Next Article in Journal
Prevalence and Risk Factors of Low Health Literacy: A Community-Based Study in Shanghai, China
Next Article in Special Issue
Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria
Previous Article in Journal
Solidification and Biotoxicity Assessment of Thermally Treated Municipal Solid Waste Incineration (MSWI) Fly Ash
Previous Article in Special Issue
Lithium in the Natural Waters of the South East of Ireland
Article Menu
Issue 6 (June) cover image

Export Article

Open AccessArticle
Int. J. Environ. Res. Public Health 2017, 14(6), 627; doi:10.3390/ijerph14060627

Lithium in Drinking Water and Incidence of Suicide: A Nationwide Individual-Level Cohort Study with 22 Years of Follow-Up

1
National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd Floor, 1353 Copenhagen, Denmark
2
Geological Survey of Denmark and Greenland (GEUS), Department of Groundwater and Quaternary Geology Mapping, C.F. Møllers Allé 8, Aarhus, 8000 Aarhus, Denmark
3
Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
4
National Centre for Register-Based Research, Aarhus University, Fuglesangs Allé 4, 8210 Aarhus, Denmark
5
Geological Survey of Denmark and Greenland (GEUS), Hydrological Department, Øster Voldgade 10, 1350 Copenhagen, Denmark
6
Department of Geoscience, Aarhus University, Høegh-Guldbergs Gade 2, 8000 Aarhus, Denmark
7
Current affiliation (DDV): Department of Geography, National University of Singapore, AS2, #03-01, 1 Arts Link, Kent Ridge, 117570 Singapore, Singapore
8
Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
9
Psychiatric Center Copenhagen, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
Shared Last Authorship.
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 29 April 2017 / Revised: 28 May 2017 / Accepted: 6 June 2017 / Published: 10 June 2017
View Full-Text   |   Download PDF [1907 KB, uploaded 10 June 2017]   |  

Abstract

Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water. View Full-Text
Keywords: drinking water; lithium; suicide; individual-level data; spatial analysis; Denmark; exposure assessment drinking water; lithium; suicide; individual-level data; spatial analysis; Denmark; exposure assessment
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Supplementary material

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Knudsen, N.N.; Schullehner, J.; Hansen, B.; Jørgensen, L.F.; Kristiansen, S.M.; Voutchkova, D.D.; Gerds, T.A.; Andersen, P.K.; Bihrmann, K.; Grønbæk, M.; Kessing, L.V.; Ersbøll, A.K. Lithium in Drinking Water and Incidence of Suicide: A Nationwide Individual-Level Cohort Study with 22 Years of Follow-Up. Int. J. Environ. Res. Public Health 2017, 14, 627.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top