Linking of Environmental and Health Indicators by Neural Networks: Case of Breast Cancer Mortality, Slovak Republic

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This work aims to evaluate the impact of the chemical composition of groundwater/drinking water on the health of inhabitants of the Slovak Republic. Primary data consists of 20,339 chemical analyses of groundwater (34 chemical elements and compounds) and data on the health of the Slovak population expressed in the form of health indicators (HI). Fourteen HIs were evaluated including life expectancy, potential years of lost life, relative/standardized mortality for cardiovascular and oncological diseases, and diseases of the gastrointestinal and respiratory systems. The chemical and health data were expressed as the mean values for each of the 2883 Slovak municipalities. Artificial neural network (ANN) was the method used for environmental and health data analysis. The most significant relationship between HI and chemical composition of groundwater was documented as Ca + Mg (mmol·L−1), Ca and Mg. The following limit values were set for these most significant groundwater chemical parameters: Ca + Mg 2.9–6.1 mmol·L−1, Ca 78–155 mg·L−1 and Mg 28–54 mg·L−1. At these concentration ranges, the health of the Slovak population is the most favorable and the life expectancy is the highest. These limit values are about twice as high in comparison to the current Slovak valid guideline values for drinking water.

Section: Methodsmentioning

confidence: 99%

Impact of Calcium and Magnesium in Groundwater and Drinking Water on the Health of Inhabitants of the Slovak Republic

Rapant

Cvečková

Fajčíková

et al. 2017

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“…The numbers of residents in municipalities were not random. It is clear from our previous studies [ 29 , 30 ] that small municipalities below 100 residents often showed unbalanced health indicators (small number error). On the other hand, large municipalities (towns) with ≥10,000 residents are often supplied with drinking water from several sources.…”

Section: Methodsmentioning

confidence: 91%

“…We also wanted to avoid the fact that when 4–5 municipalities with >10,000 residents were selected, the necessary variability of health indicators could not be obtained. Municipalities with 500–5000 residents showed the most balanced health indicators and were most closely connected with the environment [ 29 , 30 ]. The selected municipalities are of rural character with similar socio-economic characteristics and other major determinants of health, such as lifestyle, quality and availability of health care [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…Limit values multiplied with UF represent the minimum required concentration (MRC) ( Table 4 ). The health status of the Slovak population in the four main HIs reaches an average value at this content of Ca, Mg and hardness in drinking water [ 16 , 29 ]. The calculated MRC values of Ca and Mg in drinking water are in accordance with the recommended concentrations of Ca and Mg given by several authors, e.g., [ 15 , 17 ].…”

Section: Methodsmentioning

confidence: 99%

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Proposal of New Health Risk Assessment Method for Deficient Essential Elements in Drinking Water—Case Study of the Slovak Republic

Rapant

Cvečková

Hiller

et al. 2020

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The US EPA health risk assessment method is currently widely used to assess human health risks for many environmental constituents. It is used for risk assessment from the exposure to various contaminants exceeding tolerable or safe reference doses, determined e.g., for drinking water, soil, air and food. It accepts widely that excess contents of non-essential elements (e.g., As, Pb or Sb) in environmental compartments represent a general risk to human health. However, contrary to toxic trace elements, deficient contents of essential (biogenic) elements e.g., F, I, Se, Zn, Fe, Ca or Mg may represent even higher health risk. Therefore, we propose to extend the human health risk assessment by calculating the health risk for deficient content and intake of essential elements, and to introduce the terms Average Daily Missing Dose (ADMD), Average Daily Required Dose (ADRD) and Average Daily Accepted Dose (ADAD). We propose the following equation to calculate the Hazard Quotient (HQ) of health risk from deficient elements: HQd = ADRD/ADAD. At present, there are no reference concentrations or doses of essential elements in each environmental compartment in world databases (Integrated Risk Information System IRIS, The Risk Assessment Information System RAIS). ADRD and ADMD can be derived from different regulatory standards or guidelines (if they exist) or calculated from actual regional data on the state of population health and content of essential elements in the environment, e.g., in groundwater or soil. This methodology was elaborated and tested on inhabitants of the Slovak Republic supplied with soft drinking water with an average Mg content of 5.66 mg·L−1. The calculated ADMD of Mg for these inhabitants is 0.314 mg·kg−1·day−1 and HQd is equal to 2.94, indicating medium risk of chronic diseases. This method extending traditional health risk assessment is the first attempt to quantify deficient content of essential elements in drinking water. It still has some limitations but also has potential to be further developed and refined through its testing in other countries.

“…In some districts, this may be related to higher levels of standardized death rates of breast and prostate cancer. Among other things, some districts in Slovakia (e.g., Spišská Nová Ves, Levice, Rimavská Sobota, Bardejov, and others) belong to districts that are burdened with so-called old waste-disposal sites, as well as sites abandoned by their former mainly agricultural, but also industrial, plants that will have to be dismantled in order to avoid further pollution of the soil and groundwater, and, eventually, related health risks [ 60 ]. The map outputs imply a range of information, related to both content and spatial aspects of the regional differences in the standardized death rate of breast and prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

Spatial Autocorrelation of Breast and Prostate Cancer in Slovakia

Vilinová

2020

Cancer is one of the dominant causes of death in the Slovak population. Monitoring the course of the cancer death rate in Slovakia can be considered as a relevant subject for geographical research. Relatively little is known about the geographic distribution of breast and prostate cancer incidence in Slovakia. In the submitted paper, it is hypothesized that breast and prostate cancer in the examined territory are characterized by different intensities, incidences, and spatial differences. The spatial patterns of breast and prostate cancer in Slovakia were examined by means of spatial autocorrelation analyses with the Local Moran’s I and Anselin Local Moran’s statistics. Data on standardized death rates of breast and prostate cancer in Slovakia between 2001 and 2018 were used. Prostate cancer in men and breast cancer in women show a positive statistically significant Global Moran’s I, whose values indicate a tendency to cluster. The Anselin Local Moran’s I analysis indicates significant clusters of breast cancer in the western part of Slovakia, and prostate cancer clusters mostly in the central part of Slovakia. The findings we have obtained in this study may help us investigate further hypotheses regarding the causes and identification of spatial differences in breast and prostate cancer incidence. Our findings might stimulate further research into the possible causes which underlie the clusters.