-------
pressure medication and have lived greater than 10 years or 10 years and
less in the community, (4) males and females who do not have definite hyper-
tension, nor are taking high blood pressure medication, and have lived
greater than 10 years or 10 years and less in the community, (5) males and
females who do not have definite hypertension nor are currently taking high
blood pressure medication, (6) males and females with definite hypertension
or taking blood pressure medication, C7) males and females on high blood
pressure medication, (8) males and females no longer taking high blood
pressure medication, (9) males and females who do not have water softeners,
(10) males and females who do not have water softeners and have lived greater
than 10 years or 10 years and less in the community, (11) males and females
who do not have water softeners and are not taking blood pressure medication,
(12) males and females who do not have water softeners, are not taking blood
pressure medication, and have lived greater than 10 years or 10 years and
less in the community, (13) males and females who do not have water softeners,
who do not have definite hypertension, nor are taking high blood pressure
medication, (14) males and females who do not have water softeners, who do
not have definite hypertension, are not taking high blood pressure medica-
tion, and have lived greater than 10 years or 10 years and less in the com-
munity, (15) males and females who have never smoked, or have smoked some-
time during their lifetime, and (17) obese and nonobese males and females.
When systolic and diastolic blood pressures for males and females from
West Dundee were compared to blood pressures for males and females from
McHenry for all of the above categories, significant differences (P < 0.05)
unless stated otherwise were found as follows:
1. Systolic total population (P = 0.06) and age-specific means for females
living 10 years or less in the community (Table 23).
2. Systolic total population and age-specific (P = 0.06) means for females
who are not taking blood pressure medication and have lived 10 years or
less in the community (Table 25).
3. Systolic total population means for females who do not have definite
hypertension, are not taking high blood pressure medication, and have
lived greater than 10 years or 10 years and less in the community (Table
26 and 27). The age-specific mean systolic blood pressures were only
significantly different between West Dundee and McHenry females living
10 years and less in the community.
4. Systolic total population (P = 0.06) and age-specific means for males
who do not have water softeners and have lived greater than 10 years in
the community (Table 33).
5. Systolic total population (P = 0.05) and age-specific (P = 0.08) means
for males who do not have water softeners, are not taking high blood
pressure medication, and have lived greater than 10 years in the com-
munity (Table 36). Also, systolic age-specific (P = 0.08) means for
females having the same corrections made as for the males above with
the exception of living in the community for 10 years and less (Table
37) .
70
-------
6. Systolic total population and age-specific means for males who do not
have water softeners, who do not have definite hypertension, are not
taking high blood pressure medication, and have lived greater than 10
years in the community (Table 39). Also, systolic age-specific means
for females having the same corrections made as for the males above with
the exception of living in the community for 10 years and less (Table 40).
In addition to making comparisons for blood pressure differences between
communities and time of residence, a comparison was made for possible blood
pressure differences within the study communities with respect to time of
residence. The only significant difference found was for both systolic and
diastolic total population and age-specific mean blood pressures among males
who have lived in West Dundee greater than 10 years compared to those males
who have lived in West Dundee for 10 years or less (Table 21).
Further analysis indicates that there are no significant differences for
the proportion of males and females from West Dundee who have definite hyper-
tension or are taking blood pressure medication when compared to McHenry
males and females under the same conditions. More West Dundee males were
found to take blood pressure medication for their hypertension than McHenry
males. Finally, no significant differences were found in West Dundee male
and female pulse rates when compared to the pulse rates of males and females
in McHenry.
Although there were some significant differences found in the blood
pressure data between the high barium and the low barium communities, the
data is inconclusive mainly because of inconsistencies in the findings. For
instance, significant difference in female systolic blood pressures occurred
for those females residing in the community for 10 years or less, while no
significant difference was found for females residing greater than 10 years
in the community. This same finding was also shown for females living 10
years or less in the community and not on high blood pressure medication.
Sometimes a significant difference would be found for males living greater
than 10 years in the community and for females living 10 years or less in
the community. Finally, since over 100 analyses were run to test for sig-
nificant difference in the total population and age-specific mean systolic
blood pressures, and over 100 tests for differences in these means for dia-
stolic blood pressures, some of the significant differences happened by
chance alone. It must be pointed out that all of the findings could not
have happened by chance alone, and that significant differences between West
Dundee and McHenry residents were found for male systolic blood pressures
when corrections were made for water softeners, and time of residence; water
softeners, time of residence, and blood pressure medication; and water soft-
eners, time of residence, blood pressure medication, and hypertension. Also,
female systolic blood pressures were found significantly different between
these high barium and low barium populations when corrections were made for
time of residence, hypertension, and blood pressure medication.
71
-------
C. Prevalence rates of hypertension, stroke, heart disease, diabetes and
kidney disease (Tables 46-53}.
All age-specific prevalence rates for males and females were analyzed
using the signed rank test for age-specific rates and the weighted Z test
for total population rates. The prevalence rates for definite and border-
line hypertension in males and females from West Dundee were not signifi-
cantly different from the prevalence rates for these two types of hyperten-
sion in the males and females of McHenry (Tables 46 and 47). In addition,
the prevalence rates for both males and females in West Dundee and McHenry
with definite hypertension were slightly lower when compared with those
males and females in the United States as a whole (Table 48} (68). The
above comparisons might not be totally meaningful because those individuals
on blood pressure medication were not considered. However, when those males
and females from West Dundee taking blood pressure medication or having defi-
nite hypertension were compared to the same type of male and female populat-
ions in McHenry (Table 49), no significant differences were found. Although
no significant differences were found, these prevalence rates were now sligh-fe-
ly higher for both communities when compared with those males and females in
the United States as a whole (Table 48) (68). Also, five of the seven age
grouping had higher prevalence rates for West Dundee males in comparison to
McHenry males (Table 49).
The prevalence rates for stroke, heart disease, diabetes and kidney dis-
ease in males and females from West Dundee were not significantly different
from the prevalence rates for these respective diseases in males and females
of McHenry (Tables 50-53). In Table 50, more males in West Dundee in age-
groups 45 years old and older have higher rates of stroke than their counter-
parts in McHenry. Therefore, an additional statistical test (Mantel-
Haenszel) (59) was run to see if there was a difference in actual numbers of
stroke between these West Dundee and McHenry males. No significant differ-
ences were found.
Refusals
West Dundee had 165 households (20.1%) refusing to participate in the
study, while McHenry had 181 households (21.4%) that refused. As mentioned
previously (Section 5), an attempt was made to bring the refusals into the
study. However, it was felt that the health data obtained from the refusals
should be treated separately from the data collected from those who volun-
teered initially to prevent biasing the data in any manner. As it turned
out, there were not enough refusals, who agreed to participate when asked a
second time, to warrant analysis of the data separately. Ten households
totaling 18 people from West Dundee, and 28 households totaling 46 people
from McHenry agreed to participate, after initially refusing. The blood
pressure data from this population sample is presented in Table 54.
Water Sample Analysis
A water sample was collected and analyzed for each household surveyed
to see if the concentration of various metals in specific household water
was different from the community's water treatment plant metal analysis.
72
-------
TABLE 46 AGE-SPECIFIC PREVALENCE RATES OF DEFINITE HYPERTENSION FOR
PERSONS 18-75+ YEARS OF AGE: WEST DUNDEE AND McHENRY, ILLINOIS,
1976-77
Definite
Hyper-
tension
and Age
(Years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop. *
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/100
Pop.
5.2
7.4
12.0
15.7
14.5
31.0
21.4
14.8
Female
Pop.
Size
114
147
133
91
75
60
49
669
Rate/100
Pop.
0.0
2.7
6.0
17.6
20.0
21.7
44.9
13.7
McHenry
Male
Pop.
Size
54
77
74
75
77
128
47
532
Rate/100
Pop.
3.7
5.2
13.5
18.7
23.4
28.9
38.3
17.0
Female
Pop.
Size
53
111
88
90
136
137
56
671
Rate/100
Pop.
0.0
1.8
11.4
13.3
27.9
29.2
32.1
15.3
TABLE 47 AGE-SPECIFIC PREVALENCE OF BORDERLINE HYPERTENSION FOR PERSONS
18-75+ YEARS OF AGE: WEST DUNDEE AND McHENRY ILLINOIS, 1976-77
Border-
line
Hyper-
tension"1"1"
and Age
(Years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop. *
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/ 100
Pop.
13.0
14.8
10.9
19.1
20.3
24.1
53.6
19.6
Female
Pop.
Size
114
147
133
91
75
60
49
669
Rate/100
Pop.
0.0
2.7
6.8
15.4
17.3
25.0
32.7
12.7
McHenry
Male
Pop.
Size
" 54
77
74
75
77
128
47
532
Rate/100
Pop.
11.1
13.0
13.5
17.3
22.1
24.2
25.5
17.3
Female
Pop.
Size
53
111
88
90
136
137
56
671
Rate/100
Pop.
0.0
8.1
11.4
12.2
16.2
22.6
39.3
14.0
+ Systolic blood pressure of at least 160 mm. Hg or diastolic blood
pressure of at least 95 mm. Hg.
