EXPANDING THE HOUSEHOLD USE OF REVERSE OSMOSIS WATER IN DEVELOPING COUNTRIES IS PHYSIOLOGICALLY UNSUSTAINABLE

Reverse osmosis (RO), the demineralization and decontamination of brackish or highly mineralized water, facilities have increased globally because of rising demands from growing populations, industrialization, tourism and the decreased cost of production. Reverse Osmosis was established in Sri Lanka because of increasing scientific evidence of an association between the use of ground water and chronic kidney disease of unknown origin (CKDu).

This rise in use of RO is not without risk; demineralized water with very low total dissolved solids (TDS) values may be associated with adverse health effects in humans and is not physiologically sustainable over the intermediate to long term. Essential minerals and microelements found naturally in water are beneficial and the low mineral content of RO water has direct negative effects on metabolism, electrolyte and water homeostasis and gastrointestinal tract, mental and skeletal development and function. Further high loss (about 60%) of essential elements occurs in food cooked in low mineral water.

There are significant negative health implications for intermediate and long term continued use of RO water in Sri Lanka. Our preliminary results show well water in Anuradhapura, North Central Province with TDS of about 600 ppm but RO water averaging less than 20 ppm. The Environmental Protection Agency (EPA) recommends levels of about 500 ppm. We can expect to see an increase in the incidence of demineralized water related pathologies for example children with dental and skeletal disease from the lack of fluoride and calcium respectively. Studies have shown lower cardiovascular morbidity and mortality in regions with hard water. The continued long-term use of RO is not physiologically sustainable and will likely lead to non-CKDu health problems.