RT Journal Article
T1 Spatial analysis of the relationship between mortality from cardiovascular and cerebrovascular disease and drinking water hardness.
A1 Ferrandiz, Juan
A1 Abellan, Juan J
A1 Gomez-Rubio, Virgilio
A1 Lopez-Quilez, Antonio
A1 Sanmartin, Pilar
A1 Abellan, Carlos
A1 Martinez-Beneito, Miguel A
A1 Melchor, Inmaculada
A1 Vanaclocha, Hermelinda
A1 Zurriaga, Oscar
A1 Ballester, Ferran
A1 Gil, Jose M
A1 Perez-Hoyos, Santiago
A1 Ocana, Ricardo
K1 Adulto
K1 Anciano
K1 Calcio
K1 Enfermedades Cardiovasculares
K1 Trastornos Cerebrovasculares
K1 Niño
K1 Preescolar
K1 Análisis por Conglomerados
K1 Exposición a Riesgos Ambientales
K1 Estudios Epidemiológicos
K1 Sistemas de Información Geográfica
K1 Humanos
K1 Lactante
K1 Magnesio
K1 Masculino
K1 Mediana Edad
K1 Valores de Referencia
K1 Medición de Riesgo
K1 Agua
K1 Abastecimiento de agua
AB 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.
PB National Institute of Environmental Health Science
SN 0091-6765
YR 2004
FD 2004-04-15
LK http://hdl.handle.net/10668/1954
UL http://hdl.handle.net/10668/1954
LA en
NO 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
NO Journal Article; Research Support, Non-U.S. Gov't; Reproduced with permission from Environmental Health Perspectives.
DS RISalud
RD Apr 12, 2025