++ Systolic blood pressure 160 mm. Hg and below 95 mm. Hg. diastolic
blood pressure, but not simultaneously below 140 and 90 mm. Hg.
*
Total population rates are age-sex adjusted to the total sample size.
73
-------
TABLE 48 AGE-SPECIFIC PREVALENCE RATES OF DEFINITE HYPERTENSION AMONG
WHITE PERSONS 18-74 YEARS OF AGE: UNITED STATES,1971-74(68)
Definite
Hypertension +
and Age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
To-l-al
Male
Rate/100
Population
4.9
8.2
17.3
25.8
31.1
35.3
18.5
Female
Rate/100
Population
1.4
3.7
10.1
18.9
31.7
42.3
15.7
+ Systolic blood pressure of at least 160 ram. Hg or_ diastolic blood
pressure of at least 95 mm. Hg.
TABLE 49" AGE-SPECIFIC PREVALENCE RATES FOR PERSONS 18-75+ YEARS OF AGE WITH
DEFINITE HYPERTENSION OR WHO ARE CURRENTLY TAKING HIGH BLOOD PRES-
SURE MEDICATION: WEST DUNDEE AND McHENRY, ILLINOIS 1976-77
Hyper-+
tension
or on
medica-
tion
and age
(Ypars)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
West Dundee
Male
Total
No.
77
122
92
89
69
29
28
506
Rate/100
Population
6.5
7.4
18.5
30.3
29.0
48.3
35.7
24.1
Female
Total
No.
114
147
133
91
75
60
49
669
Rate/100
Population
0.9
2.7
9.8
29.7
36.0
46.7
61.2
23.7
McHenry
Male
Total
No.
54
77
74
75
77
L28
47
532
Rate/100
Population
3.7
5.2
14.9
28.0
31.2
40.6
46.8
22.3
Female
Total
No.
53
111
88
90
136
137
56
671
Rate/100
Population
0.0
2.7
12.5
18.9
40.4
48.2
44.6
22.1
+ Systolic Blood Pressure of at least 160 mm. Hg or Diastolic Blood
Pressure of at least 95 mm. Hg.
* Total population rates are age-sex adjusted to the total sample size.
74
-------
TABLE 50 AGE-SPECIFIC PREVALENCE RATES OF WHITE PERSONS 18-75+ YEARS OF
AGE, WHO HAVE HAD A STROKE DIAGNOSED BY A PHYSICIAN: WEST
DUNDEE AND McHENRY, ILLINOIS, 1976-77
Stroke
and Age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop. *
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/100
Pop.
0.0
0.0
0.0
0.0
2.9
13.8
17.9
3 = 8
Female
Pop.
Size
114
147
133
91
75
60
49
669
Rate/100
Pop.
0.0
0.0
1.5
1.1
2.7
8.5
4.1
2.4
McHenry
Male
Pop.
Size
54
77
74
75
77
128
47
532
Rate/100
Pop.
1.9
0.0
0.0
1.3
6.5
5.5
6.4
2.7
Female
Pop.
Size
53
111
88
90
136
137
56
671
Rate/100
Pop.
0.0
0.0
0.0
1.1
3.7
8.0
8.9
2.6
TABLE 31 AGE-SPECIFIC PREVALENCE RATES OF WHITE PERSONS 18-75+ YEARS OF
AGE, WHO HAVE HAD HEART DISEASE DIAGNOSED BY A PHYSICIAN: WEST
DUNDEE AND McHENRY, ILLINOIS, 1976-77
Heart
Disease
and Age
(Years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
* Total
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/ 100
Pop.
0.0
0.0
3.3
3.4
4.3
13.8
21.4
5.3
Female
Pop.
Size
.114
147
133
91
75
60
49
669
Rate/ 100
Pop.
0.0
0.0
1.5
4.4
4.0
5.0
8.2
2.8
population rates are age-sex adj\
McHenry
Male
Pop.
Size
54
77
74
75
77
128
47
532
isted t
Rate/ 100
Pop.
0.0
0.0
0.0
6.7
13.0
15.6
14.9
6.3
o the tot
Female
Pop.
Size
53
111
88
90
136
137
56
671
al samp
Rate/100
Pop.
0.0
0.0
2.3
4.4
9.6
8.0
16.1
4.9
.e size .
75
-------
TABLE 52 AGE-SPECIFIC PREVALENCE RATES OF WHITE PERSONS 18-75+ YEARS OF
AGE, WHO HAVE HAD DIABETES DIAGNOSED BY A PHYSICIAN: WEST
DUNDEE AND McHENRY, ILLINOIS, 1976-77
Diabetes
and Age
(Years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/100
Pop.
1.3
1.6
1.1
5.6
11.6
10.3
21.4
6.3
Female
Pop.
Size
114
147
133
91
75
60
49
669
Rate/100
Pop.
0.0
6.1
3.0
5.5
8.0
8.3
8.2
5.1
McHenry
Male
Pop.
Size
54
77
74
75
77
128
47
532
Rate/100
Pop.
1.9
1.3
12.2
6.7
14.3
20.3
21.3
10.1
Female
Pop.
Size
53
111
88
90
136
137
56
671
Rate/ 100
Pop.
3.8
4.5
5.7
4.4
7.4
9.5
17.9
6.9
TABLE 53 AGE-SPECIFIC PREVALENCE RATES OF WHITE PERSONS 18-75+ YEARS OF
AGE, WHO HAVE HAD KIDNEY DISEASE DIAGNOSED BY A PHYSICIAN: WEST
DUNDEE AND McHENRY, ILLINOIS, 1976-77
Kidney
Disease
and Age
(Years)
18-24.
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop. *
West Dundee
Male
Pop.
Size
77
122
92
89
69
29
28
506
Rate/100
Pop.
5.2
7.4
4.3
13.5
7.2
6.9
3.7
7.3
Female
Pop.
Size
114
147
133
91
75
60
49
669
Rate/ 100
Pop.
21.1
21.8
9.0
16.5
10.7
10.0
14.3
14.9
McHenry
Male
Pop.
Size
54
77
74
75
77
128
47
532
Rate/ 100
Pop.
1.9
9.1
6.8
10.7
10.4
10.9
14.9
8.9
Female
Pop.
Size
53
111
88
90
136
137
56
671
Rate/ 100
Pop.
9.4
16.2
13.6
20.0
8.8
18.2
12.5
14.3
Total population rates are age-sex adjusted to the total sample size.
76
-------
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-------
Also, household water samples were analyzed to make sure that some toxic
metal, like cadmium or lead, was not present to bias interpretation of the
data.
Results of West Dundee and McHenry water treatment plant sample analysis
for 12 metals are shown in Table 55. The major differences found between the
metal concentrations in the two water supplies occurred with barium and
strontium. The mean concentration for barium and strontium in West Dundee
treatment plant water exceeded that of McHenry treatment plant water by
approximately 75 and seven-fold respectively.
In addition, 12 samples were collected on a biweekly basis for six
months and analyzed by Purdue University (under contract to Health Effects
Research Laboratory, US. EPA) using proton induced x-ray emission (Table 56).
The samples were analyzed for 81 elements to detect if there were any other
differences between the two water supplies. Major differences from the above
analyses were as follows: (1) an eight and six-fold increase in rubidium
and potassium in West Dundee treatment plant water when comapred to McHenry
treatment plant water respectively (a mean of 0.00560 mg/1 vs. 0.00067 mg/1
rubidium and 8.51 vs. 1.44 mg/1 potassium). (2) a 19 fold increase in iron
was found in McHenry treatment plant water when compared to the plant at
West Dundee (a mean of 0.632 mg/1 vs. 0.033 mg/1 iron). (3) a mean of 14.9
mg/1 sulfur was found in McHenry treatment plant water, while sulfur in West
Dundee treatment plant water was below the limit of detection (< 0.1 mg/1).
Although there were some differences between the two water supplies, barium
was the only substance analyzed that exceeded the National Interim Primary
Drinking Water Regulations (3). Also, no possible health effects from con-
sumption of rubidium, potassium, iron, or sulfur from drinking water were
even suggested or discussed in these drinking water regulations (3), in Water
Quality Criteria 1972 (70), or in Quality Criteria for Water (71).
Results of West Dundee and McHenry household water sample analysis are
shown in Tables 57-63. These results are depicted in seven tables to show
the impact home water softeners have on altering the metal concentrations
of treatment plant water.
Tables 57-59 are directed toward question number 21 in the questionnaire
(Appendix A) which asks, "Is there a water softening unit for your home water
supply?" Table 57 presents the water sample analysis for 12 metals in all
households. When Table 57 was compared with Table 55 (Water Treatment Plant
Samples), the major differences noted, particularly in McHenry, were a de-
crease in calcium and magnesium concentrations and an increase in sodium.
