In this paper, the spatial distribution of the first event of acute myocardial infarction among 35- to 74-year-old men in Finland was examined for the cross-section years 1983, 1988 and 1993. The analysis was performed using a Bayesian hierarchical spatial approach to the geographically referenced data. The population data and case data received from nationwide registries were aggregated into 10 × 10 km cells. The estimated maps show that along with the overall decreasing incidence, the high-risk area withdrew deeper into the northeast, with an incidence 7–12% higher in rural than in urban areas. It could be concluded that eastern Finland is likely to remain a high-risk area in the future due to the concentration of certain risk factors.

Study objective: To examine the association of spatial variation in acute myocardial infarction (AMI) incidence and its putative environmental determinants in ground water such as total water hardness, the concentration of calcium, magnesium, fluoride, iron, copper, zinc, nitrate, and aluminium. Design: Small area study using Bayesian modelling and the geo-referenced data aggregated into 10 km610 km cells. Setting: The population data were obtained from Statistics Finland, AMI case data from the National Death Register and the Hospital Discharge Register, and the geochemical data from hydrogeochemical database of Geological Survey of Finland. Participants: A total of 18 946 men aged 35-74 years with the first AMI attack in the years 1983, 1988, and 1993. Main results: One unit (in German degree˚dH) increment in water hardness decreased the risk of AMI by 1%. Geochemical elements in ground water included in this study did not show a statistically significant effect on the incidence and spatial variation of AMI, even though suggestive findings were detected for fluoride (protective), iron and copper (increasing). Conclusions:The results of this study with more specific Bayesian statistical analysis confirm findings from earlier observations of the inverse relation between water hardness and coronary heart disease. The role of environmental geochemistry in the geographical variation of the AMI incidence should be studied further in more detail incorporating the individual intake of both food borne and water borne nutrients. Geochemical-spatial analysis provides a basis for the selection of areas suitable for such research.

Several epidemiologic studies have shown an association between calcium and magnesium and coronary heart disease mortality and morbidity. In this small-area study, we examined the relationship between acute myocardial infarction (AMI) risk and content of Ca, Mg, and chromium in local groundwater in Finnish rural areas using Bayesian modeling and geospatial data aggregated into 10 km × 10 km grid cells. Data on 14,495 men 35–74 years of age with their first AMI in the years 1983, 1988, or 1993 were pooled. Geochemical data consisted of 4,300 measurements of each element in local groundwater. The median concentrations of Mg, Ca, and Cr and the Ca:Mg ratio in well water were 2.61 mg/L, 12.23 mg/L, 0.27 μg/L, and 5.39, respectively. Each 1 mg/L increment in Mg level decreased the AMI risk by 4.9%, whereas a one unit increment in the Ca:Mg ratio increased the risk by 3.1%. Ca and Cr did not show any statistically significant effect on the incidence and spatial variation of AMI. Results of this study with specific Bayesian statistical analysis support earlier findings of a protective role of Mg and low Ca:Mg ratio against coronary heart disease but do not support the earlier hypothesis of a protective role of Ca.

The results showed that although there was no significant difference in incidence between rural and urban areas, there was a tendency to increasing risk of Type 1 diabetes with the increasing concentration of NO3 in drinking water. The fact that no significant effect was found may stem from the aggregated data being too crude to detect it.

Increasing evidence has emerged that Mn derived from drinking water could be a health risk, especially for children. This study aimed to provide more information on the variation in Mn concentrations in well water and factors that affect manganese concentrations in groundwater in the natural environment. The geochemical data consisted of analyses of single water samples (n = 5311) that were taken only once and data from monitoring sites where water samples (n = 4607) were repeatedly taken and analyzed annually from the same wells. In addition, the well-specific results from six wells at monitoring sites were described in detail. We obtained the data on water samples from the groundwater database of Geological Survey of Finland. In single samples, Mn concentrations varied from < 0.02 µg/l to 5800 µg/l in bedrock well waters and up to 6560 µg/l in Quaternary deposit well waters. Results from single water samples from bedrock wells and Quaternary deposit wells indicated that the dissolved oxygen content has an inverse association with the Mn concentration. When the dissolved oxygen O2 levels were lower, the Mn concentrations were higher. No clear association was found between the Mn concentration and the pH or depth of the well for single samples. Part of Mn was particle bound, because total Mn was higher than soluble Mn in most measured samples. In the monitoring survey, large variation in Mn concentrations was found in bedrock well water in Kemijärvi, 114–352 µg/l, and in dug well water in Hämeenkoski, 8.77–2640 µg/l. Seasonal and spatial variability in Mn concentrations in water samples from two bedrock wells was large at monitoring sites in northern Finland. Variability in the Mn concentrations in groundwater can be large, even in the same area. These data suggest that single measurements of the Mn concentration from a water source may not reveal the Mn status, and measurement of both the total and soluble Mn concentrations may be recommended.