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HARD WATERS AND HEALTH
By L. R. L. EDWARDS, M.D., London, D.P.H., Liverpool
Medical Officer of Health, Borough of Beckenham
The purpose of this article is to consider the evidence relating to
health in areas where the drinking water is of a hard nature, and
especially concerning stone in the urinary tract.
This is a matter of some importance to areas such as the Borough
of Beckenham whose drinking water supply is moderately hard and
is obtained by admixture of water from the River Thames with waters
from wells in chalk strata. The total hardness as calcium carbonate
from the River Thames averages 282 mg./l. and in the wells of
Orpington, Shortlands and West Wickham averages 272, 280 and
260 mg./l. respectively. There are no comparative studies to indicate
whether calculus of the kidney and ureter is more common in this area
than in other parts of the country where the incidence is generally a
low one. A research study of the College of General Practitioners
and the General Register Office covering the clinical records of over
100 medical practitioners at random throughout the country over the
period May, 1955, to April, 1956, gave an incidence of 0.4 per 1,000
for males and 0.2 per 1,000 for females. The population at risk was
180,000 males and 202,769 females. In practically all cases the hardness
of a water depends upon the presence of certain salts, calcium and
magnesium, bicarbonates and sulphates. Temporary hardness is due
to bicarbonates and permanent hardness to sulphates.
Effects on general health
Excessively hard waters have been alleged to cause kidney disease,
calculus, gout, rheumatism, constipation, biliousness, goitre and
arteriosclerosis.
Amongst veterinarians there is a popular idea that hard water
has a bad effect on animals in some general indefinite way.
It is thought that the coats of horses and cattle is made rougher
and the animals do not " do as well " if forced continually to drink
hard water. This belief is particularly prevalent among poultry raisers.
Many sanitarians think that hard water has no effect on human
health either good or bad. Thresh (1913) remarked that hard water
had no bad effects on health. He based his conclusions on a comparison
of the death-rate from typhoid fever and similar diseases in
hard water regions and in soft water regions.
Sherman (1919) states that "since inorganic forms of calcium are
utilised in nutrition, the lime of drinking water may be added to that
of the food in calculating the amount consumed, and to this extent
the nutritive supply may be greater than the dietary studies show, but
unless a very hard water is used for drinking it is unlikely that the
lime from this source will cover more than a small part of the calcium
requirement."
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