These differences in calcium, magnesium and sodium concentrations became
more pronounced when only households that answered yes to the water soften-
ing question were compared to the same water parameters of their respective
treatment plants (Tables 58 and 55). In addition to altering the concentra-
tions of calcium, magnesium and sodium, home water softeners removed barium
and strontium from West Dundee water (Tables 58 and 55). Also, the copper
concentrations in the softened water houses showed an increase over those of
the treatment plants (Tables 58 and 55). This increase in copper might be
due to the more corrosive softened water leaching copper out of home plumb-
ing systems. When the results of water sample analysis from households
78
-------
TABLE 55 ANALYSIS OF WATER TREATMENT PLANT SAMPLES USING ATOMIC ABSORPTION
FROM WEST DUNDEE AND McHENRY, ILLINOIS, 1976-77
METAL
Barium
Cadmium
Calcium
Chromium (Total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee
Treatment Plant*
Mean +
6.78
<0.01
53.26
<0.01
0.01
<0.05
22.90
<0.0001
<0.10
18.58
3.12
0.09
Standard Deviation
1.15
—
7.99
—
.02
—
1.40
—
—
0.98
0.36
0.14
McHenry
Treament Plant**
Mean +
0.09
<0.01
85.50
<0.01
0.01
<0.05
41.50
<0.0001
<0.10
19.58
0.46
0.01
Standard Deviation
0.13
—
8.50
—
0.01
—
2.81
—
—
1.80
0.08
0.02
* 19 Samples
** 20 Samples
+ Mean values with (<) are below instrumental detection limits
79
-------
TABLE 56 PROTON INDUCED X-RAY EMISSION ANALYSIS (ug/1) FOR ELEMENTS FOUND IN
WATER SAMPLES COLLECTED OVER A SIX MONTH PERIOD (OCTOBER, 1976-
MARCH, 1977) FROM THE WATER TREATMENT PLANTS IN WEST DUNDEE AND
McHENRY, ILLINOIS
Element
Arsenic
Barium
Bromine
Calcium
Chlorine
Copper
Iodine
Iron
Lead
Maganese
Nickel
Potassium
Rubidium
Sodium
Strontium
Sulfur
Zinc
Wes
#
Samples
5*
12
12
12
11*
12
6*
12
12
12
10*
12
12
12
12
0*
12
t Dundee
Mean
1.6
7307.5
16.0
55178.8
2986.3
10.0
7.6
33.3
4.9
26.1
0.5
8510.4
5.6
20716.7
2937.0
—
36.6
Standard
Deviation
1.2
858.4
2.8
8502.3
3437.7
9.1
2.7
6.9
1.9
6.3
0.4
1386.0
4.3
560.6
236.1
—
16.6
#
Samples
9*
11
11
11
9*
11
4*
11
9*
11
8*
11
2*
11
11
11
11
McHenry
1
Mean
1.9
104.1
29.5
84234.3
6009.0
16.3
4.98
632.3
2.1
73.1
0.8
1437.5
0.7
21354.5
503.3
14906.1
40.9
Standard
Deviation
2.4
15.5
3.3
9863.1
4872.5
8.7
0.9
724.0
1.3
57.9
0.5
335.7
0.3
2443.5
61.0
5666.8
36.1
* Only those collected samples above the
are included in this table.
detection limits of the instrument
80
-------
TABLE 57 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITH AND WITHOUT WATER SOFTENERS, PLUS THOSE HOUSEHOLDS NOT KNOWING
WHETHER OR NOT A SOFTENER IS USED: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean+
6.40
<0.01
47.31
<0.01
0.03
<0.05
19.53
<0.0001
<0.10
32.06
2.73
0.09
Standard Deviation
2.45
—
18.39
—
0.04
—
7.53
—
—
36.27
1.05
0.18
McHenry **
Mean +
0.09
<0.01
54.25
<0.01
0.25
<0.05
30.32
<0.0001
<0.10
64.42
0.31
0.10
Standard Deviation
0.11
r-
35.57
—
0.32
—
20.62
—
—
75.06
0.27
0.25
* 631 Samples
** 643 Samples
+ Mean values with (<) are below instrumental detection limits.
81
-------
TABLE 58 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1 FROM HOUSEHOLDS
WITH WATER SOFTENERS: WEST DUNDEE AND McHENRY, ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean+
4.32
<0.01
33.38
<0.01
0.03
<0.05
13.98
<0.0001
<0.10
62.315
1.86
0.10
Standard Deviation
3.39
—
26.39
—
0.04
—
11.03
—
—
53.29
1.48
0.19
McHenry **
Moan +>
0.08
<0.01
43.64
<0.01
0.28
<0.05
24.93
<0.0001
<0.10
86.51
0.25
0.09
Standard Deviation
0.10
--
37.92
—
0.34
—
21.93
—
—
81.49
0.26
0.25
* 189 Samples
** 426 Samples '
+ Mean values with (<) are below instrumental detection limits.
82
-------
without water softeners were compared to their respective treatment plants,
it was noted that the concentrations for the 12 metals were very similar
(Tables 59 and 55).
Since many people do not properly maintain their home water softener,
there could be some masking of the true impact that water softeners have on
changing the concentrations of specific metals. As a consequence, households
with low and high concentrations of sodium were compared with one another
(Tables 60-63). Tables 60 and 61 compare the analysis of household water
samples that had concentrations of sodium equal to or less than 25 mg/1 with
water samples exceeding 25 mg/1 sodium. A concentration of 25 mg/1 sodium
was chosen because neither water treatment plant exceeded this concentration.
Therefore, it was assumed that a sodium concentration greater than 25 mg/1
was due to the home water softener. In Table 60, with sodium concentrations
<_ 25 mg/1, the concentrations of the 12 metals from both communities were
quite similar when compared to their respective treatment plant (Table 55).
However, when the treatment plant data was compared with households that had
greater than 25 mg/1 in their water (Table 61) changes in concentration were
observed for several of the metals. As expected, water softeners were re-
moving the divalent cations and exchanging them with sodium, a monovalent
cation. Both communities showed a decrease in calcium and magnesium, and an
increase in sodium. Also, West Dundee had a marked reduction in barium and
strontium. In fact, the barium concentration was reduced five-fold, leaving
a mean concentration just above the water quality standard of 1.0 mg/1.
Since there are differences in the functioning and maintenance of home
water softeners, a comparison was made between households with 100 mg/1 or
less sodium in their water and those with a greater than 100 mg/1 sodium
(Tables 62 and 63). As noted in Table 62, (households with sodium concen-
trations < 100 mg/1), the metal concentrations closely resembled those of
their respective treatment plant. However, those households exceeding 100
mg/1 sodium in their water (Table 63) showed a decrease in the barium, cal-
cium, magnesium and strontium concentrations to negligible amounts when com-
pared to the treatment plant concentrations of these metals (Table 55). It
can be noted from the above tables that households with water softeners con-
tributing to greater than 100' mg/1 sodium in their water were able to easily
reduce the barium levels below the MCL of 1 0 mg/1.
Althoush household water data were analyzed in many different ways, only
one metal found in West Dundee household water and two metals found in Mc-
Henry water exceeded either the U.S. (3) or Illinois drinking water regula-
tions (4). In West Dundee, barium exceeded the 1.0 mg/1 standard in 555 of
the 631 household water samples analyzed. Water softeners in 76 households
were able to reduce the barium levels below the standard. In McHenry, the
lead standard for water (0.05 mg/1) was exceeded in 3 households out of 643
surveyed. Of those three households exceeding the lead standard, two of
them had a water softener. All three households exceeding the lead standard
had newly installed copper plumbing. The lead was probably coming from
solder in the plumbing joints that had not been thoroughly washed out of the
system. Although there is not a specific U.S. drinking water regulation for
copper, Illinois has a copper drinking water standard of 1.0 mg/1 (maximum
allowable twelve-month average concentration). This limit is based on ones
83
-------
TABLE 59 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITHOUT WATER SOFTENERS: WEST DUNDEE AND McHENRY, ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean +
7.J5
<0.01
53.54
<0.01
0.03
<0.05
22.10
<0.0001
<0.10
18.36
3.12
0.09
Standard Deviation
0.85
—
7.26
—
0.03
—
2.84
—
—
5.12
0.34
0.17
McHenry **
Mean +
0.12
<0.01
76.75
<0.01
0.19
<0.05
41.72
<0.0001
<0.10
17.20
0.44
0.10
Standard Deviation
0.12
-—
12.28
—
0.26
—
10.53
—
—
16.11
0.20
0.23
* 390 Samples
** 206 Samples
+ Mean values with (<) are below instrumental detection limits.
84
-------
TABLE 60 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITH SODIUM CONCENTRATIONS <_ 25 mg/1: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean +
7.32
<0.01
54.11
<0.01
0.03
<0.05
22.22
<0.0001
<0.10
18.11
3.13
0.08
Standard Deviation
0.84
—
6.54
—
0.03
—
2.69
—
—
0.82
0.30
0.17
McHenry **
Mean +
0.12
<0.01
77.57
<0.01
0.23
<0.05
42.27
<0.000]
<0.10
15.81
0.44
0.10
Standard Deviation
0.12
—
11.57
—
0.31
—
9.85
—
5.85
0.21
0.23
* 545 Samples
** 420 Samples
+ Mean values with (<) are below instrumental detection limits.
