Too Much Water Can Kill You
NEW YORK (Reuters Health) - A new review of three deaths of US
military recruits highlights the dangers of drinking too much
The military has traditionally focused on the dangers associated
with heat illness, which has killed a number of healthy, young enrollees,
Colonel John W. Gardner of the Office of the Armed Forces Medical
Examiner in Rockville, Maryland told Reuters Health. However, pushing
the need to drink water too far can also have deadly consequences,
"The risk has always been not drinking enough," Gardner said.
"And then people who aren't medically attuned get overzealous,"
inducing recruits to drink amounts of water that endanger their
health, he added.
"That's why we published this paper: to make it clear to people
that overzealousness can be dangerous," Gardner explained.
In September 1999, a 19-year-old Air Force recruit collapsed
during a 5.8-mile walk, with a body temperature of 108 degrees
Fahrenheit. Doctors concluded he had died of both heat stroke
and low blood sodium levels as a result of overhydration.
During January 2000, a 20-year-old trainee in the Army drank
around 12 quarts of water during a 2- to 4-hour period while trying
to produce a urine specimen for a drug test. She then experienced
fecal incontinence, lost consciousness and became confused, then
died from swelling in the brain and lungs as a result of low blood
In March 2001, a 19-year-old Marine died from drinking too much
water after a 26-mile march, during which he carried a pack and
gear weighing more than 90 pounds. Although he appeared fine during
the beginning stages of the 8-hour walk, towards the end he began
vomiting and appeared overly tired. He was then sent to the hospital,
where he fell into a coma, developed brain swelling and died the
next day. It is unclear how much water he drank during the march,
but Marines were given a "constant emphasis" on drinking water
before and during the activity, Gardner writes in the latest issue
of Military Medicine.
In an interview with Reuters Health, Gardner explained that
drinking too much water is dangerous because the body cannot excrete
that much fluid. Excess water then goes to the bowel, which pulls
salt into it from the body, diluting the concentration of salt
in the tissues.
Changing the concentration of salt, in turn, causes a shifting
of fluids within the body, which can then induce a swelling in
the brain. The swollen organ will then press against the bones
of the skull, and become damaged.
The researcher added that previous cases of water toxicity have
been noted in athletes who consume excessive amounts in order
to avoid heat stroke. In addition, certain psychiatric patients
may drink too much water in an attempt to wash away their sins,
or flush out poisons they believe have entered their bodies.
In 1998, the Army released fluid replacement guidelines, which
recommend a certain intake of water but limit it to 1 to 1-1/2
quarts per hour and 12 quarts per day.
It takes a while for these guidelines to get "permeated out"
to everybody, Gardner admitted. In the meantime, he suggested
that bases take notice of the mistakes of others, and "not wait
for somebody to die from (water toxicity) again," he said.
"You can't prevent everything bad from happening," Gardner noted.
"But when it does, you have to learn from it."
SOURCE: Military Medicine 2002;167:432-434.
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