Rectal cancer mortality and total hardness levels in Taiwan's drinking water

Association of Domestic Water Hardness with All-Cause and Cause-Specific Cancers: Evidence from 447,996 UK Biobank Participants

BACKGROUND

Accumulating evidence suggests that domestic water hardness is linked to health outcomes, but its association to all-cause and cause-specific cancers warrants investigation.

OBJECTIVE

The aim of this study was to investigate the association of domestic hard water with all-cause and cause-specific cancers.

METHODS

In the prospective cohort study, a total of 447,996 participants from UK Biobank who were free of cancer at baseline were included and followed up for 16 y. All-cause and 22 common cause-specific cancer diagnoses were ascertained using hospital inpatient records and self-reported data until 30 November 2022. Domestic water hardness, measured by CaCO 3 concentrations, was obtained from the local water supply companies across England, Scotland, and Wales in 2005. Data were analyzed using Cox proportional hazard models, with adjustments for known measured confounders, including demographic, socioeconomic, clinical, biochemical, lifestyle, and environmental factors.

RESULTS

Over a median follow-up of 13.6 y (range: 12.7-14.4 y), 58,028 all-cause cancer events were documented. A U-shaped relationship between domestic water hardness and all-cause cancers was observed (p for nonlinearity < 0.001 ). In comparison with individuals exposed to soft water (0 - 60 mg / L ), the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause cancer were 1.00 (95% CI: 0.98, 1.02) for those exposed to moderate hard water (> 60 - 120 mg / L ), 0.88 (95% CI: 0.84, 0.91) for those exposed to hard water (> 120 - 180 mg / L ) and 1.06 (95% CI: 1.04, 1.08) for those exposed to very hard water (> 180 mg / L ). Additionally, domestic water hardness was associated with 11 of 22 cause-specific cancers, including cancers of the esophagus, stomach, colorectal tract, lung, breast, prostate, and bladder, as well as non-Hodgkin lymphoma, multiple myeloma, malignant melanoma, and hematological malignancies. Moreover, we observed a positive linear relationship between water hardness and bladder cancer.

DISCUSSION

Our findings suggest that domestic water hardness was associated with all-cause and multiple cause-specific cancers. Findings from the UK Biobank support a potentially beneficial association between hard water and the incidence of all-cause cancer. However, very hard water may increase the risk of all-cause cancer. https://doi.org/10.1289/EHP13606.

Scientific study on acid rain and subsequent pH-imbalances in humans, case studies, treatments

SCIENTIFIC STUDY

Acid Rain attacked South West Sweden 1960-1990, making well water acid, causing Cu dissolution from pipes, disturbing intestines. In a scientific study Ca was 6 times higher in alkaline well waters and hair. Women drinking acid water were unhealthy.

CASE STUDIES

Case studies: 1 (woman): Scleroderma had caused shortened finger tips, and loss of hair. Urinary pH was 5. Hair analysis showed severe mineral imbalances. After 1.5 years of treatment with supplements and increasing urinary pH with NaHCO₃, symptoms disappeared. 2 (woman): Fibromyalgia, cataract, constipation and basal carcinoma was treated by increasing urinary pH with limestone, and supplements. 3 (man). Fe in drinking water, 3.4 mg/L, had caused intestinal disturbances and subsequent symptoms. Fe was elevated in hair. Aloe vera juice, lactic bacteria and digestive enzymes healed his intestines. Mg, antagonist to Fe, decreased severity of Fe overload. Drinking water guideline of 0.2 mg Fe/L is suggested.

Assessment of hydrogeochemical characteristics and quality of groundwater resources in relation to risk of gastric cancer: comparative analysis of high- and low-risk areas in Iran

