be caused by changes in environmental and lifestyle habits. The study aimed to identify the association between the quality of drinking water, i.e., physiochemical and biological aspects of the phenotype and activity of IBD in Eastern Croatia. The study included 312 patients (63.4% ulcerative colitis, UC, and 36.6% Crohn’s disease, CD) from the area of Eastern Croatia. The data were collected by questionnaires and the analysis of the water safety, based on 65 samples of drinking water by the patient’s water supply method (public supply, rural water supply, and private well). IBD was active in 38.0% patients (34.0% CD and 40.0% UC). Significant differences ( p = 0.001) were observed in the distribution of patients, according to counties in which they lived in. The largest deviation was noted in coliform bacteria, Escherichia coli , and enterococci bacteria, Fe, Al, and nitrate in rural water supply and private wells, although, without significant impact on IBD phenotype and activity. The hazard quotient (HQ) simulations showed that children are a sensitive group, regarding exposure to nitrates in drinking water over a long period of time, so there is a need for further monitoring and analysis of this issue.

Keywords: inflammatory bowel disease; ulcerative colitis; Crohn’s disease; Eastern Croatia; drinking water quality; rural public supply; private wells (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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