Online Program

Health effects of magnesium deficiency in drinking water – the case of water desalination

Tuesday, November 5, 2013

Itamar Grotto, MD, MPH, PhD, Department Of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
Seawater desalination is an important source of drinking water in increasing number of countries. In Israel, the use of desalinated water is on the rise and it is expected that in a few years the main source of drinking water will be desalinated water. Most desalination plants apply reverse osmosis, leaving minimal concentrations of minerals. Drinking water contributes about 20% of magnesium intake and the lack of magnesium in the water may lead to magnesium deficiency. This deficiency may increase morbidity and mortality from various diseases, particularly cardiovascular diseases. A systematic review was conducted in order to identify studies that examined the health effects of drinking water magnesium concentration. Fourteen studies that examined the association between magnesium concentration and cardiovascular morbidity or mortality were identified. Six of eleven studies and one of three studies found that higher magnesium concentration in drinking water had a protective effect against myocardial infarction and cerebrovascular disease, respectively. A meta-analysis of these studies reported an overall protective effect (OR = 0.75, 95% CI: 0.68-0.82). The range of magnesium concentrations measured in studies was large. We performed a cost-utility analysis of the possible effects of adding magnesium to desalinated water in Israel. Adding 30 mg magnesium/Liter of water can lead to possible reduction of 250 yearly deaths from coronary heart disease, with a cost of 23,000$ per QALY. In conclusion, more and better epidemiological studies to examine the effects of drinking water magnesium deficiency are required. However, intervention may start simultaneously with those studies. Adding magnesium to desalinated drinking water is simple, effective, safest and most equal public health measure compared with other interventions such as using nutritional supplements or magnesium enrichment of food. It should be considered taking into account the implementation costs and technological feasibility.

Learning Areas:

Chronic disease management and prevention
Environmental health sciences
Public health or related public policy

Learning Objectives:
Describe the effects of magnesium in drinking water on human health Evaluate the cost-utility of adding magnesium to desalinated drinking water.

Keyword(s): Water Quality, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal researcher of the study and directed the policy making procedure
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.