Balneotherapy using thermal mineral water baths and dermatological diseases: a systematic review.

Balneotherapy includes practices and methods using medically and legally recognized mineral-medicinal waters, muds and natural gases from natural springs for therapeutic purposes. One of the most widely used method in balneotherapy is bathing with thermal mineral water. In the course of the years, scientific community has produced an increasing number of evidences that this practice is an effective method for treating signs and symptoms of several pathologies such as rheumatic, cardiovascular and dermatological diseases. This systematic review is aimed at evaluating the effect of balneotherapy with thermal water baths as a treatment to manage signs and symptoms of patients affected by all types of dermatological diseases. The systematic review was conducted according to the PRISMA Statement, and its protocol was registered on PROSPERO platform (CRD42022295913). The research was performed on the databases Pubmed, Scopus, Web of Science and Cochrane. We included clinical trials evaluating the effects of balneotherapy using thermal mineral water baths for managing dermatological diseases in humans, published in English and Italian language. Eight studies were included, seven of them enrolled adults affected by psoriasis and one studied atopic dermatitis patients. The common result of all the articles included was a clear improvement of signs and symptoms of psoriasis and eczematous diseases after use of thermal mineral water baths. These effects seem to be strictly related to physical and chemical properties of thermal water used for balneotherapy. However, studies in this field are still limited to support robust evidence of the effectiveness of balneotherapy using thermal mineral water baths and often their quality is low. Thus, new clinical studies need to be carried out, using more correct methods for conducting the studies and for processing statistical data.

Assessing health risks in bottled water: chemical compounds and their impact on human health.

Bottled mineral and spring water constitute one of the main sources of drinking water. Relevant legal acts in each country individually regulate the highest permitted concentrations of harmful substances in these waters. However, current regulations do not take into account newly emerging contaminants such as BPA. Analysis of the chemical composition of 72 bottled waters from the Polish market showed that undesirable elements occur in quantities that do not exceed the maximum permissible concentrations. Special attention should be paid to bottled therapeutic water, which may contain elevated concentrations of some micronutrients, such as Al, B, Ba, Fe, Mn, or Sr contributing to the pattern of health risk with excessive consumption of this type of water. The presence of BPA was confirmed in 25 tested waters. The calculated hazard index values showed that the most exposed group are children up to 12 years of age. The greatest attention should be paid to waters with high mineralisation, for which the calculated risk values are the highest.

Evaluating boron levels in Turkish mineral waters: a comparative study of three analytical techniques.

Turkey is abundant in natural mineral water sources, thanks to its location on the Alpine-Himalayan belt. Natural mineral water is drinking water characterized by its natural mineral, trace elements, and carbon dioxide content. Because of quite insufficient data, the boron content in bottled natural mineral waters in Turkey was analyzed by three different methods and compared: inductively coupled plasma mass spectrometry technique, carminic acid, and azomethine-H methods, in this study. The boron levels in mineral waters ranged from a minimum of 0.05 mg/L to a maximum of 8.61 mg/L. It was also safe by the upper limit level estimated by the World Health Organisation. As boron plays a beneficial role in human physiology, consuming natural mineral water may offer a positive contribution to public health by supporting boron intake in our country. The other outcome of our research was that the spectrophotometric carminic acid method can yield results similar to those obtained using the inductively coupled plasma mass spectrometry technique since the boron level of Turkish mineral water was within the limits level of the carminic acid method. However, the result of the azomethine-H method was found not to be suitable. Cross-sensitivity with other elements in mineral water might have caused this.

Assessment of barium diffusion from therapeutic mud wrapped in micro-perforated polyethylene bags towards the human organism.

Barium is present within the clay-derived therapeutic mud packs deposed on the patient's skin for treating some rheumatologic conditions. We studied in twenty-four young healthy volunteers the diffusion of Ba from mud wrapped in micro-perforated polyethylene bags and soaked in mineral water. No significant systematic increase in plasma or urine Ba levels was evidenced when comparing pre- and post-treatment samples using inductively-coupled plasma mass spectrometry. These levels were markedly inferior to the recommended thresholds in nearly all the participants. Noticeably variability in blood and especially urine Ba concentrations was large and mainly explained by environmental exposure (alimentation). Interestingly, we evidenced an intense Ba accumulation within the therapeutic mud at the end of the regimen. Because we chose a clay with one of the highest Ba content available in France for medical therapy and participants with an optimal transcutaneous diffusion capacity (young individuals with low-fat mass), we conclude unambiguously that there is no risk of Ba overexposure in patients receiving pelotherapy according to the procedure used in French medical spas.