The chemical quality of groundwater supplies in two high-risk area (HRA) and low-risk area (LRA) for gastric cancer in Iran was assessed through hydrogeochemical analysis and water quality indices. For this aim, Piper and Schoeller diagrams and water quality index (WQI) were applied. In addition, exposure to nitrate via drinking water and its corresponding risk were also assessed using Monte Carlo simulation technique. Data on physicochemical properties of groundwater resources were obtained from Iran Water Resources Management Company. Sampling and analysis of tap water for nitrate concentration were conducted in two cities of Shiraz (as a representative of LRA) and Ardabil (as a representative of HRA). According to Piper diagrams, the dominant hydrogeochemical facies of groundwater supplies in HRA and LRA were Na-HCO₃ (43.75%) and Ca-HCO₃ (41.77%), respectively. The predominant cations in groundwater resources of HRA were found to be Na⁺ (68.06%) and Ca²⁺ (31.94%). For LRA, the typical cations were in decreasing trend: Ca²⁺ (39.64%) > Mg²⁺ (18.35%) > Na⁺ (17.26%). For two areas, HCO₃^-, SO₄^2- and Cl^- were, respectively, the most frequent anions. Two-sample Wilcoxon test showed that there were statistically significant difference between two areas in terms of anions and cations concentrations (p value < 0.05). The mean of total hardness (Ca²⁺ + Mg²⁺) concentration of water supplies in LRA (528.1 mg/L) was higher than HRA (263.1 mg/L), whereas the mean of Na⁺ concentration was found to be lower in LRA (90.6 mg/L) compared with HRA (108.1 mg/L). The sum of nitrate intake and its risk in LRA was higher than HRA. WQI results showed that drinking water quality in HRA and LRA ranged from excellent to poor and most water resources were of a good quality class. Further studies are suggested to investigate the role of drinking water in the etiology of gastric cancer in Iran.

Rectal Cancer in Asian vs. Western Countries: Why the Variation in Incidence?

OPINION STATEMENT

Colorectal cancer (CRC) is the third most common cancer worldwide. CRC has been thought to be less common in Asia compared to Western countries. However, the incidence rates of CRC in Asia are high and there is an increasing trend in the Asian population. Furthermore, colorectal cancer accounts for the greatest number of all incidences of CRC in Asia. The increasing adoption of a Western lifestyle, particularly in dietary habits, is likely the most important factor contributing to the rapid increase in colon cancer incidence; it is noteworthy that trends for rectal cancer were flat. The etiology of colon and rectal cancer is a bit different. The risks of distal colon and rectal cancers are more likely to be related to environmental factors, such as polluted surface water sources, alcohol consumption, and habitual smoking. The lack of great change in the incidence of rectal cancer might be due to weaker associations with such lifestyle factors. Therefore, it has been hypothesized that proximal and distal sections of the colon and rectum are two different organs in terms of function and genetic background. It may mean differences in differential sensitivities and exposures to carcinogens. However, despite the decrease in whole incidence, the CRC incidence in young adults in Western countries are reversely increasing, especially in rectal cancer, due to reasons largely unknown. Although the treatment algorithm is different between Asia and western countries, globally, the survival rate for patients with rectal cancer has risen during the past 10 years. Screening contributes a great deal to reducing the incidence and improving survival. Most countries in Asia, such as China, need nationwide registration and screening systems to provide better data.

Impact of Calcium and Magnesium in Groundwater and Drinking Water on the Health of Inhabitants of the Slovak Republic

This work aims to evaluate the impact of the chemical composition of groundwater/drinking water on the health of inhabitants of the Slovak Republic. Primary data consists of 20,339 chemical analyses of groundwater (34 chemical elements and compounds) and data on the health of the Slovak population expressed in the form of health indicators (HI). Fourteen HIs were evaluated including life expectancy, potential years of lost life, relative/standardized mortality for cardiovascular and oncological diseases, and diseases of the gastrointestinal and respiratory systems. The chemical and health data were expressed as the mean values for each of the 2883 Slovak municipalities. Artificial neural network (ANN) was the method used for environmental and health data analysis. The most significant relationship between HI and chemical composition of groundwater was documented as Ca + Mg (mmol·L⁻¹), Ca and Mg. The following limit values were set for these most significant groundwater chemical parameters: Ca + Mg 2.9–6.1 mmol·L⁻¹, Ca 78–155 mg·L⁻¹ and Mg 28–54 mg·L⁻¹. At these concentration ranges, the health of the Slovak population is the most favorable and the life expectancy is the highest. These limit values are about twice as high in comparison to the current Slovak valid guideline values for drinking water.

