Fluoride in Bottled Waters Consumed in Northeastern Brazil

ABSTRACT Objective: To assess the fluoride concentration of bottled waters from municipalities in northeastern Brazil. Material and Methods: Bottled mineral waters were purchased in two periods at different commercial places of four large municipalities (João Pessoa, Campina Grande, Patos, and Cajazeiras) in the Paraíba state. The municipalities selected to present the following annual average temperature: João Pessoa 26.5 °C, Campina Grande 23.3 °C, Patos and Cajazeiras 27.5 °C. Fluoride concentration was determined using a combined ion-specific electrode. Readings (in mV) were conducted in triplicates for each standard solution and converted into fluoride concentration (mg F/L) using the Excel® software. Results: A total of 72 samples from six brands of bottled water were analyzed. The fluoride concentrations of all samples were low (0.11-0.21mg/L) but higher than those reported on the label and varied among different batches of the same brand. Conclusion: The fluoride levels in bottled water vary among brands, and these actual values are not stated in the labels.

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.

Transfer of Bisphenol A and Trace Metals from Plastic Packaging to Mineral Water in Ouagadougou, Burkina Faso.

The consumption of packaged water is growing rapidly in both urban and rural centres in Burkina Faso. Bisphenol A (BPA) and trace metals are among the compounds used in the manufacture of plastic packaging, and their presence in water can pose a health risk to consumers due to their alleged toxicity. Therefore, this study explores the transfer of these compounds from plastic packaging to mineral water in Sudano-Sahelian climatic conditions. Ten samples of packaged sachet water commercialised in Ouagadougou were studied. An absence of BPA in the borehole water used to produce packaged water has been shown. The transfer of BPA into mineral water increases with storage temperature. The BPA that appears in packaged water degrades over time. BPA concentrations ranged from 0 to 0.38 mg/L after two weeks of storage, 0 to 0.8 mg/L after four weeks of storage and 0 to 0.35 mg/L after 8 weeks of storage. Analysis of the trace metals showed steadily increasing concentrations from the second to the sixth weeks, with concentrations ranging from 0 to 9.7 µg/L for cadmium and from 0 to 0.13 mg/L for iron in the sachet water samples.

Lithium concentration in tap water, bottled mineral water, and Danube River water in Hungary.

Due to increased manufacture and recycling of lithium batteries across the world, we may anticipate a rise in lithium pollution in the aquatic environment and drinking water reservoirs. In order to investigate the current status regarding the lithium content in Hungarian tap waters, samples were collected from the public drinking water supply systems of 19 county seats in Hungary during seasonally selected times. Depending on the water sources, such as bank-filtrated river water, surface water from open reservoirs, and groundwater, the lithium concentrations varied between 0.90-4.23, 2.12-11.7 and 1.11-31.4 µg/L, respectively, while the median values were 3.52, 5.02 and 8.55 µg/L, respectively. The lithium concentration in the bottled Hungarian mineral waters was also determined since the daily intake of lithium can be influenced by the consumption of mineral waters. The concentrations ranged from 4.2 to 209 µg/L, while the median value was only 17.8 µg/L. Additionally, a correlation was only found between lithium and potassium concentrations. The lithium concentration was also assessed at ten sampling locations in the Hungarian segment of the Danube River since the Danube water is also a water source for additional drinking water utilities using bank filtration technology. The mean and median lithium concentrations were 2.78 and 2.64 µg/L, respectively.

Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review.

This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.

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.

Microplastic pollution and human risk assessment in Turkish bottled natural and mineral waters.

