Groundwater Chemistry and Blood Pressure: A Cross-Sectional Study in Bangladesh

• Type of Material: Article
• Authors: Abu Mohd Naser, Emory University; Thomas Clasen, Emory University; Stephen P. Luby, Stanford University; Mahbubur Rahman, International Centre for Diarrhoeal Disease Research; Leanne Unicomb, International Centre for Diarrhoeal Disease Research; Kazi M. Ahmed, University of Dhaka; Solaiman Doza, International Centre for Diarrhoeal Disease Research; Shadassa Ourshalimian, Emory University; Howard Chang, Emory University; Jennifer D. Stowell, Emory University; K.M. Venkat Narayan, Emory University; Mohammad Shamsudduha, University College London; Shivani Patel, Emory University; Bethany O'Shea, University of San Diego; Matthew Gribble, Emory University
• Language: English
• Date: 2019-07-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijerph16132289
• Title of Journal or Parent Work: International Journal of Environmental Research and Public Health
• ISSN: 1661-7827
• Volume: 16
• Issue: 13
• Grant/Funding Information: This article published with support from Emory Libraries' Open Access Publishing Fund.; A.M. Naser’s effort on the analyses was supported by a grant from Unilever Ltd.
• Keywords: groundwater; ASSOCIATION; exposure mixtures; Environmental Sciences & Ecology; medical geology; Public, Environmental & Occupational Health; NUTRITION; Life Sciences & Biomedicine; Environmental Sciences; HEALS; DRINKING-WATER; TEMPORAL VARIABILITY; blood pressure; POTASSIUM; Science & Technology; CALCIUM; chemical mixtures; SODIUM; exposure combinations; DISEASE; MAGNESIUM
• Research Categories: Biology, Biostatistics; Health Sciences, Public Health

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.