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An evaluation of semi-quantitative test strips for the measurement of nitrate in drinking water in epidemiologic studies


Consumption of nitrate and nitrite is associated with a variety of health outcomes. Commercially available test strips that allow semi-quantitative estimation of these contaminants in drinking water are inexpensive relative to laboratory testing, and are simple to use. To examine the accuracy of a nitrate/nitrite test strip, we recruited Washington State residents to estimate levels of these contaminants in their tap water using these strips, and simultaneously provide a tap water sample for laboratory analysis. Paired results were available from 102 homes. On the basis of laboratory assay, nitrate levels as nitrogen ranged from no nitrate (27%) to 40.5 mg/l (median 0.4 mg/l). Spearman's correlation coefficient between test strip- and laboratory-measured nitrate indicated moderate precision overall (r=0.72). Correlation was similar for homes inside and outside city/town limits, but differed by primary source of water for the purveyor indicated by residents (r=0.72 for groundwater and r=0.34 for surface water). Seven (7%) participants reported difficulty in distinguishing colors (contaminant levels) when using the test strip; and among the samples with nitrate, the laboratory assay indicated higher nitrate levels than the test strip for 81%. Nitrite was not detected by laboratory assay; in comparison, five (5%) subjects reported any nitrite according to the test strip. Nitrate/nitrite test strips may be useful in some epidemiologic studies, but should be used with caution, preferably as a screening tool or when laboratory assays are not feasible.

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We thank all study participants, and Dr. Lynda Voigt and Ms. Barbara Hansen for their assistance in recruiting them. This study was supported by grant R03 CA94735 from the National Cancer Institute at the National Institutes of Health (NCI/NIH).

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Correspondence to Susan Searles Nielsen.

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Nielsen, S., Mueller, B. & Kuehn, C. An evaluation of semi-quantitative test strips for the measurement of nitrate in drinking water in epidemiologic studies. J Expo Sci Environ Epidemiol 18, 142–148 (2008).

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  • dipsticks
  • nitrate
  • nitrite
  • exposure assessment
  • epidemiologic methods

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