Microplastics (MPs), which arise from the deterioration of larger plastics that are frequently used in daily life and are smaller than 5 mm in size, are found in many environments and can pose a serious threat to human health. Humans ingest these microplastics unintendedly through drinking water. Although plastic pollution has been extensively investigated in a variety of water sources, research on MP contamination in bottled waters is scarce. Hence, in this study, the presence and distribution of MPs were investigated in 150 samples of bottled natural and mineral water brands in Türkiye. Using FTIR stereoscopy and stereomicroscope analysis, MPs were detected in 43 out of the 50 (86%) of these brands. Among the four types of polymers detected, the most abundant type was polyethylene (33%), polypropylene (31%), polyethylene terephthalate (25%), and polyamid (11%). In comparison to natural waters, mineral waters had larger average-sized particles (63.98 ± 4.06 vs. 104.83 ± 14.28 µm) and higher MP concentrations (4.6 ± 0.5 vs. 12.6 ± 1.6 particles/L). Although the most dominant shape was found as fiber in natural waters, fragments were more prevalent in mineral waters. The estimated daily intakes (EDI) for adults and children were expected to be 0.019 and 0.42 MP/kg/bw/day, respectively, in natural waters while EDI were 0.009 and 0.04 MP/kg/bw/day, respectively, in mineral waters. The results of the study suggest that the EDI and annual intake (EAI) are negligible when compared to other studies. The baseline data on MP contamination of bottled water provided in the present study may be significant and useful for researchers to have a better understanding of microplastic contamination exposure.

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.

Quantitative Assessment of Full Size Microplastics in Bottled and Tap Water Samples in Hong Kong.

Human exposure to microplastics (MPs) through drinking water has drawn serious concern recently because of the potential adverse health effects. Although there are reports on the occurrence of MPs in bottled water, little is known about the abundance of a whole spectrum of MPs with sizes ranging from 1 µm to 5 mm due to the restrictions of conventional MPs detection methods. Some studies using micro-Raman spectroscopy can achieve MPs with a size of <10 µm, however, quantitation of all MPs was extremely time consuming and only a small portion (<10%) of MPs would be analyzed. The present study quantified MPs from nine brands of bottled water using fluorescence microscopy and flow cytometry for MPs with a size of ≥50 µm and a size of <50 µm, respectively. The average abundance of MPs with a size of ≥50 µm in bottled water samples was found ranging from 8-50 particles L-1, while MPs with a size of <50 µm were found to be 1570-17,817 particles L-1, where the MPs abundance from mineral water samples were significantly more than distilled and spring water samples. The modal size and shape of MPs were found at 1 µm and fragments, respectively. Besides, three tap water samples obtained locally were analyzed and compared with the bottled water samples, where less MPs were found in tap water samples. In addition, contamination of MPs from bottle and cap and interference by addition of mineral salts were studied, where no significant difference from all these processes to the control sample was found, suggesting the major contamination of MPs was from other manufacturing processes. Estimated daily intake (EDI) of MPs increased substantially when data of small MPs are included, suggesting that previously reports on exposure of MPs from drinking water might be underestimated, as only large MPs were considered.

Perfluoroalkyl Substances (PFASs) in Rivers and Drinking Waters from Qingdao, China.

Perfluoroalkyl substances (PFASs) in rivers; drinking water sources (reservoirs and groundwater); and various types of drinking waters (tap waters, barreled pure waters, and bottled mineral waters) in Qingdao, Eastern China were quantified by high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS). The total concentrations of PFASs (ΣPFASs) in the river waters ranged from 28.3 to 292.2 ng/L, averaging 108 ± 70.7 ng/L. PFBS was the most abundant compound, with a maximum concentration of 256.8 ng/L, followed by PFOA (maximum concentration: 72.4 ng/L) and PFBA (maximum concentration: 41.6 ng/L). High levels of PFASs were found in rivers in the suburban and rural areas. The estimated annual mass loading of the total PFASs to Jiaozhou Bay (JZB) was 5.9 tons. The PFASs in the drinking water reservoirs were relatively low. The ΣPFASs in the tap water ranged from 20.5 ng/L to 29.9 ng/L. Differences in the PFAS levels and composition profiles were found among barreled water at different market sites and for different brands of mineral water products. The sequence of the contamination levels of the waters related to drinking water was reservoir water > tap water > barrel water > groundwater > bottled mineral water. The PFASs in drinking water may not pose a serious risk to the drinking water consumers of Qingdao City.

Are bottled mineral waters and groundwater for human supply different?

