
adults and children. The same is the case with radio-
active elements. An increased content of radon has
been found in some of the wells in the USA and
Europe. In some European countries where radon
mineral water is used for treatment of diseases, an
increased incidence of lung cancer has been reported
in employees working in the spas.
0019 In comparison with the amount of mineral water
consumed in different parts of the world, the inci-
dence of adverse effects described in literature, is,
however, negligible. When one takes into consider-
ation the ill health caused by waterborne diseases in
many parts of the world, the introduction of mineral
water that is free from pathogenic organisms can play
a role in protecting societies from such diseases. At
the same time, the considerable increase in mineral
water sales in developed countries during the last few
decades has compelled the public health authorities to
set up very strict regulations concerning the quality of
mineral water. (See Calcium: Physiology; Heavy
Metal Toxicology; Iodine: Physiology; Nitrosamines;
Trace Elements; Water Supplies: Water Treatment.)
0020 Commercially available mineral waters have no
calories or alcohol. These two qualities make mineral
water a suitable beverage for low-calorie diets. It is
not uncommon for doctors to prescribe mineral water
to pregnant women and infants, especially in areas
where the drinking water contains high levels of ni-
trates and fluorides. In recent years, attention has
been focused on the health hazard arising from the
ingestion of nitrates and nitrites. Nitrate, when re-
duced to nitrite, is a precursor of the carcinogenic
nitrosamine or nitrosamide. The extensive use of fer-
tilizers in recent years has resulted in the contamin-
ation of drinking water with nitrates in many parts of
the world. The situation is much worse in most de-
veloping countries. In such areas, mineral water can
be an excellent substitute for drinking water for risk
groups such as pregnant women, infants, and young
children. Drinking water in some parts of the world
may also contain significant amounts of toxic elem-
ents, including arsenic, cadmium, mercury, and lead.
Contamination of ground water with arsenic, for
example, in Bangladesh and West Bengal is currently
a serious health problem in Bangladesh and India.
Several million people are affected by this contamin-
ation. Mineral water, however, has only negligible
amounts of these elements (see Table 2). During the
last few decades, a number of investigations have
reported an association between the calcium–magne-
sium (water hardness) contents of drinking water and
mortality from ischemic heart disease. Most brands
of mineral water that are commercially available at
present do not have a high concentration of calcium
or magnesium. Since mineral water contains no
alcohol, it is an ideal beverage to drink before driving.
Mineral water has become very common and popular
as a healthy beverage during social gatherings in af-
fluent countries owing to the low level of alcohol (in
some countries like Sweden, almost zero level) that is
permitted to be consumed before driving.
0021In conclusion, mineral water per se has no medi-
cinal property other than being free from pathogenic
organisms. The mineral salts and trace elements pre-
sent in many of the well-known brands of mineral
water are in such low concentration as to be virtually
devoid of physiological or pharmacological action.
The possible exceptions are with regards to the con-
tent of fluorine, calcium, and some toxic metals and
metalloids such as arsenic. Mineral waters are usually
free from chlorine, and the taste is often superior to
treated water.
Trends in Consumption
0022In recent years, sales of commercially available min-
eral waters have rapidly expanded, transforming
mineral water from a market niche to a sizeable
mainstream market segment, in many countries. The
reasons for this growth have already been described.
People enjoy still and carbonated waters all over the
world. Sales of packaged waters in Europe and North
America have risen considerably in recent years. The
consumption of packaged water in some countries
such as the UK and the Netherlands is somewhat
modest when compared with that of the other central
European countries. The demand, however, is grow-
ing steadily in most countries. The per capita con-
sumption of packaged mineral water a decade ago in
the central European region was around 80 l. The
corresponding figures in the UK and USA were 23
and 28 l, respectively. Even in East European coun-
tries, the per capita consumption of mineral water
was significant during the last couple of decades.
In the former Yugoslavia, the per capita consump-
tion during the 1990s was around 20 l. Although the
consumption of mineral water, especially still water,
is fairly common in the former Soviet Union, con-
sumption data are not currently available. The
same applies to many countries in Asia where the
consumption of packaged mineral water is significant
mainly owing to the poor quality of public water
and the increase in tourism. Generally speaking,
the per capita consumption of packaged mineral
water in most affluent countries has more than
doubled during the last decade. This trend is likely
to increase in future years as a result of a heightening
of the consumer awareness of health and increas-
ing concern about the quality and taste of public
drinking water.
4016 MINERAL WATER/Types of Mineral Water