Potentially toxic element contamination and health risk assessment in bottled mineral waters consumed in Turkey.

This study aimed to evaluate the human health risk posed by potentially toxic elements (PTEs) in 59 bottled mineral water (BMW) samples of 25 different brands marketed in Turkey. The concentrations of Ag, Al, As, Cd, Cr, Co, Cu, Fe, Mn, Ni, and Pb in the BMW samples were analyzed using an ICP-OES and compared with maximum allowable concentrations (MACs). A higher concentration of As than MAC was detected in five BMW samples. The concentrations of Cd, Pb, Cr, Ni, and Al in the majority of BMW samples are higher than the MACs. The human health risk was evaluated for adults estimating non-carcinogenic risk index (HI), incremental lifetime cancer risk (ILCR) and total cancer risk (TCR). All HI values estimated for PTEs in BMW samples are less than one, except for one sample. ILCR values for Cd in approximately half of the BMW samples are above the upper limit.

Measurement of radium and radon gas in bottled mineral waters.

In this study, the radon gas and radium concentration in the bottled mineral water samples was measured. A total of sixty samples were collected from bottled mineral water sold in the markets in Kahramanmaras. DURRIDGE Rad7 electronic radon detector was used for measurements. Radon and radium activity amounts range from 33.50 ± 1.30 mBq/L to 51.70 ± 2.20 mBq/L, and 2.92 ± 0.15 mBq/L to 4.51 ± 0.26 mBq/L, respectively. Average radon and radium active amounts are 41.67 ± 1.54 mBq/L and 3.63 ± 0.18 mBq/L, respectively. Total annual effective dose values were calculated for these mineral waters according to three different scenarios. In the first of these, it was assumed that natural mineral water was consumed annually instead of 730 L of drinking water (S1). In the second case, 150 L which was the annual average amount of natural mineral water consumed in European Union member countries was used for the annual average amount of natural mineral water consumed by adults (S2). Finally, the annual average amount of natural mineral water consumed in Turkey, 14 L, was used for adults (S3). For scenarios (S1, S2, S3), the total (ingestion + inhalation) annual average dose values ranged from 6.83E-04 mSv/y to 1.05E-03 mSv/y, 1.40E-04 mSv/y to 2.17E-04, and 1.32E-05 mSv/y to 2.03E-05 mSv/y, their average values were 8.49E-04 mSv/y, 1.75E-04 mSv/y, and 1.64E-05 mSv/y, respectively. The total effective dose values calculated within the scope of the current study were below the limit value announced by WHO.

A microscopic survey on microplastics in beverages: the case of beer, mineral water and tea.

It has been reported that microplastics exist ubiquitously in aquatic and terrestrial environments. Microplastic surveys on diverse daily foods with high consumption possibly containing microplastics have essential implications in clarifying the contamination routes, health risk assessment, and thereby preventing food pollution. Given the dependence of microplastic pollution on the regional environment, production and transportation, it further remains an open question on the number, size distribution and type of microplastics in foods from different countries worldwide. Here, we show that daily drinks produced worldwide, including beer, mineral water and tea, are all polluted with microplastics without exception. The number of microplastics investigated in this work lies in the range of 20-80 mL-1 for the beers, 10 mL-1 for the bottled mineral water, and 200-500 g-1 for the tea leaves. Quasi-spherical particles and irregular fragments dominate the shape of microplastics in beer and mineral water, whereas tea leaves carry numerous microplastic fibers. By identification through Raman spectroscopy, we observed the presence of polystyrene (PS) and polypropylene (PP) microplastics in beers, PP in bottled mineral water, and polyethylene (PE) and polyethylene terephthalate (PET) in tea leaves. Possible contamination sources include raw materials, atmosphere, and tools and containers that release microplastics. Given the facile adsorption of heavy metals and antibiotics to microplastics in beverages, public concern may arise regarding the accumulation of microplastics through the food chain and their synergetic harmful effect. Thus, our results should inspire further efforts that may contribute to the elimination and removal of microplastics from foods.

Geochemistry and therapeutic properties of Caucasian mineral waters: a review.