Increasingly, bottled natural mineral water (NMW) is proposed as a healthy and safe alternative to supply water. However, tap supply water often comes from aquifers (TGW), even from the same aquifers as NMW, sharing the exact formation mechanisms and mineralization processes. Therefore, it is hypothesized that NMW and TGW cannot be distinguished. The chemical composition of TGW and NMW samples in Spain has been compared using five criteria: expert judgment, hydrochemistry, legal regulations, statistical analysis, and machine learning (ML). Hydrochemical criteria included all the NMW samples in the TGW group, as did the legal criterion, whereas classical statistical analysis could not find significant differences between the two groups. Although experts could correctly differentiate a small subsample of both types of water with an accuracy of 0.67, ML-based classification with Extreme Gradient Boosting yielded a balanced accuracy of 0.92 on an extremely imbalanced data set. Shapley Additive Explanations (SHAP) analysis identified pH, SiO2, E, K+, Ca2+, K+/Na+ and NO3- as the most relevant variables for water type discrimination. The overall consistency and generalization ability of the ML classifier has been proven by the spatial distribution of hits and misses, where the few cases of indistinguishable waters seem to be related to proximity to nature reserves (i.e., land use) more than to geological characteristics. Therefore, it can be concluded that NMW and TGW are indeed different and that only ML could find the hidden structure in the chemical data that determines the differences. This structure originates in how the market and consumers decide which water is ultimately bottled. The results can help on future choices of TGW and NMW in a context of water scarcity.

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.

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.

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.

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.

[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.

Water Quality and Mortality from Coronary Artery Disease in Sardinia: A Geospatial Analysis.

The role of water hardness on human health is still debated, ranging from beneficial to harmful. Before the rise of drinking bottled water, it was a common habit to obtain supplies of drinking water directly from spring-fed public fountains. According to the geographic location, spring waters are characterized by a variable content of mineral components. In this ecological study, for the first time in Sardinia, Italy, the spatial association between spring water quality/composition and standardized mortality ratio (SMR) for coronary artery disease (CAD) in the decade from 1981 to 1991 was investigated using data retrieved from published databases. In a total of 377 municipalities, 9918 deaths due to CAD, including acute myocardial infarction (AMI), ICD-9 code 410, and ischemic heart disease (IHD), ICD-9 code 411-414, were retrieved. A conditional autoregressive model with spatially structured random effects for each municipality was used. The average SMR for CAD in municipalities with a predominantly "soft" (<30 mg/L) or "hard" (≥30 mg/L) water was, respectively, 121.4 ± 59.1 vs. 104.7 ± 38.2 (p = 0.025). More specifically, an inverse association was found between elevated calcium content in spring water and cardiovascular mortality (AMI: r = -0.123, p = 0.032; IHD: r = -0.146, p = 0.009) and borderline significance for magnesium (AMI: r = -0.131, p = 0.054; IHD: r = -0.138, p = 0.074) and bicarbonate (IHD: r = -0.126, p = 0.058), whereas weak positive correlations were detected for sodium and chloride. The lowest CAD mortality was observed in geographic areas (North-West: SMR 0.92; South-East: SMR 0.88), where calcium- and bicarbonate-rich mineral waters were consumed. Our results, within the limitation of an ecological study, confirm the beneficial role of waters with high content in calcium and bicarbonate against coronary artery disease.

Monitoring of Fluoride Content in Drinking Water by Ion Chromatography: A Case Study in the Suzhou Urban Area, China.

BACKGROUND: Both deficient and excessive intake of fluoride can lead to adverse health problems. OBJECTIVE: The aim of this study is to investigate the fluoride content in three types of drinking water in Suzhou urban area. METHOD: Ion chromatography was employed to conduct the validation of analysis of fluoride ion in water and the method was applied to analyze the concentration of fluoride in 22 drinking water samples, including tap water, purified water, and commercially available bottled water, collected from five municipal districts of Suzhou urban area. RESULTS: The method was validated in the range of 0.05-2.00 mg/L with good repeatability and accuracy. Results of water analysis indicated that fluoride content in tap water ranged from 0.267 to 0.336 mg/L (average 0.304 mg/L), and the levels of fluoride in purified water and bottled water were 0.068-0.317 mg/L (average 0.134 mg/L) and 0-0.120 mg/L (average 0.080 mg/L), respectively. CONCLUSIONS: The amount of fluoride in all samples analyzed were lower than the limit set for fluoride in drinking water according to the China standard (1.0 mg/L). Low fluoride exposure for the population in the studied area was observed, and the replacement of tap water with purified and bottled water could further aggravate the deficiency of fluoride intake for local residents. HIGHLIGHTS: The present study is the first to characterize the fluoride content in these three types of drinking water in Suzhou urban area by ion chromatography.