85
-------
TABLE 61 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITH SODIUM CONCENTRATIONS > 25 mg/1: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean+
1.29
<0.01
9.39
<0.01
0.05
<0.05
4.57
<0.0001
<0.10
109.56
0.54
0.11
Standard Deviation
2.13
—
16.81
—
0.06
—
8.16
—
—
38.55
1.00
0.22
McHeniy **
Mean +
0.05
<0.01
13.08
<0.01
0.29
<0.05
9.10
<0.0001
<0.10
151.49
0.08
0.10
Standard Deviation
0.07
—
25.13
—
0.34
—
1 / . 42
—
—
62.48
0.14
0.27
* 101 Samples
** 235 Samples
+ Mean values with (<) are below instrumental detection limits.
86
-------
TABLE 62 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITH SODIUM CONCENTRATIONS £ 100 mg/1: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chr omi um (total)
Copper
Lead
Magnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean-*-
7.21
<0.01
53.38
<0.01
0.03
<0.05
22.07
<0.001
<0.10
19.15
3.09
0.08
Standard Deviation
1.05
.
7.76
—
0.03
—
2.94
—
—
6.46
0.39
0.17
McHenry **
Meant-
0.12
<0.01
75.45
<0.01
0.23
<0.05
42.00
<0.0001
<0.10
18.92
0.43
0.10
Standard Deviation
0.11
—
15.11
—
0.30
—
10.89
—
—
12.45
0.21
0.22
* 568 Samples
** 466 Samples
+ Mean values with (<) are below instrumental detection limits.
87
-------
TABLE 63 ANALYSIS OF WATER SAMPLES, FOR 12 METALS IN mg/1, FROM HOUSEHOLDS
WITH SODIUM CONCENTRATIONS > 100 mg/1: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
Metal
Barium
Cadmium
Calcium
Chromium (total)
Copper
Lead
Hagnesium
Mercury
Nickel
Sodium
Strontium
Zinc
West Dundee *
Mean +
0.27
<0.01
1.55
<0.01
0.05
<0.05
0.42
<0.0001
<0.10
128.92
0.05
0.10
Standard Deviation
0.32
—
6.87
—
0.06
—
0.83
—
—
12.37
0.08
0.23
McHenry **
Mean +
0.03
<0.01
2.62
<0.01
0.30
<0.05
1.69
<0.0001
<0.10
176.86
0.02
0.09
Standard Deviation
0.05
"T~~
7.65
—
0.35
—
4.58
—
—
38.27
0.06
0.29
* 78 Samples
** 189 Samples
+ Mean values with (<) are below instrumental detection limits.
88
-------
ability to taste it rather than on a health hazard (70). Copper exceeded 1.0
mg/1 in 22 of 643 households surveyed in McHenry. Seventeen of the 22 house-
holds replied in the questionnaire that they had a water softener.
Drinking Water Sodium Concentrations And Blood Pressure Levels
Age-specific systolic and diastolic blood pressures for males and fe-
males from McHenry, exposed to diverse sodium concentrations in their drink-
ing water, were analyzed using the Wilcoxon Signed-Rank Test (66) (Tables 64-
67). Only males and females from McHenry were used to determine whether or
not increased sodium levels had an effect on blood pressure because barium
in the West Dundee water supply might also effect blood pressure and possibly
mask any health effects of elevated sodium levels. A drinking water concen-
tration of < 25 mg/1 sodium was used as the baseline for comparison because
that was the level found at the McHenry treatment plant (Tables 55 and 56).
Any sodium concentration greater than 25 mg/1 could be attributed to home
water softeners. Therefore, male and female blood pressures that were ex-
posed to < 25 mg/1 sodium were compared to those male and female blood
pressures that were exposed to > 25 mg/1, 25-99 mg/1, <_ 100 mg/1, >100 mg/1,
100-200 mg/1 and > 200 mg/1 sodium respectively. The only significant dif-
ference found for any of the above comparisons was between male systolic and
diastolic blood pressures when exposed to greater than 200 mg/1 sodium in
comparison to those males who were exposed to 25 mg/1 or less sodium (Tables
64 and 65). Since the sample size for those exposed to greater than 200 mg/1
sodium is small and all of the other comparisons were not significant, there
is little relevance to this finding. It can be concluded that elevated
sodium concentrations in McHenry drinking water had little effect on the
blood pressures of McHenry residents.
Drinking Water Sodium Concentrations And Prevalence Rates Of Heart Disease,
Hypertension, Stroke, And Kidney Disease
It was mentioned previously that softened water may be associated with
cardiovascular disease (52,53,54,55). Therefore, persons exposed to greater
than 100 mg/1 sodium from home water softeners were compared to those persons
exposed to 100 mg/1 or less sodium in their water to ascertain if there were
differences in heart disease, hypertension, stroke, and kidney disease. The
Mantel-Haenszel Chi Square Statistics (59) with adjustment for sex, age
(18-44 and 45 75+), and town (West Dundee and McHenry) was used to decide
whether or not there was a relationship between the above diseases and sodium
concentration. Age was adjusted for only two groupings because further re-
finement into numerous groupings would have resulted in too few people with
a particular disease in each group. The Mantel-Haenszel Chi Square Statis
tics (59) for the above diseases were not significant (Tables 68-75) . This
finding indicates that there were no significant differences- between-the high
and low sodium groups with respect to heart disease, hypertension, stroke,
and kidney disease.
89
-------
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ro CTi
c^ ^* ^*
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93
-------
TABLE 68
AGE-SPECIFIC PREVALENCE RATES OF WHITE MALES 18-75+ YEARS OF AGE
WHO HAVE HAD HEART DISEASE DIAGNOSED BY A PHYSICIAN AND ARE EX-
POSED TO VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER:
WEST DUNDEE AND McHENRY, ILLINOIS, 1976-77
West Dundee
McHenry
Heart
Disease
and age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Male
Total
No.
73
108
77
72
58
28
26
442
Rate/100
Population
0.0
0.0
3.9
4.2
5.2
14.3
19.2
5.5
Sodium >100mg/l
Male
,Total
No.
4
13
' 13
15
9
1
2
57
Rate/ 100
Population
0.0
0.0
0.0
0.0
0.0
0.0
50.0
2.9
Sodium -tlOOmg/l
Male
Total Rate/100
No . Population
40 0.0
52 0.0
49 0.0
54 9.3
49 14.3
94 13.8
37 18.9
375 6.9
Sodium >100mg/l
Male
Total
No.
13
25
24
21
24
34
9
150
Rate/ 100
Population
0.0
0.0
0.0
0.0
8.3
20.6
0.0
4.8
TABLE 69
AGE-SPECIFIC PREVALENCE RATES OF WHITE FEMALES 18-75+ YEARS OF AGE
WHO HAVE HAD HEART DISEASE DIAGNOSED BY A PHYSICIAN AND ARE EX-
POSED TO VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER:
WEST DUNDEE AND McHENRY, ILLINOIS, 1976-77
West Dundee
McHenry
Heart
Disease
and age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Female
Total
No.
104
121
106
82
63
55
48
579
Rate/ 100
Population
0.0
0.0
1.9
4.9
4.8
5'. 5
8.3
3.2
Sodium >100mg/l
Female
Total
No.
7
25
24
8
11
3
1
79
Rate/ 100
Population
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Sodium <100mg/l
.
Female
Total
No.
40
75
60
73
95
98
40
481
Rate/100
Population
0.0
0.0
3.3
4.1
6.3
4.1
17.5
4.0
Sodium >100mg/l
Fenale
Total
No.
13
34
28
17
36
39
14
181
Rate/100
Pepulation
0.0
0.0
0.0
5.9
13.9
17.9
7.1
7.7
* Total population rates are age-adjusted to the total sample size.
94
-------
TABLE 70 AGE-SPECIFIC PREVALENCE RATES OF WHITE MALES 18-75+ YEARS OF AGE
WHO HAVE DEFINITE HYPERTENSION+ AND ARE EXPOSED TO VARYING SODIUM
CONCENTRATIONS IN THEIR DRINKING WATER: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
West Dundee
McHenry
Defin-
ite Hy~
perten-
sior.+
and age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
754
Total
Pop.*
Sodium '<100mg/l
Male
Total
No,
73
108
77
72
58
28
26
442
Rate/ 100
Population
5^5
6.5
13.0
18.1
15.5
32.1
23.1
15.4
Sodium >100mg/l
Male
Total '
No.
4
13
13
15
9
1
2
57
Rate/100
Population
0.0
15.4
7.7
6.7
11.1
0.0
0.0
7.2
Sodium <100mg/l
Male
Total
No.
40
52
49
54
49
94
37
375
Rate/100
Population .
