Publication: Spatial analysis of the relationship between mortality from cardiovascular and cerebrovascular disease and drinking water hardness.
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Identifiers
Date
2004-04-15
Authors
Ferrandiz, Juan
Abellan, Juan J
Gomez-Rubio, Virgilio
Lopez-Quilez, Antonio
Sanmartin, Pilar
Abellan, Carlos
Martinez-Beneito, Miguel A
Melchor, Inmaculada
Vanaclocha, Hermelinda
Zurriaga, Oscar
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
National Institute of Environmental Health Science
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Abstract
Previously published scientific papers have reported a negative correlation between drinking water hardness and cardiovascular mortality. Some ecologic and case-control studies suggest the protective effect of calcium and magnesium concentration in drinking water. In this article we present an analysis of this protective relationship in 538 municipalities of Comunidad Valenciana (Spain) from 1991-1998. We used the Spanish version of the Rapid Inquiry Facility (RIF) developed under the European Environment and Health Information System (EUROHEIS) research project. The strategy of analysis used in our study conforms to the exploratory nature of the RIF that is used as a tool to obtain quick and flexible insight into epidemiologic surveillance problems. This article describes the use of the RIF to explore possible associations between disease indicators and environmental factors. We used exposure analysis to assess the effect of both protective factors--calcium and magnesium--on mortality from cerebrovascular (ICD-9 430-438) and ischemic heart (ICD-9 410-414) diseases. This study provides statistical evidence of the relationship between mortality from cardiovascular diseases and hardness of drinking water. This relationship is stronger in cerebrovascular disease than in ischemic heart disease, is more pronounced for women than for men, and is more apparent with magnesium than with calcium concentration levels. Nevertheless, the protective nature of these two factors is not clearly established. Our results suggest the possibility of protectiveness but cannot be claimed as conclusive. The weak effects of these covariates make it difficult to separate them from the influence of socioeconomic and environmental factors. We have also performed disease mapping of standardized mortality ratios to detect clusters of municipalities with high risk. Further standardization by levels of calcium and magnesium in drinking water shows changes in the maps when we remove the effect of these covariates.
Description
Journal Article; Research Support, Non-U.S. Gov't; Reproduced with permission from Environmental Health Perspectives.
MeSH Terms
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Metals::Metals, Alkaline Earth::Calcium
Medical Subject Headings::Diseases::Cardiovascular Diseases
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders
Medical Subject Headings::Named Groups::Persons::Age Groups::Child
Medical Subject Headings::Named Groups::Persons::Age Groups::Child::Child, Preschool
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Cluster Analysis
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Environmental Pollution::Environmental Exposure
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Information Science::Information Science::Information Storage and Retrieval::Databases as Topic::Databases, Factual::Geographic Information Systems
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant::Infant, Newborn
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Metals::Metals, Light::Magnesium
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Weights and Measures::Reference Values
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Hydroxides::Water
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Sanitation::Sanitary Engineering::Water Supply
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Metals::Metals, Alkaline Earth::Calcium
Medical Subject Headings::Diseases::Cardiovascular Diseases
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders
Medical Subject Headings::Named Groups::Persons::Age Groups::Child
Medical Subject Headings::Named Groups::Persons::Age Groups::Child::Child, Preschool
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Cluster Analysis
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Environmental Pollution::Environmental Exposure
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Information Science::Information Science::Information Storage and Retrieval::Databases as Topic::Databases, Factual::Geographic Information Systems
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant
Medical Subject Headings::Named Groups::Persons::Age Groups::Infant::Infant, Newborn
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Metals::Metals, Light::Magnesium
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Weights and Measures::Reference Values
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Hydroxides::Water
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Sanitation::Sanitary Engineering::Water Supply
DeCS Terms
CIE Terms
Keywords
Adulto, Anciano, Calcio, Enfermedades Cardiovasculares, Trastornos Cerebrovasculares, Niño, Preescolar, Análisis por Conglomerados, Exposición a Riesgos Ambientales, Estudios Epidemiológicos, Sistemas de Información Geográfica, Humanos, Lactante, Magnesio, Masculino, Mediana Edad, Valores de Referencia, Medición de Riesgo, Agua, Abastecimiento de agua
Citation
Ferrandiz J, Abellan JJ, Gomez-Rubio V, Lopez-Quilez A, Sanmartin P, Abellan C, et al. Spatial analysis of the relationship between mortality from cardiovascular and cerebrovascular disease and drinking water hardness Environ Health Perspect. 2004; 112(9): 1037-44