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Health hazard assessment of water hardness .pdf

Nom original: Health hazard assessment of water hardness.pdf
Titre: new version (Poster for MEDGEO 2013)3
Auteur: Evens

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Health hazard assessment of water hardness and cardiovascular
diseases. Case study from port-au-prince (Haiti)
Yanick Simon, Farah Alfred, Tatiana Charles, Islande Léandre, Magalie Romain, Emmlyne
Emmanuel, Geneviève Poitevien, Ketty Balthazard-Accou, Evens Emmanuel
Laboratoire Santé-Environnement, Université Quisqueya, 218 Avenue Jean Paul II, Haut de Turgeau, Port-au-Prince, Haïti.

Many studies have reported the existence of a relationship between cardiovascular mortality and hardness of drinking water In other studies, diagnoses of diseases studied were sometimes imprecise,
with broad definitions that include both cardiac and cerebrovascular diseases. Other studies have shown that social factors, climate and environment can both significantly reduce or increase the
apparent magnitude of the effect of water hardness. The most important conclusion, on water hardness and human health, is that magnesium in drinking water can prevent the death of an acute
myocardial infarction.
In Haiti, the fundamental geological factor is formed by limestone, which covers two-thirds of the country area. Cardiovascular diseases are the 7th cause of death and represent 3% of total deaths. In
the Metropolitan Area of Port-au-Prince (MAPP), the review of death certificates for the period 2000-2003, showed that the cardiovascular represent a third of reasons. Information on water quality
used for supplying the MAPP shows that all spring waters sources have a total hardness greater than 200 mg/L, with some magnesium concentrations less than 6 mg/L. This work aims to study the
relationship between high calcium concentration, low magnesium concentration of MAPP water resources, and the high prevalence of cardiovascular diseases in this region.

Water hardness is defined as the sum of concentration of a variety of dissolved polyvalent metallic ions such as aluminium, barium, iron, manganese, strontium, zinc and predominantly calcium and
magnesium. These ions enter a water supply by leaching from minerals within an aquifer and can also occur locally in groundwater from chemical and mining industry effluent, waste or excessive
application of lime to the soil in agricultural areas.
These ions provide substantial contributions to total intakes of some nutrients and prevent various diseases (cardiovascular diseases, urolithiasis, …, neural tube defects, type 1 diabetes mellitus).
In a way to overcome domestic inconvenience (scale formation in pipes, the decrease ability of water to bind soap to form lather), an optimal variation ranged from 60 to150 mg / L has been
Indeed, several studies have reported an association between water hardness and theses diseases particularly mortality related to ischemic heart disease (IHD) in connection with the geology in
industrialized and developing countries in the tropics. Base on research investigations, the hypothesized effect of total water hardness on IHD mortality has been ascribed to the higher intake of
calcium and/or magnesium from tap water itself.
In Haiti, the fundamental geological factor is formed by limestone. Water resources of the Metropolitan Region of Port-au-Prince, the largest urban area in the country, are known to be very hard. Work
on the sources used to supply the population of this area showed a total hardness greater than 200 mg / L, with calcium and magnesium concentrations ranged from 72,4 to 93,5 mg/L and from 5,5 to
11,36 mg/L. Otherwise, cardiovascular diseases occupy an important place among the leading cause of death.

The aim of this study was to present the health hazard assessment of water hardness and cardiovascular diseases in the Metropolitan Region of Port-au-Prince

Methodological approach
Cause of death due to cardiovascular
disease in Haiti (MSPP, 2003)







Heart attack








Results and Discussion

Magnesium and calcium in mg/L


Hardnessin mg/L



•The public water supply of the Metropolitan Region of Port-auPrince has a total hardness greater than 200mg/L with some
concentrations less than 6mg/L.
•Results showed that the population who consume this water
(with magnesium concentration ≤ 6mg/L) is exposed at an
important health hazard.
• It would be interesting to adopt a monitoring policy (including
epidemiological studies on exposed population, health risk
assessment of water hardness and cardiovascular diseases,
experimental study, observation on groundwater quality, and
application of Techniques for water Treatment).



Sample Points
Total hardness (mg/L) (100-300)
Magnesium Hardness (mg/L) (75-200)

Samples Points

Calcium Hardness (mg/L)(75-200)



Hardness of spring water (Tractebel, 1998)
Magnesium and calcium in mg/L


Hardness in mg/L







Samples Points
Total Hardness (mg/L)

Calcium Hardness (mg/L)

Magnesium (mg/L)

Total Hardness (mg/L)

Hardness of groundwater (Simon et al., 2013)

Calcium Hardness (mg/L)

Magnesium (mg/L)

•Dissanayake C.B.; Chandrajith R. Water hardness in relation to
cardiovascular diseases and urinary stones. IN: Introduction to medical
geology: Focus on tropical environments. London: Springer Dordrecht
Heidelberg, 2009, pp.190-2005. ISBN: 978 3-642-004 85-8
•Emmanuel E. et Lindskog P. Regards sur la situation des ressources en
eau de la République d’Haïti. IN: Emmanuel E. et Vermande P. Actes du
Colloque International « Gestion Intégrée de l’Eau en Haïti ». 26, 27, 28
Juin 2002. Port-au-Prince: Université Quisqueya, 2002, pp. 30-50.
•MSPP. Analyse du secteur de la santé pour la reforme. Haïti, 2003,PP.1115
•Rubenowitz – Lundin E., Hiscock M.K. Water Hardness and Health
Effects. IN: Selinus O., Alloway J.B., Centeno A.J., Finkelman B.R., Fuge
R., Lindh U.,Smedley P. Essentials of Medical Geology. London: Elsevier
Academic Press, 2005, pp. 331-345. ISBN: 0-12-636341-2.
•Sellinus O. et Franck A. Medical geology.IN: Environmental medicine.
Stockolm, Sweden: Lennart Möller, Karolinska Institutet, 2000, PP. 164182.ISBN: 91-7522-634-0.
• Simon Y., Leandre I., Charles T., Jean-Pierre C.T. Caractérisation de la
dureté des ressources en eau exploitées pour la consommation humaine
dans la Région Métropolitaine de Port-au-Prince. IN: Colloque
international sur la coopération dans le domaine de l'eau. Université
Quisqueya, Port-au-Prince, 22 mars 2013, CDROM.
•TRACTEBEL DEVELOPMENT Définition des perimetres de protection
pour les sources exploitées par la CAMEP. Bruxelles, 1998.
• U.S. Environnemental Protection Agency: Flood water test results:
chemical testing. avialasssble at:
_2005_09_05.html .

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