WATER IN RELATION TO HUMAN HEALTHProf. Dr. Faqir Muhammad Anjum (TI)Director General

National Institute of Food Science & TechnologyUniversity of Agriculture, Faisalabad

Water in life2/3 of body cells contain waterWater plays pivotal role in:Body functions and Biochemical reactions Used as building material in every cell Involved in mechanisms for controlling and maintaining normal body temperatureActs as a medium for carrying:nutrients to cells wastes out of cells*

Water In LifeOrganisms usually contain 60% to 90% waterLowest- Plant Seed (20%)Highest- Jellyfish (99%)Water helps all organisms in metabolism and plants in photosynthesis and support99% Water20% Water*

Human body water composition*

Water in Human BodyBabies and kids have more water (%) than adults70-80% water during birth, drops to 65% after 1 yearObese people have less water (%) than skinnyMuscle is 75% waterFat is 20% waterFor this reason, older people (who generally have a higher fat % have less water than youngerWomen have less water (%) than men due to naturally higher fat content*

Human Body Water Composition By Organ/Tissue*

Human Water Balance*

Water input, mL/dayWater output, mL/dayDrinks1500Urine1500Food700Sweat500Metabolic water300Respiration 400Feces100

Water : Recommended Daily Amount (litres/day)Children 1.3-1.7Men 3.7Women 2.7Pregnant women 3.0Lactating women 3.8*

Functions of Water in Human BodyTransports nutrients and oxygen into cellsRegulates body temperatureDetoxifiesMoisturizes the air in lungsHelps with metabolismProtects vital organHelps organs to absorb nutrients Protects and moisturizes our joints

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Fitness and Fat Loss Water important for fitness and fat loss due to: Fills up stomach/ satiety without adding any caloriesDehydration degrades a persons ability to exercise and burn caloriesDehydration reduces protein synthesis required for building and/or repair muscles

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Water As A SolventWater contains 1 oxygen atom and 2 hydrogen atoms which are covalently bondedWater molecule is polar, because electrons are not equally sharedBecause water molecule is polar, it can ionize substances easily, making it a good solventWater known as The Universal Solvent

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Water As A Way of TransportWater is a carrier, distributing essential nutrients to cells, such as minerals, vitamins and glucoseMany different substances, such as blood and sap, are transported by waterSap and blood contain high amounts of water making them good solventsBeing good solvents allows them to dissolve the substances they are transportingTree SapHuman Blood Cells*

Water As A ReactantWater, being a good solvent, allows many reactions to occurUsed in photosynthesis to make NADPH2, and ultimately sugarThese reactions release oxygen, which is vital to human lifeWithout water in photosynthesis, organisms unable to obtain energy, and life would be impossible*

Water As A LubricantWater is an effective lubricant around jointsIt also acts as a shock absorber for eyes, brain, spinal cord and even for the foetus through amniotic fluidWhen bones meet at a joint, a fluid between the bones is required to prevent scraping against each otherThat fluid is called a synovial fluid, which is made mainly of waterMany internal organs have fluid around them to keep them protected, e.g.,Brain: Cerebro-spinal fluidLungs: Pleural FluidEyes: Mix of fluids

Synovial Fluid*

Hydrolysis/ Energy Release Water is needed to separate (by a process called hydrolysis) a phosphate group from adenosine triphosphate (ATP) or guanosine triphosphate (GTP) to get energyWithout water hydrolysis is not possible

ATP +H2O = Energy + ADP + Inorganic PhosphateGTP +H2O = Energy + GDP + Inorganic Phosphate*

Regulation of Body TemperatureWater has a large heat capacity which helps limit changes in body temperature in a warm or a cold environmentWater allows the body to release heat when ambient temperature is higher than body temperatureThe body begins to sweat, and the evaporation of water from the skin surface very efficiently cools the body

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Regulation of Body Temperature*

MetabolismWater is the engine of metabolismParticipates in the biochemical break-down of what we eat

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Waste RemovalWater removes waste products including toxins that the organs cells reject, and removes them through urines and faeces

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Treatment of Polycystic kidney disease (PKD)Polycystic kidney disease - Genetic disease that occurs in 1 among 500 individuals and leads to kidney failure in about half of affected individualsPKD-affected kidney cells divide and multiply inappropriately, and form fluid-filled sacs called cystsKidney cysts continue to grow throughout life, destroying normal kidney tissue, leading to kidney failureDrinking high amounts of water can slow the abnormal cysts growth*

Water QualityAll people, irrespective of their stage of development and social and economic condition, have the right to access to safe drinking water in quantities and of a quality equal to their basic needsWHO recognizes that access to adequate water supplies is a fundamental human rightWater-related diseases are a human tragedy, killing millions of people each year (account for 80% of all deaths in developing countries)*

Chemical contamination in Water and Human HealthCommon chemical contaminants include:NitratesArsenicFluoridePrevalence of arsenic and fluoride in drinking water is known to cause cancer of lungs, bladder, still births, post neonatal mortality, Ischemic heart diseases (heart attack), diabetes mellitus etc.

