- NEW YORK (Reuters Health)
- A new review of three deaths of US military recruits highlights the dangers
of drinking too much water.
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- 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, he said.
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- "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.
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- "That's why we published this paper: to make it
clear to people that overzealousness can be dangerous," Gardner explained.
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- 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.
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- 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 sodium.
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- 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.
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- 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.
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- 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.
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- 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.
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- 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.
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- 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.
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- "You can't prevent everything bad from happening,"
Gardner noted. "But when it does, you have to learn from it."
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- SOURCE: Military Medicine
2002;167:432-434.
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