Abstract
BACKGROUND: The World Health Organization (WHO) released the fourth edition of Guidelines for Drinking-Water Quality in July 2011. In this edition, the 400-µg/L drinking-water guideline for manganese (Mn) was discontinued with the assertion that because "this health-based value is well above concentrations of manganese normally found in drinking water, it is not considered necessary to derive a formal guideline value." OBJECTIVE: In this commentary, we review the WHO guideline for Mn in drinking water--from its introduction in 1958 through its discontinuation in 2011. METHODS: For the primary references, we used the WHO publications that documented the Mn guidelines. We used peer-reviewed journal articles, government reports, published conference proceedings, and theses to identify countries with drinking water or potential drinking-water supplies exceeding 400 µg/L Mn and peer-reviewed journal articles to summarize the health effects of Mn. DISCUSSION: Drinking water or potential drinking-water supplies with Mn concentrations > 400 µg/L are found in a substantial number of countries worldwide. The drinking water of many tens of millions of people has Mn concentrations > 400 µg/L. Recent research on the health effects of Mn suggests that the earlier WHO guideline of 400 µg/L may have been too high to adequately protect public health. CONCLUSIONS: The toxic effects and geographic distribution of Mn in drinking-water supplies justify a reevaluation by the WHO of its decision to discontinue its drinking-water guideline for Mn.