Background
Sodium (Na
+
) in saline water may increase blood pressure (
BP
), but potassium (K
+
), calcium (Ca
2+
), and magnesium (Mg
2+
) may lower
BP
. We assessed the association between drinking water salinity and population
BP
.
Methods and Results
We pooled 6487
BP
measurements from 2 cohorts in coastal Bangladesh. We used multilevel linear models to estimate
BP
differences across water salinity categories: fresh water (electrical conductivity, <0.7 mS/cm), mild salinity (electrical conductivity ≥0.7 and <2 mS/cm), and moderate salinity (electrical conductivity ≥2 and <10 mS/cm). We assessed whether salinity categories were associated with hypertension using multilevel multinomial logistic models. Models included participant‐, household‐, and community‐level random intercepts. Models were adjusted for age, sex, body mass index (
BMI
), physical activity, smoking, household wealth, alcohol consumption, sleep hours, religion, and salt consumption. We evaluated the 24‐hour urinary minerals across salinity categories, and the associations between urinary minerals and
BP
using multilevel linear models. Compared with fresh water drinkers, mild‐salinity water drinkers had lower mean systolic
BP
(−1.55 [95%
CI
: −3.22–0.12] mm Hg) and lower mean diastolic
BP
(−1.26 [95%
CI
: −2.21–−0.32] mm Hg) adjusted models. The adjusted odds ratio among mild‐salinity water drinkers for stage 1 hypertension was 0.60 (95%
CI
: 0.43–0.84) and for stage 2 hypertension was 0.56 (95%
CI
: 0.46–0.89). Mild‐salinity water drinkers had high urinary Ca
2+
, and Mg
2+
, and both urinary Ca
2+
and Mg
2+
were associated with lower BP.
Conclusions
Drinking mild‐salinity water was associated with lower
BP
, which can be explained by higher intake of Ca
2+
and Mg
2+
through saline water.
We evaluated the effectiveness of a sand barrier around latrine pits in reducing fecal indicator bacteria (FIB) leaching into shallow groundwater. We constructed 68 new offset single pit pour flush latrines in the Galachipa subdistrict of coastal Bangladesh. We randomly assigned 34 latrines to include a 50 cm thick sand barrier under and around the pit and 34 received no sand barrier. Four monitoring wells were constructed around each pit to collect water samples at baseline and subsequent nine follow-up visits over 24 months. Samples were tested using the IDEXX Colilert method to enumerate E. coli and thermotolerant coliforms most probable number (MPN). We determined the difference in mean log 10 MPN FIB counts/100 mL in monitoring well samples between latrines with and without a sand barrier using multilevel linear models and reported cluster robust standard error. The sand barrier latrine monitoring well samples had 0.38 mean log 10 MPN fewer E. coli (95% CI: 0.16, 0.59; p = 0.001) and 0.38 mean log 10 MPN fewer thermotolerant coliforms (95% CI: 0.14, 0.62; p = 0.002), compared to latrines without sand barriers, a reduction of 27% E. coli and 24% thermotolerant coliforms mean counts. A sand barrier can modestly reduce the risk presented by pit leaching.
Table SI1: FT-IR vibrational frequencies for main functional groups and 1 H NMR chemical shifts of different type of protons present in compounds C1-C6 Wavenumber (cm -1 ) Functional groups (CH, aliphatic) (C=O in ester) (C=C, vinyl) (C=C, aromatic) (N=N)
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