Health and environmental groups have urged the World Health Organization (WHO) to overhaul its decades-old nitrate limit for drinking water, saying that even low levels of nitrate can be linked to cancer and premature birth.
Dozens of international health and environmental organisations called on the World Health Organization on Tuesday to revise decades-old standards for nitrate levels in drinking water, arguing they do not reflect recent scientific evidence of possible harm.
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In an open letter, signed by 85 organisations, including Greenpeace International, the World Organization of Family Doctors (WONCA) and the European Environmental Bureau, the groups called on the United Nations health agency to include nitrate in an upcoming review of its drinking water guidelines.
Nitrates and nitrites are naturally occurring compounds composed of nitrogen and oxygen. They are found throughout the environment – in soil, water and many foods, including meat – and are also used as food additives.
Human activities such as the use of agricultural fertilisers, manure runoff and failing septic systems elevate nitrate levels in water, making it harmful to humans, in particular children and pregnant women.
“Water should be life-giving, not life-threatening,” Amanda Larsson, the global project lead for agriculture at Greenpeace, said in a statement.
The current WHO guidelines – which set the maximum acceptable level of nitrate in drinking water at 50 milligrammes per litre (mg/L) as nitrate or 11.3 mg/L as nitrate-nitrogen – date back to 1958 and are “outdated”, the organisations warned.
That level was set specifically to prevent so-called “blue-baby syndrome”, a potentially fatal condition in which the blood’s capacity to carry oxygen is reduced.
But the limit “has not been updated in response to robust epidemiological evidence linking chronic, low-level nitrate exposure to long-term human health risks”, the open letter said, citing in particular “colorectal cancer and adverse birth outcomes”.
"Studies now link nitrate in drinking water, at levels well below the current WHO limit, to bowel cancer and premature birth," WONCA chair Pratyush Kumar said in a joint statement.
The organisations noted that an expert panel commissioned by the Danish government last year concluded that the current international standard was inadequate to protect public health.
That expert panel recommended reducing the nitrate limit to 6.0 mg/L, something Denmark committed to, although no implementation deadline has been set, earlier this year.
“This regulatory shift creates a misalignment between global guidelines and national health policies,” organisations wrote.
Most national governments base their drinking water standards on WHO guidelines, the organisations said, stressing that updating those guidelines was "vital for global policy reform".
The letter was sent on WHO’s annual One Health Day, which aims to raise awareness of how closely linked the wellbeing of humans, animals, plants and shared ecosystems is.
“Governments must take decisive action to curb the growth of intensive livestock farming and actively support producers in transitioning to ecological farming practices – ensuring that clean, safe drinking water isn’t a luxury but a guarantee,” said Larsson.