5.0
3.8
12.2
18.5
24.5
24.5
43.2
16.3
Sodium >100mg/l
Male
Total
No. :
13
25
24
21
24
34
9
150
late/ 100
'opulation
0.0
8.0
16.7
19.0
16.7
41.2
22.2
18.4
TABLE 71 AGE-SPECIFIC PREVALENCE RATES OF WHITE FEMALES 18-75+ YEARS OF AGE
WHO HAVE DEFINITE HYPERTENSION+ AND ARE EXPOSED TO VARYING SODIUM
CONCENTRATIONS IN THEIR DRINKING WATER: WEST DUNDEE AND McHENRY,
ILLINOIS, 1976-77
West Dur
Defin-
nite Hy-
pe rten-
sion+
ana age
{years )
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Female
Total
No.
104
121
106
82
63
55
48
579
Rate/100
Population
0.0
3.3
5.7
17.1
22.2
18.2
45.8
13.7
+ Systolic blood press
dee
Sodium >100mg/l
Female
Total
No,.
7
25
24
8
11
3
1
79
ure of
Rate/100
Population
0.0
0.0
8.3
12.5
0.0
33.3
0.0
8.1
at least 16
McHenry
Sodium <100mg/l
Female
Total
No.
40
75
60
73
95
98
40
481
J mm. He
Rate/100
Population
0.0
1.3
15.0
15.1
21.1
29.6
32.5
14.9
j or diastol
Sodium >100mg/l
Female
Total
No.
13
34
28
17
36
39
14
181
Rate/100
Population
0.0
2.9
3.6
5.9
44.4
28.2
28.6
16.2
ic blood
pressure of at least 95 mm.Hg.
* Total population rates are age-adjusted to the total sample size.
95
-------
TABLE 72 AGE-SPECIFIC PREVALENCE RATES OF WHITE MALES 18-75+ YEARS OF AGE
WHO HAVE HAD STROKE DIAGNOSED BY A PHYSICIAN AND ARE EXPOSED TO
VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER: WEST DUNDEE
AND MCHENRY, ILLINOIS, 1976-77
West Dundee McHenry
Stroke
and
age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
I
Total
^No.
73
108
77
72
58
28
26
442
tele
Rate/100
Population
0.0
0.0
0.0
0.0
3.4
14.3
19.2
4.0
Sodium >100mg/l
Male
Total
No.
4
13
13
15
9
1
2
57
Rate/100
Population
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Sodium <100mg/l
ME
Total
No.
40
52
49
54
49
94
37
375
tie
Rate/100
Population
2.5
0.0
0.0
1.9
4.1
5.3
5.4
2.0
Sodium >100mg/l
Ma
Total
No.
13
25
24
21
24
34
9
150
lie
Rate/100
Population
0.0
0.0
0.0
0.0
12.5
5.9
11.1
4.0
TABLE 73 AGE-SPECIFIC PREVALENCE RATES OF WHITE FEMALES 18-75+ YEARS OF AGE
WHO HAVE HAD STROKE DIAGNOSED BY A PHYSICIAN AND ARE EXPOSED TO
VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER: WEST DUNDEE
AND McHENRY, ILLINOIS 1976-77
West Dundee McHenry
Stroke
and
age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Female
Total
No.
104
121
106
82
63
55
48
579
Rate/100
Population
0.0
0.0
1.9
1.2
3.2
9.1
4.2
2.6
Sodium >100mg/l
Female
Total
No.
7
25
24
8
11
3
1
79
Rate/100
Population
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Sodium <100mg/l
Female
Total
No.
40
75
60
73
95
98
40
481
Rate/100
Population
0.0
0.0
0.0
1.4
3.2
7.1
10.0
2.5
Sodium >100mg/l
Female
Total
No.
13
34
28
17
36
39
14
181
Rate/100
Population
0.0
0.0
0.0
0.0
5.6
10.3
0.0
3.3
* Total population rates are age-adjusted to the total sample size.
96
-------
TABLE 74
AGE-SPECIFIC PREVALENCE RATES OF WHITE MALES 18-75+ YEARS OF AGE
WHO HAVE HAD KIDNEY DISEASE DIAGNOSED BY A PHYSICIAN AND ARE EX-
POSED TO VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER:
WEST DUNDEE AND McHENRY, ILLINOIS 1976-77
West Dundee
McHenry
Kidney
Disease
and
age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Male
Total
No.
73
108
77
72
58
28
26
442
Rate/ 100
Population
5.5
7.4
3.9
15.3
6.9
7.1
3.8
7-3
Sodium >100mg/l
Male
Total
No.
4
13
13
15
9
1
2
57
Rate/100
Population
0.0
7.7
7.7
6.7
0.0
0.0
0.0
3.9
Sodium <100mg/l
Male
Total
NO.
40
52
49
54
49
94
37
375
Rate/100
Population
2.5
11.5
6.1
11.1
8.2
11.7
13.5
9.2
Sodium >100mg/l
Male
Total
No.
13
25
24
21
24
34
9
150
Rate/100
Population
0.0
4.0
8.3
9.5
16.7
8.8
22 .2
9.2
TABLE 75 AGE-SPECIFIED PREVALENCE RATES OF WHITE. FEMALES 18-75+ YEARS OF AGE
WHO HAVE HAD KIDNEY DISEASE DIAGNOSED BY A PHYSICIAN AND ARE EX-
POSED TO VARYING SODIUM CONCENTRATIONS IN THEIR DRINKING WATER:
WEST DUNDEE AND McHenry, ILLINOIS 1976-77
West Dundee McHenry
Kidney
Disease
and
age
(years)
18-24
25-34
35-44
45-54
55-64
65-74
75+
Total
Pop.*
Sodium <100mg/l
Female
Total
No.
104
121
106
82
63
55
48
579
Rate/100
Population
22.1
21.5
10.4
14.6
12.7
10.9
14.6
15.4
Sodium >100mg/l
Female
Total
NO.
7
25
24
8
11
3
1
79
Rate/ 100
Population
14.3
24.0
4.2
37.5
0.0
0.0
0.0
10.8
Sodium <100mg/l
Female
Total
No.
40
75
60
73
95
98
40
481
Rate/100
Population
5.0
21.3
15.0
20.5
8.4
20.4
10.0
15.6
Sodium >100mg/l
Per
Total
No.
13
34
28
17
36
39
14
181
lale
Rate/100
Population
23.1
5.9
10.7
17.6
11.1
12.8
21.4
12.3
* Total population rates are age-adjusted to the total sample size
97
-------
REFERENCES
1. Advisory Report on Health Effects of Barium in Water. HEQ Document
No. EHRC-12, Illinois Institute for Environmental Quality, 1974.
2. Gilkeson, R., Specht, S., Cartwright, K. and Griffin, R. Geologic Studies
to Identify the Source for High Levels of Radium and Barium in Illinois
Groundwater Supplies. Illinois State Geological Survey, 1978.
3. U.S. Environmental Protection Agency. National Interim Primary Drinking
Water Regulations. EPA-570/9-76-003, 1977.
4. Illinois Pollution Control Board Rules and Regulations. Chapter 6.
Public Water Supplies, November 22, 1974.
5. Roza, D. and Herman, L.B. The pathophysiology of barium: Hypokalemic
and cardiovascular effects. J. Pharmacol. Exp. Thera., 177:
433-439, 1971.
6. Diengott, D., Roza, 0., Levy, N. and Muammar, S. Hypokalemia in barium
poisoning. Lancet, 2:343-344, 1964.
7. Goodman, L.S. and Gilman, A. The Pharmacological Basis of Therapeutics.
New York, The Macmillan Company, 1970.
8. Sollman, T.A. Manual of Pharmacology. Philadelphia, W.B. Saunders
Company, 1953.
9. Tardiff, R.G., Robinson, M. and Ulmer, N.S. Subchronic oral toxicity
of BaCl2 in rat. Toxicol. Appl. Pharmacol., 99: (In press).
10. Schroeder, H.A. and Kitchener, M. Life-term studies in rats: Effects of
aluminum, barium, beryllium and tungsten. J. Nutr., 105:421-427, 1975.
11. Domanski, T., Liniecki, J. and Witkowska, D. Kinetics of calcium,
strontium, barium, and radium in rats. In:Delayed Effects of Bone-
Seeking Radionuclides, ed. by C.W. Mays, W.S.S. Jee, R.D. Lloyd,
B.J. Stover, J.H. Dougherty and G.N. Taylor. University of Utah
Press, pp. 79-84, 1969.
12. Bauer, G.C.H., Carlsson, A. and Lindquist, B. A comparative study on
the metabolism of 140Ba and 45Ca in rats. Biochem. J., 63:535-542,
1956.
140
13. Bauer, G.C.H. Carlsson, A. and Lindquist, B. Metabolism of BA in man.
Acta Orthop. Scand., 26:241-254, 1957.
98
-------
14. Sowden, E.M. Trace elements in human tissue. 3. strontium and barium
in non-skeletal tissues. Biochem. J., 70:712-715, 1958.
15. Schroeder, H.A., Tipton, I.H. and Nason, A.P. Trace metals in man:
Strontium and barium. J. Chron. Pis., 25:491-517, 1972.
16. Harrison, G.E., Carr, T.E.F. and Button, A. Plasma concentration and
excretion of calcium-47, strontium-85, barium-133 and radium-223
following successive doses to a healthy man. Nature, 209:526-527, 1966.
