Jaundice: Understanding The Link Between Pollution And Liver Health

Jaundice is a medical condition that causes a yellowing of the skin and eyes due to the accumulation of bilirubin in the blood. This occurs when the liver is unable to effectively break down bilirubin. It is often caused by liver diseases, infections, and toxins. One of the most common viral infections that lead to jaundice is hepatitis, which can be contracted through contaminated water. Therefore, water pollution is a significant cause of jaundice.

Water pollution and contaminated drinking water

Waterborne jaundice is primarily associated with viral infections, particularly hepatitis A and hepatitis E, which are transmitted through the faeces-oral route. Consuming food or water contaminated with the faeces of an infected person can lead to these viral infections, impairing the liver's ability to secrete bilirubin and resulting in jaundice. This is more prevalent during the summer months when higher temperatures increase the chances of water contamination.

Sewage contamination of drinking water is believed to be a leading cause of the widespread occurrence of jaundice in the summer. Drinking untreated water directly from streams or rivers, as well as poor personal hygiene among food vendors, further elevate the risk of contracting waterborne jaundice.

To prevent waterborne jaundice, it is crucial to prioritise good hygiene and ensure access to clean drinking water. Recommended preventive measures include drinking only filtered or boiled water, storing water in clean containers, and regularly washing water jars and containers. Additionally, maintaining proper hand hygiene by washing hands with soap and water after using the washroom or changing a child's diaper is essential.

While travelling, it is advisable to drink bottled water and avoid uncooked food to minimise the risk of contracting waterborne diseases like jaundice. Maintaining a healthy liver through a balanced diet, regular exercise, and limiting alcohol consumption can also help prevent jaundice-related issues.

Hepatitis A virus in water

Jaundice is a disease that causes a yellowish discoloration of the skin, eyes, and other mucous membranes. It is caused by the accumulation of bilirubin in the blood and blood tissues. While jaundice is common in newborn babies due to their underdeveloped livers, it can also be caused by water pollution.

One particular virus that can be transmitted through contaminated water and cause jaundice is the Hepatitis A Virus (HAV). HAV is a waterborne pathogen that can be transmitted through the consumption of contaminated water. In one instance, an outbreak of hepatitis A in a rural river-island community was found to be associated with the consumption of contaminated well water. In another instance, a patient with HAV infection was notified to the public health authority in the Republic of Korea. The virus was found at a water dispensing outlet at a groundwater facility, which was situated close to a river.

HAV can be detected in water through molecular methods such as immunocapture reverse-transcription polymerase chain reaction and immunoassay using analyzers like the Cobas e411. Despite regular examinations by the Korean public health authority, the water dispensing outlet had not been tested for viruses, only for the presence of coliform bacteria. This highlights the importance of comprehensive water testing to include viral pathogens.

The consumption of contaminated water containing HAV can lead to an infection that presents with systematic and gastrointestinal symptoms. These symptoms include fever, fatigue, nausea, vomiting, abdominal discomfort, and diarrhea. It is important to note that the administration of the hepatitis A vaccine may not always be a timely preventive measure due to the delay in identifying the infection sources. Therefore, ensuring safe and hygienic access to public drinking water is crucial to prevent the spread of HAV and subsequent jaundice.

Sewage contamination

One of the primary ways sewage contamination contributes to jaundice is through the presence of hepatitis viruses in the sewage. Hepatitis A and hepatitis E are commonly transmitted through the consumption of contaminated water and food. When an individual ingests food or water contaminated with the faeces of an infected person, they may acquire the viral infection, which can then impair the liver's ability to secrete bilirubin, resulting in jaundice.

Additionally, sewage contamination can lead to the spread of other pathogens, such as Escherichia coli (E. coli) and Campylobacter, which are commonly found in sewage-contaminated water. These bacteria can cause gastrointestinal illnesses, including diarrhoea, abdominal cramps, nausea, and vomiting. In some cases, E. coli infections can lead to hemolytic uremic syndrome, causing kidney failure and, in severe cases, death.