Chemical composition of groundwater/drinking water and oncological disease mortality in Slovak Republic

This study deals with the analysis of relationship between chemical composition of the groundwater/drinking water and the data on mortality from oncological diseases (MOD) in the Slovak Republic. Primary data consist of the Slovak national database of groundwater analyses (20,339 chemical analyses, 34 chemical elements/compounds) and data on MOD (17 health indicators) collected for the 10-year period (1994-2003). The chemical and health data were unified in the same form and expressed as the mean values for each of 2883 municipalities within the Slovak Republic. Pearson and Spearman correlation as well as artificial neural network (ANN) methods were used for analysis of the relationship between chemical composition of groundwater/drinking water and MOD. The most significant chemical elements having influence on MOD were identified together with their limit values (limit and optimal contents). Based on the results of calculations, made through the neural networks, the following eight chemical elements/parameters in the groundwater were defined as the most significant for MOD: Ca + Mg (mmol l^-1), Ca, Mg, TDS, Cl, HCO₃, SO₄ and NO₃. The results document the highest relationship between MOD and groundwater contents of Ca + Mg (mmol l^-1), Ca and Mg. We observe increased MOD with low (deficit) contents of these three parameters of groundwater/drinking water. The following limit values were set for the most significant groundwater chemicals/parameters: Ca + Mg 1.73-5.85 mmol l^-1, Ca 60.5-196.8 mg l^-1 and Mg 25.6-35.8 mg l^-1. At these concentration ranges, the mortality for oncological diseases in the Slovak Republic is at the lowest levels. These limit values are about twice higher in comparison with the current Slovak valid guideline values for the drinking water.

Health effects of desalinated water: Role of electrolyte disturbance in cancer development

This review contends that "healthy" water in terms of electrolyte balance is as important as "pure" water in promoting public health. It considers the growing use of desalination (demineralization) technologies in drinking water treatment which often results in tap water with very low concentrations of sodium, potassium, magnesium and calcium. Ingestion of such water can lead to electrolyte abnormalities marked by hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia which are among the most common and recognizable features in cancer patients. The causal relationships between exposure to demineralized water and malignancies are poorly understood. This review highlights some of the epidemiological and in vivo evidence that link dysregulated electrolyte metabolism with carcinogenesis and the development of cancer hallmarks. It discusses how ingestion of demineralized water can have a procarcinogenic effect through mediating some of the critical pathways and processes in the cancer microenvironment such as angiogenesis, genomic instability, resistance to programmed cell death, sustained proliferative signaling, cell immortalization and tumorigenic inflammation. Evidence that hypoosmotic stress-response processes can upregulate a number of potential oncogenes is well supported by a number studies. In view of the rising production and consumption of demineralized water in most parts of the world, there is a strong need for further research on the biological importance and protean roles of electrolyte abnormalities in promoting, antagonizing or otherwise enabling the development of cancer. The countries of the Gulf Cooperative Council (GCC) where most people consume desalinated water would be a logical place to start this research.

Nitrates in drinking water and the risk of death from brain cancer: does hardness in drinking water matter?

The objectives of this study were to (1) examine the relationship between nitrate levels in public water supplies and risk of death from brain cancer and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the influence of nitrates on development of brain cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death from brain cancer and exposure to nitrates in drinking water in Taiwan. All brain cancer deaths of Taiwan residents from 2003 through 2008 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO₃-N), Ca, and Mg in drinking water was obtained from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO₃-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO₃-N exposure level was <0.38 ppm, the adjusted OR (95% CI) for brain cancer occurrence was 1.04 (0.85-1.27) for individuals who resided in municipalities served by drinking water with a NO₃-N exposure ≥ 0.38 ppm. No marked effect modification was observed due to Ca and Mg intake via drinking water on brain cancer occurrence.

Trihalomethanes in drinking water and the risk of death from rectal cancer: does hardness in drinking water matter?

The objectives of this study were (1) to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of rectal cancer development and (2) to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of TTHM on risk of developing rectal cancer. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to rectal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All rectal cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from the Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level was <4.9 ppb, the adjusted OR (95% CI) for rectal cancer occurrence was 1.04 (0.88-1.22) for individuals who resided in municipalities served by drinking water with a TTHM exposure >or=4.9 ppb. There was no evidence of an interaction of drinking-water TTHM levels with low Ca intake via drinking water. However, evidence of an interaction was noted between drinking-water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of rectal cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing rectal cancer risk will aid in public policymaking and standard setting.