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NitratesBacteria in drinking water in the human body can transform nitrates/ nitrites into nitrosamines, a compound formed by the reaction between nitrite and secondary aminesBlue-baby syndrome (methemoglobinemia) is caused by exposure to elevated levels of nitrite in infants less than 6 months oldBloods ability to carry oxygen is affectedresult in a bluish color in the infants skin*

ArsenicVarious studies have been conducted in arsenic affected countries - notably Argentina, Chile, China, Japan, and Taiwan - to find the potential of arsenic exposure to cause development of cancerContinuous arsenic exposure can lead people to develop arsenicosis, which in turn elevates the risk of cancer

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ArsenicArsenic ingestion increases risk of lungs and kidney cancerSkin lesions are the most common manifestations in arsenicosis patients*

FluorideFluorosis - Ingestion of excess fluoride, most commonly in drinking-water affects:TeethBones

Moderate amounts lead to dental effectsModerate-level chronic exposure (above 1.5 mg/L of water - the WHO guideline value for fluoride in water) is more commonLong-term ingestion of large amounts can lead to severe skeletal problemsFluorides lower the intelligence capacity of humansChildren are more susceptible to fluoride toxicity

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Safe levels of chemical contaminants in drinking water*

ParameterBIS Guideline value (maximum)General & health effectspH6.5-8.5Affects mucous membrane, corrosionNitrate 100mg/ LBlue baby diseaseFluoride 1.5mg/LDental and skeletal fluorosisArsenic 0.05mg/LCarcinogenicLead0.05mg/LDamage kidneyPesticide 0.001mg/LAffects central nervous system

Pharmaceuticals and Water Quality*

Water and Sanitation-related Diseases*

Group DiseasesGroup DiseasesWater-borne diseases(diseases transmitted by water)Cholera; Typhoid; Bacillary dysentery Infectious hepatitis;GiardiasisWater-washed diseases(caused by lack of water)Scabies; Skin sepsis and ulcers; Yaws; Leprosy; Lice and thypus; Trachoma; Dysenteries; Ascariasis;ParathphoidWater based diseasesSchistomiasis; Dracunuliasis;Bilharziosis; Filariasis; ThreadwormWater-related insect vectordiseasesYellow fever, Dengue fever, Bancroftian filariasis, MalariaOnchocerciasis

Water-borne DiseasesAs per USAID report, an estimated 250,000 child deaths occur each year in Pakistan due to water-borne disease

A study conducted by UNICEF found that 20-40% of the hospital beds in Pakistan are occupied by patients suffering from water-related diseases, such as typhoid, cholera, dysentery and hepatitis, which are responsible for one third of all deaths(Pak-SCEA 2006)*

Microbial Quality Standards for Drinking WaterWater containing maximum 100 bacteria and no single coliform, considered safe for drinkingMicrobiological standards applied to determine safety of waterDrinking water must meet defined standards otherwise poor quality water hazardous to health Hence, improvement in drinking water quality results in substantial reduction in disease prevalence *

Water Deficiency / DehydrationBeing 2% dehydrated can seriously degrade physical and mental functions

Being 15% dehydrated is likely to be lethal*

Water deficiency: symptoms*

Diseases caused by dehydration over a long period of timeSymptoms of mild health problemsDigestive problems - constipation, bad breath, acnesSkin disorders - dryness, dull-looking, sensitiveOthers - fatigue and lower concentration level

Symptoms of more severe health problemsProlonged dehydration could contribute to arthritis, migraine and the malfunctioning of the digestive systemInsufficient water intake results in inefficient toxin removal, which may induce high uric acid; diabetes; liver, kidney and heart diseases; high blood pressure and even intestinal cancerIt may accelerate aging in the long run

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Signs of DehydrationAllergiesAsthmaArthritisHigh cholesterol/ heart problemsHigh blood pressureDiabetesPeptic UlcersAnginaMigrainesObesity and weight control problemsWater retentionChronic back pain

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Effects of Water DeficiencyLow blood pressureClotting of bloodKidney malfunctionSevere constipation*

Hyperhydration- water intoxicationWhen too much water enters the body's cells, the tissues swell Cells try to maintain concentration gradientExcess water outside the cells (the serum) draws out sodium from within the cells into serum in an attempt to re-establish the necessary concentrationKidneys can tolerate about 17 litres water in a dayExcessive ingestion of water and other liquids resulted in extra work for the body Signs of water intoxication: Hyponatriemya - decreased amount of natrium in blood)Rubdomiolysis - damage of muscularity (collapse of skeleton) , acute incompetence of kidneys