17. Harrison, G.E., Carr, T.E.F. and Sutton, A. Distribution of radioactive
calcium, strontium, barium and radium following intravenous injection
into a healthy man. Int. J. Radiat. Biol., 13:235-247, 1967.
18. Clary, J.J. and Tardiff, R.G. The absorption, distribution, and excre-
tion of orally administered -*--"BaCl2 in weanling male rats. Paper
presented at the Thirteenth Annual Meeting of the Society of Toxicology,
March 10-14, Washington, D.C., 1974.
19. Bligh, T.H. and Taylor, D.M. Comparative studies of the metabolism of
strontium and barium in the rat. Biochem. J., 87:612-618, 1963.
20. Ellsasser, J.C., Farnham, J.E. and Marshall, J.H. Comparative kinetics
and autoradiography of ^Ca and 133Ba in ten-year-old Beagle dogs.
J. Bone Joint Surg., 51:1397-1412, 1969.
21. Taylor, D.M., Bligh, P.H. and Duggan, M.H. The absorption of calcium,
strontium, barium and radium from the gastrointestinal tract of the
rat. Biochem. J., 83:25-29, 1962.
22. Bligh, P.H. and Taylor, D.M. Comparative studies of the metabolism of
strontium and barium in the rat. Biochem. J., 87:612-618, 1963.
23. Tipton, I.H., Stewart, P.L. and Dickson, J. Patterns of elemental ex-
cretion in long term balance studies. Health Physics, 16:455-462, 1969.
24. Smith, P.K., Winkler, A.W. 'and Hoff, H.E. Cardiovascular changes
following the intravenous administration of barium chloride.
J. Pharmacol^ JExp. Thera., 68:113-122, 1940.
25. Mascher, D. Electrical and mechanical responses in ventricular muscle
fibers during barium perfusion. Pflugers Arch., 342:325-346, 1973.
26. Slavicek, J. Effect of Ba on contractility of the isolated right rat
ventricle. Substitution of NaCl for chlorine or hypertonic sucrose.
Physiol. Bohem., 21:189-199, 1972.
27. Lehmkuhl, D. and Sperelakis, N. Ba depolarization of cultured heart
cells. Fed. Proc., 24:137, 1965.
99
-------
28. Kleinfeld, M., Stein, E. and Tionaytis, C. Effects of barium on mature
and embryonic heart cells. Circ. Res., 18:484-491, 1966.
29, Sperelakis, N. and Lehmkuhl, D. Ionic interconversion of pacemaker and
nonpacemaker cultured chick heart cells. J. Gen. Physiol., 49:867-
895, 1966.
30. LaVan, D.W., Haskin, M.E., Wohl, G.T. and Bellet, S. Cardiac changes
produced during routine roentgen study of the lower bowel by barium
enema. Circulation, 26:747, 1962.
31. Herman, C.Z., Jacobs, M.G. and Bernstein, A. Hazards of the barium
enema examination as studied by electrocardiographic telemetry:
Preliminary report. J. Amer. Geri. Soc., 13:672-686, 1965.
32. Gibbs, G., Lueker, R.D., Baxley, W.A. and Wolfel, D.A. Cardiac
arrhythmia associated with barium enema. Rocky Mt. Med. J.,
69:63-66, 1972.
33. Higgins, C., Roeske, W., Karliner, J., Berk, R. and O'Roeske, W.,
Karliner, J., Berk, R. and O'Rourke, R. Incidence of significant
arrhythmias in elderly patients during barium enema. Circulation,
49 (Suppl. Ill):230,1974.
34. Roeskie, W.R., Higgins, C., Karliner, J.S., Berk, R.N. and O'Rourke,
R.A. Incidence of arrhythmias and ST-segment changes in elderly
patients during barium enema studies. Amer. Heart J., 90:688-694, 1975.
35. Douglas, W.W. Stimulus-secretion coupling: The concept and clues from
chromaffin and other cells. Brit. J. Pharmacol., 34:451-474, 1968.
36. Rubin, R.P. The role of calcium in the release of neurotransmitter
substances and hormones. Pharmacol. Rev., 22:389-428, 1970.
37. Douglas, W.W. The role of calcium in stimulus-secretion coupling. In:
Stimulus-Secretion Coupling in the Gastrointestinal Tract, ed. by
R.M. Case and H. Goebell. Baltimore, University Park Press, pp. 17-29,
1976.
38. Douglas, W.W. and Rubin, R.P. Stimulant action of barium on the adrenal
medulla. Nature, 203:305-307, 1964.
39. Douglas, W.W. and Rubin, R.P. The effects of alkaline earths and
other divalent cations on adrenal medullary secretion. J. Physiol.,
175:231-241, 1964.
40. Boullin, D.J. Effect of divalent ions on release of H-noradrenaline
by sympathetic nerve stimulation. J. Physiol., 183:76p, 1965.
100
-------
41. Boullin, D.J. The action of extracellular cations on the release of
the sympathetic transmitter from peripheral nerves. J. Physiol.,
189:85-89, 1967.
42. Kirpekar, S.M. and Misu, Y. Release of noradrenaline by splenic nerve
stimulation and its dependence on calcium. J. Physiol., 188:219-234,
1967.
43. Engelman, K., Portnoy, B. and Sjoerdsma, A. Plasma catecholamine con-
centrations in patients with hypertension. Circ. Res., 27 (Suppl. I):
141-145, 1970.
44. Louis, W.J., Doyle, A.E. and Anavekar, S. Plasma norepinephrine levels
in essential hypertension. N. Engl. J. Med., 288:599-601, 1973.
45. deChamplin, J., Farley, L., Cousineau, D. and VanAmeringen, M. Circula-
tion catecholamine levels in human and experimental hypertension.
Circ. Res., 38:109-114, 1976.
46. Elwood, P.C., Abernethy, M. and Morton, M. Mortality in adults and
trace elements in water. Lancet, 2:1470-1472, 1974.
47. Schroeder, H.A. and Kraemer, L.A. Cardiovascular mortality, municipal
water, and corrosion. Arch. Environ. Health, 28:303-311, 1974.
48. U.S. Environmental Protection Agency. Quality Criteria for Water.
EPA-440/9-76-023, 1976.
49. Stokinger, H.E. and Woodward, R.L. Toxicologic methods for establishing
drinking water standards. Jour. Amer. Water Works Assn., 50:515-529,
1958.
50. Documentation of the Threshold Limit Values. 3rd Ed. Cincinnati,
American Conference of Government Industrial Hygienists, 1971.
51. International Classification of Diseases, Adopted. 8th Revision.
U.S. Dept. Health, Education and Welfare. Public Health Service,
Pub. No. 1693, 1968.
52. Schroeder, H.A. and Kraemer, L.A. Cardiovascular mortality, municipal
water and corrosion. Arch. Environ. Health, 28:303-311, 1974.
53. Crawford, R., M.J. and Morris, J.N. Changes in water hardness and local
death rates. Lancet., 2:327-329, 1971.
54. Gardner, M.J. and Crawford, M.D. Patterns of mortality in middle and
early old age in the country Boroughs of England and Wales. Brit. J.
Prev. Soc. Med., 23:133-140, 1969.
55. Biorck, G., Bostrom, H. and Winstrom, A. On relationship between water
hardness and death rates in cardiovascular diseases. ACTA Med. Scand.,
239-252, 1965.
101
-------
56. Illinois Department of Public Health,: Vital Statistics Illinois
1971-75, Springfield, Illinois, 1972-76.
57. Illinois Environmental Protection Agency Public Water Supplies, Cook
County to Will County (film reel Number 16283), Springfield, Illinois
April 17, 1975.
58. 1970 Census of Population. General population characteristics. Illinois
Bureau of the Census. U.S. Dept. of Commerce, pc (1) - B15.
59. Fleiss, J. Statistical Methods for Rates and Proportions, John Wiley
and Sons, New York, 1973.
60. McCaughan, D. Comparison of an electronic blood pressure apparatus
with a mercury manometer. J. for the Advancement of Medical
Instrumentation. 11-13, November, 1966.
61. Brozek, J. Physique and nutritional status of adult men. Human Biology.,
28:124-140, 1956.
62. Nie, N.H., Hull, C.H., Jenkins, J.G., Steinbrenner, K., Bent, D.H.
Statistical Package for the Social Sciences, 2nd Ed., McGraw-Hill
1975.
63. Frazier, R.P., Jr., Lang, M.C., Miller, J.A. Murray, J.F., and
Westerhold, A.F. Manual of Laboratory Methods. State of Illinois
Environmental Protection Agency. Springfield, Illinois, 1973.
64. Ronan, R. Simultaneous analysis of liquid samples for medals by in-
ductively coupled argon plasma atomic-emission spectroscopy (ICAP-AES).
United States Environmental Protection Agency, Region V, Central
Regional Laboratory, 1819 West Pershing Road, Chicago, 1975.
65. El-Wady, A., Miller, R. and Carter, M. Automated method for the
determination of total and inorganic mercury in water and wastewater
samples. Analytical Chem., 48 (1):110-116, 1976.
