全球有10億人可能因為喝的水太純淨，更易患病！

人們一直在追求著更乾淨清潔的飲用水。在人類歷史早期，我們就已經學會使用過濾，蒸餾等方法來淨化我們所喝的水。

半個多世紀前，Sidney Loeb和Srinivasa Sourirajan發明了RO逆(反)滲透膜。這是對飲水淨化科技的又一次革新。RO逆(反)滲透科技會去除水中的絕大多數的離子和有機物，生產出我們日常飲用的純淨水。

從那以後的五十多年來，學術界和製造商的不斷努力讓這項科技變得更加簡單與可靠。

RO逆(反)滲透革命為人類帶來了福音，但和所有顛覆性的科技一樣，它有可能產生意想不到的後果。你有沒有想過，喝的水太“純淨”，可能會影響到你的健康？

不久前，美國《環境科學與技術》（Environmental Science & Technology）發表了戴維·塞德拉克的一篇關於RO逆(反)滲透淨水科技的文章，並指出了一個令人震撼的結論：RO逆(反)滲透淨水科技把水中天然存在的很多有益礦物質都去除掉了。而這種“太過純淨”的水可能導致人體營養不良甚至新增患病風險。

在這篇文章中他指出，RO逆(反)滲透淨水科技正在被越來越廣泛地應用，包括許多普通家庭也開始使用RO逆(反)滲透淨水機。根據現時的情况來估算，到21世紀中葉，超過十億人口會使用RO逆(反)滲透膜淨化的水。這種經RO逆(反)滲透淨化後的水就是我們平時常喝的純淨水。因此，世界飲用水供給的性質已經發生變化，人們有必要考慮這項科技可能帶來的影響。

“RO逆(反)滲透科技革命的諷刺之處在於它製造了太過乾淨的飲用水。人們早已認識到，長期飲用去離子水會導致營養缺乏。”戴維·塞德拉克在文中如是說。

首先，RO逆(反)滲透淨化後的純淨水中去除了鈣離子。而導致普遍鈣攝入量不足。在《中國居民膳食營養指南》中描述，18～49歲成年人的每日鈣推薦攝入量（RNI）為800mg/d，50歲以上中老年人每日鈣推薦攝入量（RNI）為1000mg/d。然而，中國居民的平均鈣攝入量遠低於這一標準，不足400mg/d。

其次，經RO逆(反)滲透淨化後的水中幾乎不再有鎂離子。而人們飲用鎂缺乏的水會新增患心臟疾病的風險。

針對水中的鈣鎂元素，世界衛生組織WHO的《飲用水水質準則》中曾明確指出，“飲用水中的鈣、鎂攝入量約占成人總攝入量的5%～20%”。

而《飲用水中的營養素》更是認為：“水中的礦物質可以部分補充人群膳食礦物元素的攝入，尤其是鈣和鎂，並且可能在心血管疾病方面對人體健康存在一定保護，而去除水中礦物質可能存在一定健康風險”。

國內外已經有一些生產商意識到了RO逆(反)滲透淨水機存在的這個問題。例如以色列的一家供水商開始努力開發一種給RO逆(反)滲透淨化後的水添加鎂的方法。也有人通過家用RO逆(反)滲透系統添加鎂，但這種做法的成本非常高昂，尋常家庭基本不可能負擔得起。

現時，國內的家用RO逆(反)滲透飲水機並不能再向水中加入礦物元素，因此對於慣用RO逆(反)滲透淨水機的家庭來說，長期飲用這樣的純淨水會新增潛在的健康風險。

鎂還不是RO逆(反)滲透膜淨化的水中唯一缺少的重要營養離子。另外一個重要的礦物元素是氟。而RO逆(反)滲透膜淨化的純淨水會造成飲用水額外的氟缺乏。這個問題在低收入的群體中尤其值得關注，因為他們很少使用含氟牙膏。

氟元素的缺失對兒童的成長發育也有可能造成不利的影響。雖然沒有確定的證據可以證明氟化物的缺失是某些地區兒童身高變矮和齲齒新增的原因，但在這些地區，許多中小學都安裝了RO逆(反)滲透膜淨水機。

此外，大約10年前，流行病學家報告說飲用水中鋰濃度較低的群體，自殺率較高。雖然並非所有後續研究都支持鋰缺乏性假設，但海水淡化水的鋰濃度幾乎都處於檢測限的低端，據報導飲用這類水的地方自殺率有所增加。

綜合上述，戴維·塞德拉克鄭重地指出：“考慮到飲用RO逆(反)滲透純淨水的人數眾多，我們必須相當謹慎地思考這個問題，即人體所需要的其他微量元素也可能需要通過飲用水來攝取。”

而純淨水還存在一個風險：由於經RO逆(反)滲透處理後的純淨水幾乎沒有溶解性離子存在，這就意味著它加强了礦物質溶解速率。人如果長期飲用純淨水，會導致人體內的礦物質被溶解流失。

在戴維·塞德拉克的文章最後，他憂心忡忡地表示：“從現在開始的一個世紀，歷史學家往回看時將把RO逆(反)滲透的普及當作是飲用水供給發展中最重要的事件之一。科研群體面臨的挑戰是確保歷史書中不會註腳說明RO逆(反)滲透革命的意外後果。”