To prevent sewage contamination and reduce the risk of jaundice, it is crucial to maintain good hygiene practices and ensure access to clean drinking water. This includes drinking filtered or boiled water, storing water in clean containers, and practising proper handwashing techniques, especially after using the washroom or handling contaminated objects. By taking these precautions, the risk of contracting jaundice and other waterborne diseases associated with sewage contamination can be significantly reduced.

Bilirubin accumulation in the blood

Jaundice is caused by the accumulation of bilirubin in the blood and blood tissues. Bilirubin is a brownish-yellow waste product that is generated when red blood cells break down. This process is called hemolysis, and it occurs at the end of a red blood cell's life cycle, which is about 120 days. The breakdown of red blood cells produces approximately 4 mg/kg of bilirubin per day.

After red blood cells break down, bilirubin is transferred to the liver via the bloodstream and combines with the digestive fluid bile. The liver then processes the bilirubin, and it is excreted in urine and stool. However, if the liver is unable to process and remove bilirubin from the bloodstream, it can lead to a buildup in the blood. This condition is known as hyperbilirubinemia, and it can cause jaundice.

There are two types of hyperbilirubinemia: conjugated and unconjugated. Conjugated hyperbilirubinemia occurs when bilirubin has been altered by the liver and is more readily passed in urine and bile. Unconjugated hyperbilirubinemia is caused by the breakdown of red blood cells, and this type of bilirubin cannot be excreted in urine. Instead, it binds to albumin, a protein in the blood.

Several factors can contribute to the accumulation of bilirubin in the blood and the development of hyperbilirubinemia. Liver dysfunction, such as cirrhosis, liver cancer, or autoimmune hepatitis, can affect the liver's ability to process and excrete bilirubin. Bile duct obstruction, which can be caused by gallstones, pancreatitis, or tumours, can also lead to a buildup of bilirubin in the blood. Additionally, certain genetic disorders, such as Gilbert's syndrome and Rotor syndrome, can cause the liver to process bilirubin slowly or limit bilirubin uptake in the body, respectively.

In newborns, jaundice is common and typically resolves on its own. It occurs because newborns have more red blood cells, which break down quickly, and their livers are not fully developed, leading to a temporary buildup of bilirubin. However, in adults, jaundice can be a sign of an underlying health condition, such as liver issues, gallstones, or pancreatic cancer. Therefore, it is essential to consult a doctor if you are experiencing symptoms of jaundice or high bilirubin levels.

Liver diseases and infections

Jaundice is a condition characterised by a yellow discolouration of the skin, eyes, and mucous membranes. It is caused by elevated levels of bilirubin, a yellow substance produced when red blood cells break down, in the blood. While jaundice is common in newborn babies due to their underdeveloped livers, it can also be a symptom of liver disease in adults.

• Hepatitis A, B, C, D, and E infections: Hepatitis is an inflammation of the liver caused by a viral infection. It can lead to jaundice when the liver is unable to process and remove bilirubin from the blood effectively.
• Alcohol-induced hepatitis: Excessive alcohol consumption can damage the liver and lead to hepatitis, resulting in jaundice.
• Liver cirrhosis: This is a condition in which the liver becomes scarred and damaged, often due to long-term alcohol abuse. It can cause jaundice by impairing the liver's ability to process bilirubin.
• Liver failure: Jaundice can occur when the liver fails and is no longer able to function properly, including processing bilirubin.
• Liver enlargement: While a slightly enlarged liver may not cause any symptoms, a grossly enlarged liver can lead to abdominal discomfort and jaundice.
• Portal hypertension: This condition is characterised by high blood pressure in the portal vein, which supplies blood to the liver. It can lead to the development of varicose veins and jaundice.
• Liver encephalopathy: This is a condition where toxic substances, normally removed by the liver, build up in the blood and damage the brain and nervous system. It can cause jaundice and other serious symptoms.
• Blockage of bile ducts: Obstructive jaundice can occur when a blockage prevents bilirubin from draining into the bile ducts. This can be caused by gallstones, tumours, or other obstructions.

While water pollution, specifically contaminated water, can spread jaundice, it is important to note that the condition itself is not caused by pollution but by underlying liver conditions or infections.

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