Influence of drinking water from water supply systems on the occurrence of urolithiasis in residents of the Primorsky territory in 1991–2015

Abstract

Introduction. The imbalance of macroelements in the soft low-mineralized drinking water of the Primorsky Territory water supply systems can be a risk factor for developing many somatic diseases in the population. Aim: hygienic identification of the mineral composition components of drinking water, posing a risk factor for urolithiasis in children, adolescent, and adult populations over a 25-year follow-up period. Methods include identification of formal statistical relationships between mean annual content of iron, silicon, manganese, calcium, magnesium, sodium, total hardness in drinking water (534 water pipes and 1929 wells), and incidence of urolithiasis in the population (34 administrative areas) by rank correlation analysis, identification cause-effect relations on medical-statistical and hygienic criteria, assessment of the geographical distribution of the attributive risk of urolithiasis at the population level. Results. The relation “cause-effect” has been established between the paired ratio of calcium and magnesium in drinking water and incidence of urolithiasis in adults, adolescents, and children. Increased concentrations of silicon, manganese, and iron in drinking water do not affect the studied incidence level. The maximum risk of urolithiasis in the population is mainly located in the North and East of the Primorsky Territory. Conclusions. An imbalance of calcium and magnesium against a background of magnesium deficiency in tap and well water is the priority risk factor of aquatic origin for urolithiasis in the Primorsky Territory; the features of the geographical distribution of the immediate risk of urolithiasis among the population make it possible to form a scientifically based plan for the sequence of implementation of primary prevention measures for this disease in the region.