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We wish to thank Fewtrell, Majuru, and Hunter for their article highlighting genotoxic risks associated with the use of particulate silver for primary drinking water treatment. The recent promotion of colloidal silver products for household water treatment in developing countries is problematic due to previously identified concerns regarding manufacturing quality and questionable advertising practices, as well as the low efficiency of silver nanoparticles to treat bacteria, viruses, and protozoa in source waters. However, in the conclusion statement of the manuscript, Fewtrell  et al.  state, “Before colloidal Ag or AgNP are used in filter matrices for drinking water treatment, consideration needs to be given to how much silver is likely to be released from the matrix during the life of the filter.” Unfortunately, it appears Fewtrell  et al.  were unaware that studies of silver nanoparticle and silver ion elution from ceramic filters manufactured and used in developing countries have already been completed. These existing studies have found that: 1) silver ions, not silver nanoparticles, are eluted from ceramic filters treated with silver nanoparticles or silver nitrate; and, 2) silver ions have not been shown to be genotoxic. Thus, the existing recommendation of applying silver nanoparticles to ceramic filters to prevent biofilm formation within the filter and improve microbiological efficacy should still be adhered to, as there is no identified risk to people who drink water from ceramic filters treated with silver nanoparticles or silver nitrate. We note that efforts should continue to minimize exposure to silver nanoparticles (and silica) to employees in ceramic filter factories in collaboration with the organizations that provide technical assistance to ceramic filter factories.

Comment on “A re-assessment of the safety of silver in household water treatment: rapid systematic review of mammalian in vivo genotoxicity studies”