The Caucasian mineral water (CMW) region is a unique area where mineral waters differ by their chemical composition and balneological properties. The presence of a wide range of mineral waters with various ions and gas components and different genesis and their therapeutic properties in the restricted area is explained by complicated geological and tectonic settings. The dominant type of mineral water in the CMW region is CO2-bearing water with H2SiO3 and H3BO3 as the specific components. According to ion composition, gas phases' content into groundwater, total dissolved solids, and balneological characteristics, we would distinguish 9 groups and 16 types of these mineral waters, with each water type being of particular therapeutic interest. The CMW region includes four spa cities with a different therapeutic profile: Zheleznovodsk, Kislovodsk, Pyatigorsk, and Essentuki. Spa treatment is based on the use of different types of mineral waters, therapeutic muds within the region's diverse landscapes, and climatic conditions. Mineral waters are utilized in the form of baths, swimming pools, showers, various irrigations, inhalation, as well as drinking therapy. Therapeutic mineral waters are used to treat gastrointestinal problems, metabolic and nervous system disorders, as well as various diseases of liver, kidney, urinary tract, circulatory system, respiratory organs, and skin.

Geochemical characterisation of the thermo-mineral waters of Greece.

Geothermal areas of Greece are located in regions affected by recent volcanism and in continental basins characterised by elevated heat flow. Many of them are found along the coast, and thus, water is often saline due to marine intrusion. In the current study, we present about 300 unpublished and literature data from thermal and cold mineral waters collected along Greece. Samples were analysed for major ions, Li, SiO2 and isotopes in water. Measured temperatures range from 6.5 to 98 °C, pH from 1.96 to 11.98, while Total Dissolved Solutes (TDS) from 0.22 to 51 g/L. Waters were subdivided into four main groups: (1) thermal; (2) cold; (3) acidic (pH < 5); and (4) hyperalkaline (pH > 11). On statistical basis, thermal waters were subdivided into subgroups according to both their temperature [warm (< 29 °C), hypothermal (29-48 °C), thermal (48-75 °C) and hyperthermal (> 75 °C)] and TDS [low salinity (< 4 g/L), brackish (4-30 g/L) and saline (> 30 g/L)]. Cold waters were subdivided based on their pCO2 [low (< 0.05 atm), medium (0.05-0.85 atm) and high (> 0.85 atm)]. δ18O-H2O ranges from - 12.7 to + 2.7‰ versus SMOW, while δ2H-H2O from - 91 to + 12‰ versus SMOW being generally comprised between the Global Meteoric Water Line and the East Mediterranean Meteoric Water Line. Positive δ18O shifts with respect to the former are mostly related to mixing with seawater, while only for a few samples these shifts point to high-temperature water-rock interaction processes. Only a few thermal waters gave reliable geothermometric estimates, suggesting reservoir temperatures between 80 and 260 °C.

Hydrochemical, isotopic and microbiota characterization of telese mineral waters (Southern Italy).

The study deals with the analyses of springs and wells at the base of Montepugliano Hill that represents the SE edge of the wide carbonate Matese massif (Campania, southern Italy). At the base of the hill, from west to east and for almost one kilometre, cold springs HCO3-Ca type (Grassano springs, ~ 4.5 m3/s; TDS: about 0.45 g/L) pass to hypothermal, HCO3-Ca type, sulphurous and CO2-rich springs (~ 1 m3/s with TDS > 1 g/L). Some of the latter are widely used in Telese Spa and Centro Relax Spa. Chemical and isotopic analyses carried out for this study support the hypothesis that all these waters (mineral and non-mineral) have the same catchment area, which is located in the Matese massif. As regards the sulphurous springs, they receive both meteoric waters infiltration and uprising of deeper waters rich in endogenous CO2 and H2S gases through important faults systems. Far from these faults, the chemistry of groundwater is scarcely (or not at all) affected by these deep fluid enrichment processes. This scheme is very significant; in fact, when very important groundwater resources are present, it is possible to use both mineral waters in Spa and, in areas far from the faults, those not yet mineralized. Finally, at Montepugliano Hill, in the final stage of the flow path, groundwater is also affected by change in the microbiome: this could provide a basis for comparison between various mineral waters.

Understanding the processes in a historically relevant thermal and mineral spring water by using mixing and inverse geochemical models.