Nitrates in drinking water and the risk of death from rectal cancer: does hardness in drinking water matter?

The objectives of this study were to (1) examine the relationship between nitrate levels in public water supplies and increased risk of death from rectal cancer and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of nitrate on development of rectal cancer. A matched case-control study was used to investigate the relationship between the risk of death from rectal cancer and exposure to nitrate in drinking water in Taiwan. All rectal cancer deaths of Taiwan residents from 2003 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen (NO(3)-N), Ca, and Mg in drinking water was collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was presumed to be the source of the subject's NO(3)-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO(3)-N exposure level was <0.38 ppm, the adjusted odds ratio (OR) (95% CI) for rectal cancer occurrence was 1.15 (1.01-1.32) for individuals who resided in municipalities served by drinking water with a NO(3)-N exposure > or =0.38 ppm. There was no apparent evidence of an interaction between drinking water NO(3)-N levels with low Mg intake via drinking water. However, evidence of a significant interaction was noted between drinking-water NO(3)-N concentrations and Ca intake via drinking water. Our findings showed that the correlation between NO(3)-N exposure and risk of rectal cancer development was influenced by Ca in drinking water. This is the first study to report effect modification by Ca intake from drinking water on the association between NO(3)-N exposure and risk of rectal cancer occurrence. Increased knowledge of the mechanistic interaction between Ca and NO(3)-N in reducing rectal cancer risk will aid in public policymaking and setting threshold standards.

Concentrations of inorganic elements in 20 municipal waters in Sweden before and after treatment--links to human health

The water chemistry of 20 municipal water treatment plants in southern Sweden, representing various bedrock situations, and water qualities, were investigated. Four water samples, raw and treated, were collected from each plant and analyzed by predominantly ICP-OES and ICP-MS at four occasions from June to December, 2001. The concentrations of Ca, Mg, K, Na, HCO(3) and a number of micronutrients, varied considerably in treated waters from the studied plants (ranges; Ca: 9.1-53.7 mg L(-1), Mg: 1.4-10.9 mg L(-1), K: 1.1-4.8 mg L(-1), Na; 5.4-75.6 mg L(-1), HCO(3): 27-217 mg L(-1)). The elimination of Fe and Mn from raw water was efficient in all treatments investigated, giving concentrations in treated waters below the detection limits at some plants. Softening filters gave waters with Ca-concentrations comparable to the softest waters in this study. Adjustment of pH by use of chemicals like lye, soda or lime, modified the consumer water composition significantly, besides raising the pH. It was estimated that drinking water contributed to approximately 2.2-13% of the daily Ca uptake, if the gastrointestinal uptake efficiency from food and water was estimated to be around 50%. The corresponding figures for Mg was 1.0-7% and for F 0-59%. None of the studied elements showed any significant time trends in raw or treated waters during the follow-up period. The concentrations of potentially toxic metals such as Al, Pb and U were low and did not indicate risks for adverse health effects (ranges; Al: 0.5-2.3 microg L(-1), Pb: 0-0.3 microg L(-1), U: 0.2.5 microg L(-1)).

Tumor-promoting activity of p-hydroxybenzenediazonium is accelerated in Mg-deficient rats

Tumor-promoting activity caused by the short-term administration of p-hydroxybenzenediazonium (PDQ) has been assayed in rats fed on a Mg-deficient diet as a reference model versus rats fed on a standard diet as controls. For 5 weeks groups of 20 rats, fed either on the Mg-deficient or standard diet, were treated simultaneously with PDQ. A group of 10 Mg-deficient rats remained untreated. Topical application of PDQ was followed by the appearance of macroscopic alterations in the skin, which were more evident in the Mg-deficient rats. No deaths occurred during the treatment. After 5 weeks' PDQ treatment the rats were killed and histological analyses were made. Tissues from the skin, liver, heart, kidney, lung and thymus were screened by conventional staining methods. Both the PDQ-treated Mg-deficient and PDQ-treated control rats presented tissue lesions, although to a different extent. The untreated Mg-deficient rats showed no such lesions. Mg-deficient rats treated with PDQ developed significant incipient fibrosarcomas (p<0.05) and extended hyperplasia (p<0.001), particularly in the skin, accompanied by a significant increase in the thickness of collagen (mean value: 445.4+/-47.2microm, p<0.05) compared to the control PDQ-treated group (mean values: 258.7+/-36.4microm). The overall results provide objective proof of tumor-promoting activity after 5 weeks' treatment with PDQ. Such a fast response is interpreted as being linked to the increased vulnerability of the membrane caused by Mg deficiency, which would more readily facilitate the toxic activity of p-hydroxybenzenediazonium ions.