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HyponatremiaHyponatremia, a metabolic condition in which there is not enough sodium in body fluids outside the cellsIt is most common electrolytedisorder in the U. S.In hyponatremia, the imbalance of water to salt is caused by one of three conditions:Euvolemic hyponatremia- total body water increases, but the body's sodium content stays the sameHypervolemic hyponatremia- both sodium and water content in the body increase, but the water gain is greaterHypovolemic hyponatremia- water and sodium are both lost from the body, but the sodium loss is greater

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RhabdomyolysisBreakdown of muscle fibers result in the release myoglobin into the bloodstream Some of these are harmful to kidneys and frequently result in kidney damageRhabdomyolysis affects about one out of 10,000 people in the United States, with slighter higher incidence in menRhabdomyolysis accounts for an estimated eight to fifteen percent of cases of acute renal failureAbout five percent of rhabdomyolysis cases result in deathThere are two crucial factors involved in the development of myoglobinuric ARF (acute renal failure): Hypo-volemia/dehydration Aciduria

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Situation of Drinking Water in PakistanWater and sanitation are ignored sector sin Pakistan

Majority of Pakistani people do not have access to safe drinking water and lack satisfactory sanitation systems

In 2005, approximately 38.5 million people did not have access to safe drinking water and approximately 50.7 million people lacked access to improved sanitation facilities in Pakistan

With the same trend, by 2015, 52.8 million people will be deprived of safe drinking water and 43.2 million people will be lacking adequate sanitation facilities in PakistanKhan and Javed (2007)*

Situation of Drinking Water in PakistanHence quality of drinking water in Pakistan far from being satisfactoryRivers and sub-soil water contaminated due to disposal of untreated domestic and industrial fluid wastesContamination starts right in the mountainsTourists to the hill stations contribute to garbageShandur Festival, at 12,520 ft. altitude gathers almost 20,000 peopleProduce around 5,000 kg garbage pollutes glaciers, lakes and rivers Causes toxicity in residents using it

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Tourist points like Murree become heavily polluted contributed by touristsNaturally garbage produced finds its way into water channels that supply drinking water to downstream areas Survey conducted by NIH, Islamabad - upward trend in nitrate contents in drinking water of Islamabad and Rawalpindi Bacteriological examination shows 94% water samples unsuitable for human consumptionSituation alarming because samples taken from posh F-11, G-7, G-9, G-11, and Airport areas in IslamabadIf this quality of water in model and modern city, imagine situation in other cities

*Situation of Drinking Water in Pakistan

SOME NEWSPAPER REPORTSResidents of some villages on banks of River Chenab near Chiniot reported to suffer from stomach diseases due to poor quality drinking waterReports appeared a few years back from Manga Mandi near Lahore residents suffered from bone deformations Unsafe drinking water reports from Sheikhupura, Lahore, Toba Tek Singh, Qsur, Hyderabad, Peshawar and other citiesIn Karachi, people sell dirty water after recyclingIncreased risk of kidney, stomach and skin diseases Seashores exposed to oil contamination because of ship breaking in Gadani and leakage from oil tankers*Situation of Drinking Water in Pakistan

Oil drained into water damages marine life and pollutes environment It finds its way into drinking water in Karachi residents develop diseases and allergies Practically no organized solid disposal system in any city in PakistanSolid waste dumped in some open places and then burntGives rise to numerous chemicals including dioxin - highly toxic man-made organic chemical *Situation of Drinking Water in Pakistan

Bacterial Contamination in WaterCampylobacter: diarrhoeaE. coli: Bloody diarrhoea, mild fever, anaemiaPseudomonas: dermatitis and infections in urinary tract, respiratory system, soft tissues, bones, joints, gastrointestinal tract Shigella: gastroenteritis, bacillary dysenterySalmonella: Nausea, vomiting, abdominal cramps, diarrhoea, fever, headache Vibrio cholerae: abdominal pains, mild fever, chills, and headache, watery diarrhoea followed by lethargy and dehydration.*

Viruses Contamination in WaterNoroviruses - Group of viruses that cause gastroenteritis, inflammation of lining of stomach and intestinesHepatitis A Results in inflammation of liverSources of infection:an infected person who didnt wash his or her hands after using washroomdrinking untreated water or eating food washed in untreated water Rotavirus: Very common cause of severe diarrhoea among infants and children

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Take Home MessageDrink ample quantity of GOOD QUALITY water:Helps in digestion and avoid constipationRelieves fatigueLess cramps and sprainsGood moodNatural remedy for headacheLook younger with healthier skinLose weightBetter productivity at workLess likely to get sick and feel healthyReduce risks of kidney failure*

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