The thermal mineral water of Peñón de los Baños spa (Mexico City) has been used for over 500 years starting in pre-Hispanic times and is famous for the treatment of various pathologies. It has a temperature of 45 °C, which is rich in HCO3-, and its main trace elements are B, Li and Fe, which confers healing effects. Concerns about the sustainability of this important spa have motivated this study to understand the thermal system, possible hydraulic and hydrochemical changes over time and its implications. Stable water isotope data indicate that the thermal water sources originate from local precipitation at Sierra de las Cruces with a recharge elevation of approximately 2770 m above sea level. The recharged water percolates through volcanic and carbonate rock formations and ascends via fault structure conduits, where it eventually is extracted 25 km downstream in Peñon de los Baños. During the gravity-driven deep circulation of up to 4.9 km, the groundwater is heated up to 136-160 °C. A comparison of past and current water levels and water chemical analyses indicates a water table drop and few variations in the chemical composition, confirming the presence of anthropic impact on water quality. Due to the heavy groundwater extractions in Mexico City, the spring water flow has ceased, and water must be pumped now from a 203-m deep well. In addition, the concentration of bicarbonate, sodium and chloride has been reduced by half since the onset of groundwater development. The therapeutic effects of this thermal mineral water are at risk due to the alteration of the chemical signature. However, new and different therapeutical uses may prevent a future deterioration or closure of this historically important thermal spa. It is crucial to establish a monitoring program of the thermal mineral water and reducing or minimizing nearby urban extractions which tap the regional flow component to preserve the properties of the thermal water.

Hydrochemical and radiometric evaluation of fresh and thermal waters from Araxá city (Minas Gerais, Brazil).

This paper reports the hydrochemistry and activity concentration of the natural radionuclides 238U, 234U, and 210Po for three compartments of the hydrological/hydrogeological system in Araxá city, Minas Gerais State, Brazil: 1) mineral waters from the prominent springs Dona Beja (DBS) and Andrade Júnior (AJS), occurring at Barreiro area; 2) surface waters from Barreiro area and vicinity; and 3) rainwater. According to the Rule for Mineral Waters in Brazil (Register 7841) for temperature, the DBS water is cold (< 25 °C), while AJS is hypothermal (25-33 °C). The TDS (Total Dissolved Solids) concentration of DBS is low (70 mg/L), but high in AJS (2898 mg/L). The hydrogeochemical facies corresponded to sodium-(bi)carbonate for AJS and sodium/potassium-bicarbonate for DBS. The hydrochemical differences of DBS and AJS waters reflect the distinct characteristics of their respective aquifer systems. The DBS classification for TDS is the same of the Barreiro basin surface waters (mean TDS = 102 mg/L). Such value is somewhat higher than that of the rainwater and surface waters used for human consumption at Araxá city (TDS < 50 mg/L). The dataset reported in this paper indicated that fluoride and barium exceeded the WHO limits proposed in 2011 for drinking water. Among the natural radionuclides analyzed here that offer potential hazards for the human health is 210Po, whose WHO's limiting value of 100 mBq/L in drinking water was exceeded in rainwater, thus, restricting the use of this resource as a possible supply of drinking water for the local community.

[Drinking mineral waters: problematic issues and prospects of use in treatment and rehabilitation]. / Pit'evye mineral'nye vody: problemnye voprosy i perspektivy ispol'zovaniya v lechenii i reabilitatsii.

The article is devoted to the use of drinking mineral waters in the treatment and rehabilitation of patients with various pathologies. The results of numerous studies carried out in previous years have proven the ability of mineral waters to positively influence the functional state of the digestive system, eliminate various metabolic disorders, and affect the processes of hormonal and immune regulation. However, due to the current lack of educational programs for the training of doctors at medical universities, as well as further training in the basics of balneology, medical workers often encounter difficulties in determining the most suitable schemes for the use of mineral waters for a specific pathology. It is known that today there are quite a lot of bottled waters on the market that do not have a healing effect, but are quite suitable for use as table waters. The latter circumstance, combined with not always correct information about the real healing properties of waters, creates certain difficulties even for doctors. In addition, there is a need for a certain clarification of the methods of prescribing mineral waters, taking into account the magnitude of mineralization, the main cation-anionic composition, the nature of the disease and the phase of its course. Taking into account the fact that drinking mineral waters are actively used in the treatment of many diseases, including in children and the elderly, the task of fully and competently informing doctors of different specialties, and with their help, patients, about the features of specific mineral waters available in different regions of the Russian Federation, their unique capabilities, optimal methods of therapeutic use.