戴維·塞德拉克對RO逆(反)滲透淨水科技的研究與反思不能不引起我們的警惕。在這個家用淨水科技越來越發達的時代，我們也應當建立起對飲水健康的科學認知。認識到水中礦物元素對健康的重要性，確保自己飲用的水是安全、健康的。

下為原文

Over half a century ago, the seeds of a water revolution were sewn when Sidney Loeb and Srinivasa Sourirajan invented the reverse osmosis membrane. Over the last five decades, academics and manufacturers have reduced the cost of producing membranes, improved their energy efficiency and made their operation simpler and more reliable. Today, desalination of seawater and brackish groundwater by reverse osmosis provides water to some of the world’s most water-stressed cities. The impact of the technology is now being extended beyond desalination as potable water reuse facilities are coming online in California, Texas, and Singapore. Reverse osmosis also has become popular in household-scale water treatment and in the production of bottled water consumed in places where the public believes that their tap water is unsafe.

In 2018, about 1% of the world’s population drank desalinated seawater. Although precise estimates are not readily available, millions more used reverse osmosis to purify treated wastewater, polluted river water, and water that was deemed unsuitable for consumption. The growth in this practice shows no sign of slowing, with capital investments in reverse osmosis growing by approximately 15% per year. On the basis of these trends, it is reasonable to assume that over a billion people could be consuming reverse osmosis-treated water by the middle of the twenty-first century. The reverse osmosis revolution benefits humanity, but like all disruptive technologies, it has the potential to create unintended consequences. By considering current practices used for reverse osmosis treatment, we can identify the knowledge gaps, technology improvements, and policies needed to protect public health and the environment as the nature of the world’s drinking water supply changes.

The great irony of the reverse osmosis revolution is that it has created drinking water that may be too clean. It has long been recognized that, over the long-term, consumption of ion-free water can lead to nutritional deficiencies. For this and other reasons, treated water is typically remineralized after reverse osmosis treatment. At full-scale water treatment plants, where corrosion of water distribution pipes is a major concern, lime (i.e., Ca(OH)2(s)) is used for remineralization because it is inexpensive and readily available. Unfortunately, the near absence of magnesium in water produced by this process has resulted in deficiencies in magnesium that increase the risks of heart disease. When this problem first came to light, water providers in Israel initiated an effort to develop cost-effective and reliable approaches for introducing magnesium during remineralization. But until such systems become the norm, dietary supplements may be needed in communities where treatment plants deliver reverse osmosis-treated water that has not blended with water from other sources. (Magnesium is already added to many bottled waters produced by reverse osmosis. It is also added by some household reverse osmosis systems.)

Magnesium may not be the only nutritionally important ion missing from reverse-osmosis-treated water. The issue of whether or not to add fluoride to drinking water in places where the naturally occurring levels are low has been a matter of controversy for decades. As reverse osmosis creates additional fluoride-deficient drinking water supplies, public health experts will have to pay more attention to the need to augment dietary fluoride sources. This issue is particularly important in lower income communities, where fluoride-containing toothpaste is less common. For example, failure to appreciate the impact of reverse osmosis on fluoride led to decreases in height and increases in caries among children in communities in China where reverse osmosis systems had been installed at primary schools.

Considering the number of people who rely upon reverse osmosis-treated water, it is prudent to look more carefully at the possibility that other trace elements are derived from drinking water. About 10 years ago, epidemiologists reported increased rates of suicide in communities where lithium concentrations in drinking water are low. Although not all of the subsequent studies supported the lithium deficiency hypothesis, the concentrations of lithium in desalinated seawater are at the low end of the range reported in places where increased suicide rates have been observed. It would be possible to add a small amount of lithium, or other needed trace elements, to reverse osmosis water or to supplement diets in other ways in deficient populations, but without additional research to establish the validity of these ideas, this is unlikely to happen.

The near absence of dissolved ions also means that reverse osmosis-treated water enhances rates of mineral dissolution. The remineralization process, which decreases the tendency of reverse osmosis-treated water to dissolve the calcite and iron oxide layers that coat the inner walls of pipes, was adapted from engineering practices developed in places where the local water supply contained low concentrations of dissolved ions. In many of the locations where reverse osmosis treatment plants are being installed, water from ion-rich sources had been flowing through the pipes for decades prior to introduction of the desalinated water. Adding lime and raising the pH of reverse osmosis-treated water prior to its contact with the aged pipes may minimize dissolution of carbonates and oxides, but exposure to remineralized water could still release adsorbed trace elements, like arsenic, chromium, and lead. Reverse-osmosis-treated water could also pose risks during water storage as illustrated by the release of geogenic arsenic from an aquifer where remineralized water was used to recharge a drinking water aquifer. Furthermore, the microbes in engineered and natural systems will be affected by the change in water chemistry in a manner that could alter biogeochemical processes and affect the fate of waterborne pathogens.

A century from now, historians will look back on the popularization of reverse osmosis as one of the most significant events in the development of drinking water supplies. The challenge for the research community is to make certain that the history books do not include a footnote about the unintended consequences of the reverse osmosis revolution.

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