66. Dixon, W.J. and Massey, F.J., Jr. Introduction to Statistical Analysis,
McGraw-Hill Book Co., New York, 1969.
67. National Center for Health Statistics: Persons hospitalized by number
of episodes and days in a year, United States, 1972. Vital and Health
Statistics. Series 10-No. 116. DHEW Publication No. (HRA) 77-1544.
U.S. Government Printing Office, August, 1977.
68. National Center for Health Statistics: Blood pressure of persons
65-74 years of age in the United States. Vital and Health Statistics
Advance Data. DHEW, No. 1, October 18, 1976.
69. Mayer, J. Obesity: Diagnosis. Postgrad. Med., 25:469-475, 1959.
102
-------
70. Water Quality Criteria 1972. National Academy of Science, National
Academy of Engineering. U.S. Government Printing Office, Washington,
D.C., 1974
71. Quality Criteria for Water. U.S. Environmental Protection Agency,
Washington, D.C., July, 1976.
1Q3
-------
APPENDIX A. HOUSEHOLD LISTING AND SURVEY OF MINERALS AND HEALTH
Household Listing
_
1234
Identification
Uuaber
Address:
Street No.
City
State
Zio
Phone:
Please tell me the names of all the persons 18 years old and over living
at hone at this time, beginning with the head of the household? (Enter on line
1 below) Is there anyone else? What is their relationship to him/her?
(Repeat until all persons in household are listed)
PRIMT MAXES IM BLOCK CAPITALS
Line
No.
1
2
3
4
5
6
7
8
9
Last Nar.e
First !Iar.e
Middle Name
or initial
Relation to Head
Head
Date
Completed
Refusal (Pleasf; specify)
Other (Please specify)
104
-------
Survey of Minerals and Health
||| | | | Identification
12345 Number
I would like to ask you some questions about your health.
1. During the past year, that is between
1975 and
, 1976, about how many times have you visited a
doctors office or clinic or had a doctor to your home
because of illness?
time(s)
2.
During the past year, that is between , 1975 and
, 1976, about how many days were you away from
work or unable to carry out your usual activities
because of an illness, disability, or injury?
dayts)
Identification
Number
Interviewer
Number
8,9/
10-12/
105
-------
3.a.Were you a patient in a hospital at any tir.e in the past year?
No
2
b.
Yes
1
What was the total number of days vou have soent in a
hospital during the past year?
day(s)
For what reasons were you hospitalized? (Circle as many
as apply).
Pregnancy 1
Surgery 2
Injury 3
Illness 4
Other 5 (Specify)
13/
14-16/
17/
18/
IV
4. Have you ever had your blood pressure taken?
Yes
1
No
2
DK
9
20/
(For "Mo", Skip to Q. 6)
Now I would like to take a reading of your blood pressure.
(Reading 1. Please record on Q. 32)
106
-------
5.a. Have you ever been told by a doctor that you had high, blood
pressure?
No
2
DK
9
b.
h.
Yes
1
About how many years ago were you first told that
you had high blood pressure?
Have you ever taken high blood pressure medicine
that a doctor prescribed for you?
No
2
DK
9
d.
Yes
1
What was the name of the medicine(s)?
Are you still taking medicine(s) for
high blood pressure?
DK
9
Yes
1
f.
| ME\T SKIP TO Q. 6 I
No
2
How many years ago did you
last take medicine(s) for
high blood pressure?
ye ars
Why did you stop?
Were you pregnant when the doctor first told you that
you had high blood pressure?
No
2
DK
Yes
1
Other than when you were pregnant, have
you ever been told that you had high
blood pressure?
No
DK
9
Yes
1
22,23/
24/
25/
26/
27/
28,29/
30/
31/
32/
107
-------
6.a.Did a doctor ever tell you that you had a heart attack, coronary,
myocardial infarction, coronary throrrbosis or coronary occlusion?
No
2
DK
9
b.
Yes
1
How many years ago was this?
years
33/
34,35/
7.a.Have you ever had severe pain or discomfort in your chest following
exercise or physical exertion?
No
2
b.
Did you see a doctor about it?
No
2
d.
Yes
1
What did he say it was?
36/
37/
Did he give you medicine(s) for it?
No
2
Yes
1
What is the name of the medicine(s)?
38/
39/
40/
41/
108
-------
a. Have you ever had an EKG or electrocardiogram taken?
Nc DK I' es
2 9 i 1
b.
Were you told that it was
normal 1
or
abnormal? 2
9. a. Have you ever been told of any other heart trouble such as
rheumatic fever or a heart murmur?
No DK
2 9
b.
d.
Yes
1
What did the doctor say it was?
How many years ago were you told?
years
Have you ever taken rr.edicine(s) for it?
So DK
2 9
f.
Yes
1
What is the name of medicine(s)?
Are you still taking medicine(s) for
this hear)- trouble?
DK
9
Yes
1
h,
Mo
2
Ho-v r.any years ago did you
last take the medicine(s)?
years
Why did you stop?
42/
43/
44/
45/
46,47/
48/
49/
50/
51/
52,53/
54/
109
-------
10. Have you ever been aware of your heart beating too fast or
skipping beats?
No DK Ves
291
11.a.Have you ever been told by a doctor that you had a stroke?
No
DK
9
b.
Yes
1
How many years ago was this?
years
12.a.Has a doctor ever told you of any trouble with your kidneys?
No DK
2 9
b.
Yes
1
What did he say the trouble was?
13.a.Have you ever been told by a doctor that you have had diabetes
sugar in your urine or high blood sugar?
No
2
DK
9
b.
Yes
1
How many years ago was this?
years
55/
56/
57,58/
59/
60/
61/
62,63/
110
-------
Now I would like to take a second reading of your blood pressure. (Reading 2.
Please record on Q. 32).
14.a.What is your present weight?
pounds
b. Is this your usual weight; that is, is this what you have weighed
most of the time for the last 2 years?
Yes
No
2
What do you weigh most of the time?
pounds
64-66/
67/
68-70/
111
-------
35. a. In the past two years, have you been overweight?
No DK
2 9
b.
Yes
Have you ever been on any special diet?
No
Yes
Did your doctor recommend it?
No
2
d.
Yes
1
Vttiat kind of diet was it?(Circle as many as
apply)
Low salt 1
Low caloric 2
Low sugar 3
Low cholesterol 4
Diabetic 5
Other 6 Specify
Did you take any reducing medicines?
No
f.
Yes
1
What is the name of the medicine(s)?
?•]Are you taking them now?
Mo
2
Yes
1
71/
72/
73/
74/
75/
V6/
77/
78/
79/
80/1
Card Number
112
-------
16. a. Have you ever smoked cigarettes?
No
2
b.
Yes
1
Do you now smoke?
No
2
a.
Yes
1
Do you smoke:
Less than 1 pack/day? 1
One pack per day? 2
More than 1 pack/day? 3
What is the total number of years that
you have smoked cigarettes?
years (SKIP TO O. 17)
e. When you did smoke, was it:
Less than 1 pack per day? 1
One pack per day? 2
More than 1 pack per day? 3
f • What is the total number of years you have smoked
cigarettes?
years
g. How many years ago did you stop sirokinq?
years
1-S/
Identification
Number
7/
Interviewer Number
8/
9/
10/
11,12/
13/
14,
16/
113
-------
17. a. Have you ever been told of trouble with blood circulation in
your legs?
No
2
b.
Yes
1
Was the trouble varicose veins or some other
problem?
Varicose veins.... 1
other 2 Specify
38. a. Have you ever been told you had any form of cancer?
No
2
b.
Yes
1
What kind(s)?
(Ask Q. 19-21 of Head of Household Only-Otherwise skip to Q. 22)
Now I would like to ask some questions about your home.
19. How many years have you lived in this house(apt.)?
years
20. About how old is the building? years
O.K.
9
21. a. is there a water softening unit for your home water supply?
No
2
DK
9
b.
d.
Yes
1
Is it for:
Hot water only 1
Both hot and cold water? .... 2
O.K. 9
About how often do you add
salt to the softener?
every
nonths
How long have you had the
jsoftening unit in yoar none?
years
18/
19/
20/
21/
22,23/
24-2G/
27/
28/
29,30/
31,32/
114
-------
Now I would like to ask you sone general questions about your background.
22. IF. vhat year were you born?
23. What is the total number of years you toarvft lived in (West Dundee/
McHenry) ? years
24. Row many years of school have you finished?
None 1
Grade School 2
Some High School 3
High School 4
Sone College 5
College Graduate 6
(or more)
33-35/
36,37/
38/
115
-------
25. Are you currently working, either full or part-time?
Yes , full-tire 1
Yes, part-time 2
{ Yes , Housewife 3
Skip to question 28{
{ No, student 4
No, not now employed 5
No, retired or disabled. .. .6
(for "Unemployed" (5) or "Retired or Disabled" (6), ask about last
occupation in Question 27).
26- a. What is (was) your main occupation or job title?
39/
b. What kind of work do (did) you do, that is what
are (were) your duties on this job?
c. In what type of business or industry is (was) this,
that is, what product is (was) made or what service
is (was) given?
