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Groundwater Chemistry and Blood Pressure: A Cross-Sectional Study in Bangladesh
Authors: Abu Mohd Naser, Thomas F. Clasen, Stephen P. Luby, Mahbubur Rahman, Leanne Unicomb, Kazi M. Ahmed, Solaiman Doza, Shadassa Ourshalimian, Howard H. Chang 6, Jennifer D. Stowell 1, K. M. Venkat Narayan 2, Mohammad Shamsudduha, Shivani A. Patel, Bethany O’Shea, and Matthew O. Gribble
Source: International Journal of Environmental Research and Public Health, 16(13): 2289; DOI: 10.3390/ijerph16132289
Topic(s): Blood pressure
Water supply
Water treatment
Country: Asia
Published: JUN 2019
Abstract: Background: We assessed the association of groundwater chemicals with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods: Blood pressure data for =35-year-olds were from the Bangladesh Demographic and Health Survey in 2011. Groundwater chemicals in 3534 well water samples from Bangladesh were measured by the British Geological Survey (BGS) in 1998–1999. Participants who reported groundwater as their primary source of drinking water were assigned chemical measures from the nearest BGS well. Survey-adjusted linear regression methods were used to assess the association of each groundwater chemical with the log-transformed blood pressure of the participants. Models were adjusted for age, sex, body mass index, smoking status, geographical region, household wealth, rural or urban residence, and educational attainment, and further adjusted for all other groundwater chemicals. Results: One standard deviation (SD) increase in groundwater magnesium was associated with a 0.992 (95% confidence interval (CI): 0.986, 0.998) geometric mean ratio (GMR) of SBP and a 0.991 (95% CI: 0.985, 0.996) GMR of DBP when adjusted for covariates except groundwater chemicals. When additionally adjusted for groundwater chemicals, one SD increase in groundwater magnesium was associated with a 0.984 (95% CI: 0.972, 0.997) GMR of SBP and a 0.990 (95% CI: 0.979, 1.000) GMR of DBP. However, associations were attenuated following Bonferroni-correction for multiple chemical comparisons in the full-adjusted model. Groundwater concentrations of calcium, potassium, silicon, sulfate, barium, zinc, manganese, and iron were not associated with SBP or DBP in the full-adjusted models. Conclusions: Groundwater magnesium had a weak association with lower SBP and DBP of the participants. Keywords: medical geology; groundwater; chemical mixtures; blood pressure; groundwater; exposure mixtures; exposure combinations