[The potential of using the underground mineral waters of the Moscow region in the organization of medical rehabilitation and medical tourism]. / Potentsial ispol'zovaniya podzemnykh mineral'nykh vod Moskovskogo regiona v organizatsii meditsinskoi reabilitatsii i lechebnogo turizma.

Moscow in modern borders is the largest metropolitan area in the country with a fairly high and unevenly distributed population density. This predetermines the need to address environmental regulation of urbanization in order to create the most comfortable living conditions for the population. Health care and the maintenance of health of all age groups are the leading role in the list of the most important tasks to ensure the social well-being of citizens. In the bowels of the Moscow region there are natural therapeutic resources: low-mineralized (M 3-5 g/l) sulfate sodium-magnesium-calcium drinking mineral water and chloride sodium bromine brine. The article presents the characteristics of the natural therapeutic resources of the Moscow region, the area of their therapeutic use, justified the possibility of wider use based on the available scientific data on the effect on the body of these waters and their analogues. All this provides an opportunity to achieve the main goal of medical resortology - the use of mineral water as a means of therapy, rehabilitation and prevention of most existing human diseases.

Which Type of Water Is Recommended for Patients with Stone Disease (Hard or Soft Water, Tap or Bottled Water): Evidence from a Systematic Review over the Last 3 Decades.

PURPOSE OF REVIEW: The role of the mineral constituents in water and their role in kidney stone disease (KSD) have been a long-standing subject of debate. The aim of our systematic review was to evaluate the relevance of different types of water in stone disease. RECENT FINDINGS: Studies to date have had varying results regarding the importance of hardness of water which is mostly determined by its calcium content. Other elements including magnesium and bicarbonate also play a crucial role in prevention of renal stones. Patients with stone disease are provided varying advice due to a lack of consensus on the types of water recommended. Increased fluid intake prevents stone formation. Our review of the literature suggests that hard water and bottled mineral water might be helpful for calcium stone formers. High calcium content in them leads to hypercalciuria; however, other factors also influence stone formation and the overall impact seems to be a reduction in calcium stone formation. The mineral content varies across different water types but high magnesium and bicarbonate content in water is also recommended for kidney stone patients.

Detecting Traces of 17α-Ethinylestradiol in Complex Water Matrices.

Hormones have a harmful impact on the environment and their detection in water bodies is an urgent matter. In this work, we present and analyze a sensor device able to detect traces of the synthetic hormone 17α-ethinylestradiol (EE2) below 10-9 M in media of different complexities, namely, ultrapure, mineral and tap waters. This device consists of solid supports with interdigitated electrodes without and with a polyethylenimine (PEI) and poly (sodium 4-styrenesulfonate) (PSS) layer-by-layer film deposited on it. Device response was evaluated through capacitance, loss tangent and electric modulus spectra and the data were analyzed by principal component analysis method. While the three types of spectra were demonstrated to be able to clearly discriminate the different media, loss tangent spectra allow for the detection of EE2 concentration, with a sensitivity of -0.072 ± 0.009 and -0.44 ± 0.03 per decade of concentration, for mineral and tap water, respectively. Detection limits values were found to be lower than the ones present in the literature and presenting values of 8.6 fM (2.6 pg/L) and of 7.5 fM (22.2 pg/L) for tap and mineral waters, respectively. Moreover, the obtained response values follow the same behavior with EE2 concentration in any medium, meaning that loss tangent spectra allow the quantification of EE2 concentration in aqueous complex matrices.

The Use of Different Commercial Mineral Water Brands to Produce Oil-In-Water Nanoemulsions.

Nanoemulsions are submicron-size colloidal systems that have the ability to encapsulate, protect, and deliver active ingredients. They have been used in the pharmaceutical, cosmetics, and food industries to improve the absorption of drugs by the skin or via the gastrointestinal tract, aide in food conservation, and treat skin problems. To proper formulate a nanoemulsion, it is important to know the characteristics of its components (aqueous and oil phases, surfactants and additives), as well as the influence on the production method that will be used. This study investigates the influence of aqueous phase composition, stability and particle size in an oil-and-water nanoemulsion formation. By using a low energy method, the purified water was exchanged for different commercial mineral water and saline solutions, and the results of stability, particle size, pH and conductivity tests, were compared. These results show that the minerals present in commercial waters may alter the particle size, pH and conductivity values of nanoemulsions, as well as their stability.

