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Concentrations and spatial variations of the four cations Na, K, Mg and Ca are known to some extent for groundwater and to a lesser extent for drinking water. Using Denmark as case, the purpose of this study was to analyze the spatial and temporal variations in the major cations in drinking water. The results will contribute to a better exposure estimation in future studies of the association between cations and diseases. Spatial and temporal variations and the association with aquifer types, were analyzed with spatial scan statistics, linear regression and a multilevel mixed-effects linear regression model. About 65,000 water samples of each cation (1980⁻2017) were included in the study. Results of mean concentrations were 31.4 mg/L, 3.5 mg/L, 12.1 mg/L and 84.5 mg/L for 1980⁻2017 for Na, K, Mg and Ca, respectively. An expected west-east trend in concentrations were confirmed, mainly explained by variations in aquifer types. The trend in concentration was stable for about 31⁻45% of the public water supply areas. It is therefore recommended that the exposure estimate in future health related studies not only be based on a single mean value, but that temporal and spatial variations should also be included.

Stability of Major Geogenic Cations in Drinking Water—An Issue of Public Health Importance: A Danish Study, 1980–2017