Concentrations of inorganic elements in bottled waters on the Swedish market

This study presents the concentrations of about 50 metals and ions in 33 different brands of bottled waters on the Swedish market. Ten of the brands showed calcium (Ca) concentrations </=10 mg L(-1) and magnesium (Mg) levels <3 mg L(-1), implying very soft waters. Three of these waters had in addition low concentrations of sodium (Na; <7 mg L(-1)), potassium (K; <3 mg L(-1)) and bicarbonate (HCO(3) </=31 mg L(-1)). These brands were collected from barren districts. Nine of the brands were collected from limestone regions. They showed increased Ca-levels exceeding 50 mg L(-1) with a maximum of 289 mg L(-1). Corresponding Mg-levels were also raised in two brands exceeding 90 mg L(-1). Two soft and carbonated waters were supplemented with Na(2)CO(3) and NaCl, resulting in high concentrations of Na (644 and 648 mg L(-1)) and chloride (Cl; 204 and 219 mg L(-1)). Such waters may make a substantial contribution to the daily intake of NaCl in high water consumers. The storage of carbonated drinking water in aluminum (Al) cans increased the Al-concentration to about 70 microg L(-1). Conclusion As there was a large variation in the material as regards concentrations of macro-elements such as Ca, Mg, Na, K and Cl. Supplementation with salts, e.g., Na(2)CO(3), K(2) CO(3) and NaCl, can lead to increased concentrations of Na, K and Cl, as well as decreased ratios of Ca/Na and larger ratios of Na/K. Water with high concentrations of e.g., Ca and Mg, may make a substantial contribution to the daily intake of these elements in high water consumers. Al cans are less suited for storage of carbonated waters, as the lowered pH-values may dissolve Al. The levels of potentially toxic metals in the studied brands were generally low.

The association between drinking water source and colorectal cancer incidence in Jiashan County of China: a prospective cohort study

BACKGROUND

The pollution of drinking water, e.g. from rivers and pools, has long been recognized to be associated with an increased risk for colorectal cancer (CRC), but there are few direct prospective cohort studies related to person-years on the relative risks of different sources of drinking water for CRC, hence the reason for our study.

METHODS

Based on a screening for CRC among residents aged 30 years and over in Jiashan County, Zhejiang Province, China, a total of 64,115 residents were classified into five cohorts by their source of drinking water and followed-up from 1st May 1990 to 1st January 2001. Person-years was calculated for every cohort member and Poisson regression was used to control potential confounding variables including demographic variables and smoking history, and to attain crude and adjusted relative risks based on person-years.

RESULTS

A trend was seen toward increasing incidence rates for CRC from the drinking water sources of municipal, river, ditch, mixed water to well in turn as shown by relative risk rates of 29.61, 32.67, 33.45, 40.87 and 58.67 per 100,000 inhabitants. Only the role in risk of well water was significantly different from municipal water (P < 0.05). After the confounding variables were adjusted, the significant risk from well water could be seen for colon cancer, rectal cancer as well as CRC. The relative risks were 1.741 [95% confidence interval (CI) 1.001-3.029], 2.228 (95% CI 1.432-3.466) and 2.022 (95% CI 1.432-2.854), respectively.

CONCLUSION

Drinking well water over a long period was identified as playing a role in the risk for CRC, especially for rectal cancer.

