Potential health effects of nitrates in drinking water depend on how much nitrate a person is exposed to, how long they were exposed, their age, and pre-existing health conditions. The level of nitrates most people are exposed to would not cause adverse health effects.
An elevated level of nitrate in drinking water is primarily a health concern for bottle-fed infants less than six months of age who have not yet developed the ability to properly digest nitrates. This can lead to a rare but very serious condition called methemoglobinemia or blue-baby syndrome. The inability to digest nitrate leads to the production of nitrite which affects the amount of oxygen carried in the blood, resulting in a bluish skin colour. If the level of nitrate in your water is above 10mg/L, you should use a different water supply to prepare baby formula and food or use ready-to-use formula. Breastmilk is not affected by nitrates and is considered safe.
Nitrates have also been classified as a possible carcinogen by the International Agency for Research on Cancer (IARC) if they undergo changes in the body that result in the formation of N-nitroso compounds. The extent to which this reaction occurs in the body is influenced by long-term consumption of high levels of nitrates in exceedance of the drinking water guidelines and diet. Research continues to explore the effects associated with long-term consumption of nitrates and some cancers.