Acidic Drinking Water and Risk of Childhood-Onset Type 1 Diabetes
- Lars C. Stene, PhD12,
- Dag Hongve, MSC3,
- Per Magnus, MD, PHD2,
- Kjersti S. Rønningen, MD, PhD2 and
- Geir Joner, MD, PhD1
- 1Diabetes Research Center, Aker and Ullevål University Hospitals, Oslo, Norway
- 2Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- 3Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway
OBJECTIVE—To estimate the associations of acidity and concentration of selected minerals in household tap water with the risk of type 1 diabetes.
RESEARCH DESIGN AND METHODS—We designed a population-based case-control study with 64 cases of type 1 diabetes and 250 randomly selected control subjects. Acidity, color, and mineral content were measured in tap water from each participant’s household.
RESULTS—Tap water pH 6.2–6.9 was associated with a fourfold higher risk of type 1 diabetes compared with pH ≥7.7 (OR 3.73, 95% CI 1.52–9.15). This result was similar after exclusion of individuals with the highly protective HLA-DQB1*0602 allele, but adjustment for maternal education, urban/rural residence, sex, and age tended to strengthen the estimated association. Higher tap water concentration of zinc was associated with lower risk of type 1 diabetes after adjustment for pH and other possible confounders, but the overall association was strictly not significant.
CONCLUSIONS—These results suggest the possibility that quality of drinking water influences the risk of type 1 diabetes. The possible mechanisms by which water acidity or mineral content may be involved in the etiology of type 1 diabetes remain unknown, but the mechanisms are most likely indirect and may involve an influence on survival of microorganisms in the water.
Address correspondence and reprint requests to Lars C. Stene, Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway. E-mail:.
Received for publication 22 January 2002 and accepted in revised form 23 May 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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