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USP states "Microbes in water systems can be detected as exampled in this section or by methods adapted from Microbial Enumeration Tests and Tests for Specified Microorganisms or the current edition of Standard Methods for the Examination of Water and Wastewater by the American Public Health Association." This article provides background and guidance for maintaining high purity water systems from a microbiological aspect: System design System validation Microbial limits Water for injection systems Still Heat exchangers Holding tank Pumps Piping Reverse osmosis Purified water systems System design The type of water The temperature of the system Whether the system is circulating or one way The risk assessment or the quality that is desired System validation Description of the system

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Variations in detoxification enzymes, DNA repair pathways, and immune regulation influence how individuals metabolize and respond to carcinogens [264]

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