Health Risk Associated with Some Trace and Some Heavy Metals Content of Harvested Rainwater in Yatta Area, Palestine

Round 1

Reviewer 1 Report

Please see attached file for reference comments.

Comments for author File: Comments.pdf

Author Response

Many thanks for your valuable comments. I am sure your comments improved the manuscript and we agree with all of your comments. Please find the answers for the comments and some of the comments have been added to the manuscript.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear Authors

Please see attached.

The paper presents results from rainwater harvesting cisterns in 5 areas in Palestine. Unfortunately, the paper does not use "heavy metals" in their analyses which lets the whole paper down. A bit like making a mistake at the start and carrying it through to the end. I encourage you to re-do the water analyses if possible and correctly use heavy metals of significance such as Pb, Hg, Se, Cr, Zn, As, etc.......as used by most of the researchers you cite in your references. There are some extremely vague extrapolations between toxicity and human health which I feel are alarmist based on the results presented.

I am more than happy to expand on the comments provided if required and I encourage the authors to undertake further research in this important field.

Comments for author File: Comments.pdf

Author Response

Dear Respected reviewer

We are really apreciated the task and efforts you put in reviewing our manuscript, You added a very excellent comments to our manuscript and we agree with all of your comments. Please find the attached reply.

Thanks

Author Response File: Author Response.docx

Reviewer 3 Report

Major Comments:

1.) This paper excluded heavy metals such as Mercury (Hg), Arsenic (As) and Lead (Pb). Could the authors please provide a reason for excluding them?

2.) Generally, what were the criteria used in the selection of heavy metals for this analysis? I suggest to explicitly mention this in the introduction/methods section.

3.) Section 3.1: "It is clear that AL in Al-Hila and Khallet Salih’s cisterns samples were above the WHO 259 and Palestinian standards, but that Al was within the Palestinian limit in the Yatta center." What are the possible reasons?

4.) Section 3.1: It would be helpful to provide possible hypotheses/explanations for the high levels of K and Al in the samples.

5.) Conclusions: "Based on the conclusion of this study, efforts should therefore be made by local authorities to 452 eliminate the risks by applying technical and non-technical control measurements."

If possible, a very brief list of suggestions (what steps could be taken) by the authors to the local authorities would be valuable.

Minor Comments:

Line 53: These various sources of water 

Line 59: The risk of exposure

Author Response

Many thanks for your efforts and valuable comments. Your comments improved the manuscript a lot and we agreed with your comments. Please find the attached report.

Thanks

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

Dear authors, all changes have been made but I still have one (last) major concern over this paper.

The paragraph starting at Line 465 in the conclusion is very mis-leading.....your results seem to imply that any value over a guideline standard is carcinogenic. This is simply untrue. I have never read of any health issue where Na, Mg, Ba, K, Ca, Fe, and Sr have caused cancer in the concentrations presented; and your interpretation is based on extrapolations using CDI (meaning someone has to have a high daily intake of this water alone). In Australia, we consider many of these as aesthetic issues (taste, colour, odour) with water, and typically any water with a TDS > 1000 mg/L will more than likely be unsuitable for drinking without treatment. The results presented are below this threshold.

You have mentioned Li and Al in the previous paragraph, and again, Li is a component in some pharmaceuticals (bipolar manic depression drugs) and Al is more related to dementia/Parkinson's disease.

https://esemag.com/archive/0197/facts.html

If there is not a case of either Li or Al causing cancer then your results cannot justify an increased risk of cancer.

My recommendation is to replace the "increased cancer risk" paragraph (starting at Line 465) with the actual known health effects of the analysed elements that were statistically significant; namely Li and Al. For example, "Al concentrations reported in this study indicate a potential increased risk of dementia/Parkinson's disease if this is the only source of water available". A similar line can be used for Li. For example, "Li concentrations reported in this study indicate a potential increased risk of toxicity (causing diarhea, vomiting, stomach pains, muscle weakness and other symptoms) if this is the only source of water available".

Author Response

Dear Reviewer

We appreciate your valuable comments and we agree of what you suggested. I went to the website you recommended and I took the entire comments. The corrections were done in red. The new paragraph in conclusion looks like"

This study revealed the following elements: Na, Mg, Al, Ba, K, Ca, Fe, and Sr were elevated for both adults and children (> 10⁻⁶), through the ingestion of rainwater harvesting cisterns used for drinking. However, this does not imply that they pose a carcinogenic risk due to their concentrations alone. Al concentrations reported in this study do indicate a potential increased risk for dementia/Parkinson's disease, if it is obtained solely from the aforementioned source of water. Furthermore, Li concentrations reported in this study also indicate a potential increased risk of toxicity (causing diarrhea, vomiting, stomach pains, muscle weakness and other symptoms), again if this is the only source of water available to the population of concern. The rest of the selected heavy metals were within the acceptable limit in the five different localities in the study area. These findings make a substantial contribution to perception of the linkage of the contamination of rainwater harvesting cisterns used for drinking and their direct collaboration with public health in the context of major anthropogenic activities in the Yatta area. Through this conclusion, we could predict that the levels of contaminants in the drinking water increases the risk for local residents in developing cancer, especially children.

Again Many thanks.