Nitrates and nitrites that get into the distribution system due to a cross connection will cause what?

• A. Chlorosis
• B. Anemia
• C. Blue Baby Syndrome
• D. Methemoglobinemia

Answer: (C)

Nitrates and nitrites in drinking water pose a particular risk to infants because nitrite can convert hemoglobin into methemoglobin, which cannot carry oxygen effectively. In newborns, this leads to a drop in the blood’s oxygen-carrying capacity and a characteristic cyanosis known as Blue Baby Syndrome. Infants are especially susceptible due to higher nitrite formation and lower activity of the enzyme that reduces methemoglobin back to hemoglobin. While the underlying change is methemoglobinemia, the name most often used for the condition seen from drinking-water contamination in infants is Blue Baby Syndrome.