Short- and long-term beneficial effects of medicinal mineral water administration.

Medicinal mineral water, being provided by recognized immunosuppressive properties, results useful for treating many pathological conditions. A well-known source of sulfurous and oligomer medicinal mineral waters is located in Caramanico Terme (Pescara, Italy). Caramanico Terme is a small town in the Majella's National Park, and its precious and peculiar environment offers a medicinal mineral water (also known as cures or crenotherapy), that since 1576 is administrated to a large number of patients (around 15,000 per year). However, no scientific conclusions on the efficacy of Caramanico's Terme medicinal mineral water properties are available. Therefore, we have carried out an epidemiological study, enrolling a population of 370 subjects that have received crenotherapy. Such a population has been also compared to a control group of individuals (untreated, N = 287), never undergone any medicinal mineral water administration. Detailing the geomorphological characteristics of Caramanico Terme environment, we have also analyzed the results of the study that showed that pathology-relapses, as well as related manifestations of symptoms and drug employments, were largely reduced after one or more cycles of crenotherapy. On the other hand, a sub-group of subjects receiving crenotherapy for more than 5 years (N = 166) presented a highly reduced prevalence of a large spectrum of pathologies (cardiovascular, inflammatory, neurological and cancer diseases), with respect to an overlapping population (in terms of age and genders) of untreated subjects. We have also clarified the role of aging and long-term effects of medicinal mineral-water administration. Altogether, these data indicated that the clinical employment of Caramanico's Terme medicinal mineral water produces short- as well as long-term beneficial effects, both with respect to the amelioration of life quality of patients and in reducing the probability to develop major disabling pathologies (i.e., cardiovascular, cancer and neurological diseases). Therefore, these data will open novel strategies for a larger application of crenotherapy.

Chemical signature and antimicrobial activity of Central Portuguese Natural Mineral Waters against selected skin pathogens.

The common therapeutic indications of Portuguese Natural Mineral Waters (NMWs) are primarily for respiratory, rheumatic and musculoskeletal systems. However, these NMWs have been increasingly sought for dermatologic purposes. Opposing to what is observed in the major European Thermal Centres, there are few scientific evidences supporting the use of Portuguese NMWs for clinical applications. The aim of this study was to characterize the antimicrobial profile of individual NMWs from the central region of Portugal and correlate the results with their physicochemical characterization. An extensive multivariate analysis (principal component analysis) was also performed to further investigate this possible correlation. Six collection strains representing skin microbiota, namely Staphylococcus aureus, Escherichia coli, Corynebacterium amycolatum, Candida albicans, Staphylococcus epidermidis and Cutibacterium acnes, were analysed, and their antimicrobial profile was determined using Clinical and Laboratory Standards Institute M07-A10, M45-A2, M11-A6 and M27-A3 microdilution methods. Different NMWs presented different antimicrobial profiles against the strains used; the physicochemical composition of NMWs seemed to be correlated with the different susceptibility profiles. Cutibacterium acnes showed a particularly high susceptibility to all NMWs belonging sulphurous/bicarbonated/sodic ionic profile, exhibiting microbial reductions up to 65%. However, due to the complex physicochemical composition of each water an overall conclusion regarding the effect of a specific ion on the growth of different microorganisms is yet to be known.

[Surveillance of Chromium (VI) Concentrations in Mineral Water Products in 2018].

We used ion chromatography with post column derivatization to measure chromium (VI) concentrations in 155 mineral water (MW) products purchased from markets in Japan in 2018. Chromium (VI) recovery in spiked samples of the 155 MW products ranged from 95 to 106%, suggesting that this method is well suited for ensuring that MW products meet the requisite health and food safety standards. Chromium (VI) levels were above detection limits in 54 of the MW products, giving a total detection rate of 35%. The minimum and maximum chromium (VI) concentrations in all of the MW products were 0.0001 mg/L and 0.045 mg/L, respectively. The median chromium (VI) concentration was 0.0003 mg/L, with most MW products having chromium (VI) concentrations in the range of 0.0001 to 0.0002 mg/L. None of the MW products had chromium (VI) concentrations that exceeded the current standard value (0.05 mg/L) for MW in Japan.