Low-water quality and non-communicable disease nexus: Health impacts, mechanisms, and advanced water treatment approaches

Water quality is essential to prevent non-communicable diseases (NCDs). Low-water quality induced by contamination from natural and anthropogenic activities can lead to NCDs that affect human health. Previous studies have reported several water- and food-borne diseases. However, the direct and indirect relationships between low-water quality and NCDs must be comprehensively summarized. Thus, this review aims to comprehensively summarize the global impact of low-water quality on NCDs, water pollutants and NCDs interconnection, and potential approaches to improve water quality. Heavy metals, persistent organic pollutants, chemicals, and microplastics from agricultural runoff and leachates contaminate the water sources. These contaminants have been reported to enhance endothelial dysfunction, oxidative stress, reactive oxygen species generation, apoptosis, and DNA damage, which are indirectly linked to NCDs. Methods (such as reverse osmosis, coagulation, flocculation, floatation, and sensor monitoring) could improve water quality and prevent NCDs risk. However, prompt preventive measures at domestic, industrial, and governmental levels are required for cost-effective NCDs prevention. Extensive in vitro research, cohort studies, toxicological evaluations, and multidisciplinary cooperation are also needed to clarify the interconnections between water quality and NCDs.