BARIUM IN DRINKING-WATER
9
The prevalence of dental caries was reported to be significantly lower in 39 children
from a community ingesting drinking-water containing 8–10 mg of barium per litre
than in 36 children from another community ingesting drinking-water containing
<0.03 mg/litre (Zdanowicz et al., 1987). However, the study population was small,
and dental examinations were not conducted in a blind manner.
The impact of high doses of barium on blood pressure has resulted in interest in the
possibility of low concentrations also having an adverse effect over time.
Associations between the barium content of drinking-water and mortality from
cardiovascular disease have been observed in several ecological epidemiological
studies. Significant negative correlations between barium concentrations in drinking-
water and mortality from atherosclerotic heart disease (Schroeder & Kramer, 1974)
and total cardiovascular disease (Elwood et al., 1974) have been reported. Conversely,
significantly higher sex- and age-adjusted death rates for “all cardiovascular diseases”
and “heart disease” have been reported in an unspecified number of Illinois
communities with high concentrations of barium in drinking-water (2–10 mg/litre)
compared with those with low concentrations (<0.2 mg/litre) in 1971–1975
(Brenniman et al., 1979). There were, however, several confounding factors; although
the communities were matched for demographic characteristics and socioeconomic
status, population mobility differed between the communities with high and low
barium levels. Moreover, it was not possible to control for the use of water softeners
in the home (US NRC, 1982).
A retrospective morbidity study was reported by Brenniman & Levy (1985) on two
Illinois communities, McHenry and West Dundee, which had similar demographic
and socioeconomic characteristics, but a 70-fold difference in barium concentrations
in drinking-water. The mean barium concentration in McHenry’s drinking-water was
0.1 mg/litre, whereas the mean concentration in West Dundee’s drinking-water was
7.3 mg/litre. The levels of other minerals in the drinking-water of the two
communities were stated to be similar. Subjects were selected randomly from a pool
that included every person 18 years of age or older in a random sample of blocks
within each community. Blood pressures of all participants were measured, and data
on the occurrence of cardiovascular, cerebrovascular and renal disease and possible
confounding factors were obtained by means of questionnaires administered by
trained survey workers. No significant differences in mean systolic or diastolic blood
pressures or in history of hypertension, heart disease, stroke or kidney disease were
found for men or women of the two communities.
A more controlled study (Brenniman & Levy, 1985)
was conducted on a
subpopulation of the McHenry and West Dundee subjects who did not have home
water softeners, were not taking medication for hypertension and had lived in the
study community for more than 10 years. No significant differences were observed
between the mean systolic or diastolic blood pressures for men or women of these
subpopulations in the low-barium (0.1 mg/litre, 0.0029 mg of barium per kg of body
weight per day, assuming water ingestion of 2 litres/day and 70-kg body weights) and
elevated-barium (7.3 mg/litre, 0.21 mg of barium per kg of body weight per day)
BARIUM IN DRINKING-WATER
10
communities. The authors concluded that blood pressure in adults does not appear to
be adversely affected, even following prolonged ingestion of drinking-water
containing more than 7 mg of barium per litre.
In a clinical study, 11 “healthy” men were administered 1.5 litres of distilled drinking-
water containing various levels of barium chloride per day. Barium concentrations in
drinking-water that the subjects had been drinking prior to the study were known to be
very low. The first 2 weeks of the trial served as a control period, and no barium was
added to the water. For the ensuing 4 weeks, 5 mg of barium per litre (equivalent to
0.11 mg of barium per kg of body weight per day using a reference body weight of 70
kg) were added, and 10 mg of barium per litre (0.21 mg of barium per kg of body
weight per day) were added for the final 4 weeks of the study (Wones et al., 1990).
Attempts were made to control several of the risk factors for cardiovascular disease,
including diet, exercise, smoking and alcohol consumption, throughout the study
period (although subjects were not continuously monitored in this regard). No
consistent indication of any adverse effects was found. There was, however, a trend
towards an increase in serum calcium between 0 and 5 mg/litre, which persisted at 10
mg/litre; for total calcium, normalized for differences in albumin level, this increase
was statistically significant, but this was not considered to be clinically significant
(IPCS, 2001). The lack of adverse effects observed in this study may be attributable to
the small number of subjects included or the short period of exposure. This study
identified a NOAEL of 0.21 mg of barium per kg of body weight per day; in common
with other studies in humans, the study did not identify a level at which any adverse
effects were observed.
There appear to be no studies of nephropathy in humans.
7. GUIDELINE VALUE
As there is no evidence that barium is carcinogenic (IPCS, 1990), the guideline value
for barium in drinking-water is derived using the TDI approach. Barium has been
shown to cause nephropathy in laboratory animals, but the toxicological end-point of
greatest concern to humans at the relatively low concentrations encountered in the
environment appears to be the potential effect on blood pressure.
In the most sensitive epidemiological study conducted to date, there were no
significant differences in blood pressure or in the prevalence of cardiovascular disease
between a population drinking water containing a mean barium concentration of 7.3
mg/litre and one whose water contained a concentration of 0.1 mg/litre (Brenniman &
Levy, 1985). Using the NOAEL of 7.3 mg/litre obtained from this study and an
uncertainty factor of 10 to account for intraspecies variation, a guideline value of 0.7
mg/litre (rounded figure) was derived for barium in drinking-water.
Analytical methods for barium are adequate for measuring concentrations well below
the guideline value. Barium is a naturally occurring constituent of drinking-water and
can be controlled only by source selection or drinking-water treatment. Precipitation
softening and ion exchange softening are the only treatment processes capable of
BARIUM IN DRINKING-WATER
11
removing a substantial proportion (>90%) of barium from drinking-water (Willey,
1987).
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