40-42/
d. How many years have you been employed at this job?
years
43-4S/
46,47/
27. In what community is your job located?
West Dundee 1
East Dundee 2
HcHenry 3
Other 4 Specify
48/
28. SEX M ? (Do Not Ask!
1 2
49/
116
-------
Now I would like to ask you about your height, take your pulse and
roeasure the thickness of the skin on your arm.
29. How tall are you without shoes on?
feet inches
50-52/
30. Wow, I would like to take your pulse-
Number of beats in 30 seconds X 2
beats/min.
53-S5/
31. Now I would like to measure the thickness
of the skin on your right ana.
Reading 1
Reading 2
56,57/
58,59/
Now I would like to take the last ireasurement of your blood
pressure. (Reading 3. Please record on Q. 32).
117
-------
32. Blood Pressure Readings:
Systolic Diastolic
Reading 1
Reading 2
Reading 3
60-62/
Systolic
63-6S/
Diastolic
66-6S/
Systolic
69-71/
Diastolic
72-74/
Systolic
7S-77/
Diastolic
80/2
Card
Number
118
-------
33, Do you have a personal physician or family doctor?
No
Yes
a. May I have his name, address.
Dr.
First
Middle
Last
City or Town
State
D O.K.
Now I would like to take a sample of your tap water.
Thank you very much for you assistance and cooperation.
Interviewer signature and I.D.#
Dated interview completed
119
-------
APPENDIX B. LETTER TO REFUSALS
s,/»,,;. / I'uht,, HHI/I/I
UNIVERSITY OF1 ILiljINOIS AT THE MEDICAI-i CENTER,. CKICA.OO
January 21, 1977
Recently a representative from tlse University of Illinois School of Public
Health called at your hcire ard was told that you were not able to partici-
pate in a very iropcvtant 1-es.li.h survey at this time. Since there roignt no;
have been time to explain tho importance of your own participation in this
survey, I would like to describe briefly what we have been doing in your
community the last few months.
The purpose of our survey is to evaluate the possible health effects of human
consumption of nacurally occurring minerals found in water supplies. We are,
a]£o, re-evaluatinc the standards that the U. S. Environmental Protection
Agency has set for these minerals.
As you know, the study is being conducted by University of Illinois interviewers.
All interviewers carry credentials from the university as well as a letter of
approval signed by the Mayor of your city. The interviewers ask family aionbcrs,
over IS years of age, questions about their health and measure their blood
pressure. All information is kept strictly confidential! Before leavirg/ a
water sample is taken from the cold water tap in the kitchen for analysis. The
total time for the interview is approximately 30 minutes.
In the next few days, one of our interviewers will telephone you to see if a
convenient time can be made for an interview. Your cooperation would be greatly
appreciated because vithout ycur assistance, we will be unable to evaluate
adequately the impact of water consumption on your health.
Thank you for giving our study further consideration. If you have any questions
or comments, please feel free to call me at (312) 996-8855, or write me at the
University of Illinois School of Public Health, P. 0. Box 6998, Chicago, Illinois
60680.
Sincerely,
Gary R. Brenniman, Ph.D.
Assistant Professor
Environmental Health Sciences
GKBilv
120
-------
APPENDIX C. STANDARD ILLINOIS POPULATION, NUMBER OF PERSON YEARS USED TO
CALCULATE DEATH RATES, AND AGE-SPECIFIC DEATH RATES IN ILLINOIS
Table 76 Standard Illinois Population (April, 1970)
Age
(Years)
0- 4
5-14
15-24
25-44
45-64
65+
Total
Standard Illinois Population (April, 1970)
Males
477,213
1,136,320
903,740
1,298,971
1,124,227
451,365
5,391,836
Females
459,737
1,096,960
950,966
1,353,825
1,218,363
642,289
5,722,140
Table 77 Number Of Person Years, By Acre Groupings And Sex, Used To Calculate
Age-Specific Death Rates In High Barium Communities, City Of DeKalb,
And Low Barium Communities For The Years 1971-75
Age
(Years)
0- 4
5-14
15-24
25-44
45-64
65+
Number of Person Years (1971-75)
High Barium Communities
i Males
6,185
15,145
9,330
16,690
11,415
3,675
Females
5,750
14,400
10,335
17,055
11,715
5,470
City of DeKalb
Males
4,580
8,945
37,245
14,170
8,915
3,340
Females
4,190
8,905
46,635
12,690
10,010
5,120
Low Barium Communities
Males
10,060
24,980
17,605
26,910
24,035
9,515
Females
9,705
24,170
19,720
27,620
26,495
13,710
121
-------
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APPENDIX D. MANTEL-HAENSZEL TEST (59)
When a random sample of disease (hypertension or currently taking blood
pressure medication) and disease-free individuals is classified according to
living in a high barium (HB) versus a low barium (LB) community, the distri-
bution of this classification may be represented as follows:
HB LB TOTAL
With Disease A. B. Nlt
11 i
Disease-Free C. D. Na
Total Mi- Ma,- T-j
i i -1-
Within the above subgroup, the approximate relative risk associated
with the disease may be written as A.D./B.C.. Comparison can be made with
the observed number of diseased persons (A.) living in the HB community and
its expectation under the hypothesis of a relative risk of unity, U(A.) =
HI.MI./T.. The discrepancy between A. and U(A.) can be tested relative to
111 i i 2
its variance which is given by V(A.) = NI.Na.Mi.Ma,/T. (T.-l). Then, the
i 111111 2
corrected chi square with one degree of freedom becomes (| EA. -Eu(A.) | -3j). f
IV(A.). Data from Tables 29 and 18 are used to illustrate how the Mantel-
Haenszel Test (59) can be applied (Table 81) .
125
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TECHNICAL REPORT DATA
(Please read Instructions on the reverse before completing)
1. REPORT NO.
EPA-600/1-79-003
2.
4, TITLE AND SUBTITLE
Health Effects of Human Exposure to Barium in Drinking
Water
6. PERFORMING ORGANIZATION CODE
3. RECIPIENT'S ACCESSION NO.
5. REPORT DATE
January 1979 issuing date
7 AUTHOR(S)
Gary R. Brenniman, W. H. Kojola, P. S. Levy, B. W.
Carnow, T. Namekata and E. C. Breck
8. PERFORMING ORGANIZATION REPORT NO.
9. PERFORMING ORGANIZATION NAME AND ADDRESS
The University of Illinois at the Medical Center
Chicago, Illinois 60612
10. PROGRAM ELEMENT NO.
1CC61A
11. CONTRACT/GRANT NO.
R-8Q3918
12. SPONSORING AGENCY NAME AND ADDRESS
Health Effects Research Laboratory _
Office of Research & Development
U.S. Environmental Protection Agency
Cincinnati, Ohio 45268
Cinn, OH
13. TYPE OF REPORT AND PERIOD COVERED
Final - 8/12/75 to 10/31/78
14. SPONSORING AGENCY CODE
EPA/600/10
15 SUPPLEMENTARY NOTES
16 ABSTRACT
The overall objective of this study was to examine by epidemiologic and supportive
laboratory studies, the human health effects associated with ingestion of barium in
drinking water exceeding the U.S. drinking water standard of 1.0 mg/1.
The incidence of cardiovascular mortality and/or the prevalence of various cardio-
vascular, cerebrovascular and renal diseases was compared between communities with
barium concentrations exceeding the drinking water standard, and communities which
have negligible barium in their drinking water. Mortality rates for cardiovascular
diseases were retrospectively determined for the years 1971-1975. A comparison
between communities with elevated barium levels (>2 mg/1) and communities with low or
no barium (<0.2 mg/1) in their public water supplies did show higher mortality rates
for the exposed population.
The prevalence of various cardiovascular, cerebrovascular and renal diseases in
two communities having similar socioeconomic characteristics and different concentra-
tions of barium in their drinking water (mean barium concentration of 7 mg/1 in water
supply of exposed population as compared to 0.1 mg/1 in the control) was determined
through an epidemiology study. Results of the study revealed significant differences
in blood pressure between the two communities and especially in the male population
exposed to barium when the data were refined to correct for the influence of water
softening, blood pressure medication, hypertension and duration of exposure.
17.
a
KEY WORDS AND DOCUMENT ANALYSIS
DESCRIPTORS
Ingestion (biology)
Barium
Socioeconomic status
Epidemiology
Mortality
Morbidity
Ground water
Potable water
b.IDENTIFIERS/OPEN ENDEDTERMS
Health Effects
Epidemiology Study
c. COS AT I Field/Group
68G
18. DISTRIBUTION STATEMENT
Release to Public
19. SECURITY CLASS (ThisReport)
Unclassified
21. NO. OF PAGES
141
20. SECURITY CLASS (This page)
Un r 1 P .^ Q -f f i o H
22. PRICE
EPA Form 2220-1 (Rev. 4-77)
PREVIOUS EDITION IS OBSOLETE
127
U. 5. GOVERNMENT PRINTING OFFICE 1979 — 657-060/1574
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