Association of Fluids From Beverages With Risk of Rectal Cancer

Little information is available about how fluid intake from beverages and sources of fluid intake influence risk of rectal cancer. We examined these associations with risk of incident rectal cancer in a population-based case-control study of 952 cases and 1,205 controls living in northern California and Utah. We also determined if intake of fiber (soluble and insoluble), physical activity, and nonsteroidal anti-inflammatory medications (NSAIDs) or aspirin modified the associations between fluid intake and rectal cancer. We identified a modest inverse association of water intake (odds ratio, OR = 0.70; 95% confidence interval, CI = 0.48, 1.02) and total fluid intake (high vs. low OR = 0.70; 95% CI = 0.46, 1.06) with risk of rectal cancer in men and a positive association with juice among women (high vs. low OR = 1.56; 95% CI = 1.00, 2.41). Risk of rectal cancer increased nonsignificantly among men with beer consumption, among women with high white wine use, and among men and women with high long-term alcohol use. NSAIDs modified the association of alcohol consumption with rectal cancer: 1) risk associated with beer increased among men who did not take NSAIDs and had a high beer intake (OR = 1.60; 95% CI = 1.08, 2.39) and 2) risk associated with long-term alcohol intake increased in a linear fashion in women who did not use NSAIDs (OR = 1.98; 95% CI = 1.15, 3.40). Risk of rectal cancer increased among estrogen-negative women if they consumed any beer or white wine but decreased among estrogen-positive women with beer. In men, low intake of water and low insoluble fiber intake were associated with increased risk of rectal cancer beyond that of either factor alone (OR = 1.82; 95% CI = 1.11, 3.00). The interactions of fiber with water intake suggest that bowel motility may be the mechanism responsible for modification of rectal cancer risk for water. Associations of alcohol to risk for rectal cancer may be related to cellular hyperproliferation and may be modified by NSAID use.

Magnesium-DNA interactions and the possible relation of magnesium to carcinogenesis. Irradiation and free radicals

Magnesium deficiency causes renal complications. The appearance of several diseases is related to its depletion in the human body. In radiotherapy, as well as in chemotherapy, especially in treatment of cancers with cis-platinum, hypomagnesaemia is observed. The site effects of chemotherapy that are due to hypomagnesaemia are decreased using Mg supplements. The role of magnesium in DNA stabilization is concentration dependent. At high concentrations there is an accumulation of Mg binding, which induces conformational changes leading to Z-DNA, while at low concentration there is deficiency and destabilization of DNA. The biological and clinical consequences of abnormal concentrations are DNA cleavage leading to diseases and cancer. Carcinogenesis and cell growth are also magnesium-ion concentration dependent. Several reports point out that the interaction of magnesium in the presence of other metal ions showed that there is synergism with Li and Mn, but there is magnesium antagonism in DNA binding with the essential metal ions in the order: Zn>Mg>Ca. In the case of toxic metals such as Cd, Ga and Ni there is also antagonism for DNA binding. It was found from radiolysis of deaerated aqueous solutions of the nucleoside 5'-guanosine monophosphate (5'-GMP) in the presence as well as in the absence of magnesium ions that, although the addition of hydroxyl radicals (*OH) has been increased by 2-fold, the opening of the imidazole ring of the guanine base was prevented. This effect was due to the binding of Mg2+ ions to N7 site of the molecule by stabilizing the five-member ring imitating cis-platinum. It was also observed using Fourier Transform Infrared spectroscopy, Raman spectroscopy and Fast Atom Bombardment mass spectrometry that *OH radicals subtract H atoms from the C1', C4' and C5' sites of the nucleotide. Irradiation of 5'-GMP in the presence of oxygen (2.5 x 10(-4) M) shows that magnesium is released from the complex. There is spectroscopic evidence that superoxide anions (O2-*) react with magnesium ions leading to magnesium release from the complex. From radiolysis data it was suggested that magnesium ions can act as radiosensitizers in the absence of oxygen, while in the presence of oxygen they act as protectors and stabilizers of DNA.

Esophageal cancer mortality and total hardness levels in Taiwan's drinking water

The possible association between the risk of esophageal cancer and hardness levels in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. All eligible esophageal cancer deaths (2084 cases) of Taiwan residents from 1987 through 1996 were compared with deaths from other causes (2084 controls), and the hardness levels of the drinking water used by these residents were determined. Data on water hardness throughout Taiwan have been collected from the Taiwan Water Supply Corporation (TWSC). The control group consisted of people who died from other causes and the controls were pair-matched to the cases by sex, year of birth, and year of death. The results show that there is a 42% excess risk of mortality from esophageal cancer in relation to the use of soft water (adjusted odds ratio and 95% confidence intervals was 1.42 (1.22-1.66). This is an important finding for the Taiwan water industry and human health.