Health effects of desalinated water: Role of electrolyte disturbance in cancer development.
This review contends that "healthy" water in terms of electrolyte balance is as important as "pure" water in promoting public health. It considers the growing use of desalination (demineralization) technologies in drinking water treatment which often results in tap water with very low concentrations of sodium, potassium, magnesium and calcium. Ingestion of such water can lead to electrolyte abnormalities marked by hyponatremia, hypokalemia, hypomagnesemia and hypocalcemia which are among the most common and recognizable features in cancer patients. The causal relationships between exposure to demineralized water and malignancies are poorly understood. This review highlights some of the epidemiological and in vivo evidence that link dysregulated electrolyte metabolism with carcinogenesis and the development of cancer hallmarks. It discusses how ingestion of demineralized water can have a procarcinogenic effect through mediating some of the critical pathways and processes in the cancer microenvironment such as angiogenesis, genomic instability, resistance to programmed cell death, sustained proliferative signaling, cell immortalization and tumorigenic inflammation. Evidence that hypoosmotic stress-response processes can upregulate a number of potential oncogenes is well supported by a number studies. In view of the rising production and consumption of demineralized water in most parts of the world, there is a strong need for further research on the biological importance and protean roles of electrolyte abnormalities in promoting, antagonizing or otherwise enabling the development of cancer. The countries of the Gulf Cooperative Council (GCC) where most people consume desalinated water would be a logical place to start this research.
Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, United States. Electronic address: jnriagu@umich.edu.
Jerome
J
Nriagu
Centre of Human Safety and Environmental Research, Department of Health Sciences, College of North Atlantic, Doha, Qatar; Centre of Human Safety & Health and Diagnostic Genome Analysis, Red Crescent Hospital, Dubai, United Arab Emirates.
Firouz
F
Darroudi
Qatar Environmental and Energy Research Institute (QEERI), Qatar Foundation, Doha, Qatar.
Basem
B
Shomar
D063646:Carcinogenesis; D060766:Drinking Water / Q000009:adverse effects*; D004573:Electrolytes / Q000009:adverse effects* / Q000378:metabolism; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D018508:Water Purification; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced / Q000453:epidemiology*
D060766:Drinking Water; D004573:Electrolytes
Cancer metabolism; Electrolyte abnormalities; Hypokalemia; Hyponatremia; Hypoosmolality; Hypotonicity; Osmoregulation; Osmotic stress