LIFE Project Number LIFE12 ENV/SK/094 FINAL Report Covering the project activities from 01/10/2013 to 30/09/2017 Reporting Date 20/12/2017 The Elimination of Negative Impact of Geological Compound of the Environment on Health Status of Residents in the Krupina District (LIFE FOR KRUPINA) Project Data Project location Slovak Republic (Krupina district) Project start date: 01/10/2013 Project end date: 30/09/2017 Extension date: Total Project duration (in months) 48 months Total budget 417,750 € Total eligible budget 405,600 € EU contribution: 201,153 € (%) of total costs 48.15 (%) of eligible costs 49.59 Beneficiary Data Name Beneficiary State Geological Institute of Dionýz Štúr Contact person Mr Stanislav Rapant Postal address Mlynská dolina, 1, 817 04, Bratislava, Slovak Republic (SK) Visit address Mlynská dolina, 1, 817 04, Bratislava, Slovak Republic (SK) Telephone ++421-2-59375213 Fax: ++421-2-54771940 E-mail [email protected] Project Website http://www.geology.sk/lifeforkrupina/ 1 1. List of contents 2 2. Executive Summary 3 3. Introduction 6 4. Administrative part 7 4.1 Description of the management system 7 4.2 Evaluation of the management system 9 5. Technical part 10 5.1 Technical progress, per task 10 5.2 Dissemination actions 27 5.2.1 Objectives 27 5.2.2 Dissemination: overview per activity 27 5.3 Evaluation of Project Implementation 32 5.4 Analysis of long-term benefits 35 6. Comments on the financial report 38 6.1 Summary of Costs Incurred 38 6.2 Accounting system 39 6.3 Partnership arrangements 40 6.4 Auditor's report/declaration 41 6.5 Summary of costs per action 41 7. Annexes 7.1 Administrative annexes 7.1.1 Steering Committee Members 7.1.2 Gantt chart 7.2 Technical annexes 7.2.1 List of abbreviations 7.2.2 List of short reports 7.2.3 After-Life Communication Plan 7.2.4 Project output indicators 7.3 List of Dissemination annexes 7.3.1 Oral/Poster presentations 7.3.2 Any media work 7.3.3 Press release 7.3.4 Technical publications 7.3.5 Monographs 7.3.6 Laymanʼs reports 7.3.7 List of participants 7.3.8 Photo documentation 7.4 E-mail communication 7.4.1 E-mail communication with WHO 7.4.2 E-mail communication with MŽP SR and MZ SR 8. Financial report and annexes 8.1 Answers to EC letters 8.2 Invoices of Coordinating and Associated Beneficiary - examples 8.3 Timesheets of Coordinating and Associated Beneficiary - examples 8.4 Financial reporting 8.5 Annex Audit report 2 2. Executive Summary The main objective of the project is the elimination of negative impact of geological compound of the environment on health status of residents in the Krupina district. The district of Krupina is located in the geological environment of Neogene volcanites. These rock types are of relatively very low solubility and the main impact on human health relates in fact that drinking waters used for public supply of residents are characterized with very low (deficient) contents of essential elements, mainly Ca and Mg. This fact (deficiency of Ca and Mg in drinking water) causes increased mortality for all main causes of deaths, including cardiovascular (CVD) and oncological diseases (OD), diseases of respiratory (RS) and gastrointestinal system (GS) and shorter life expectancy of resident population of the Krupina district (about 4 years compared to the areas with favourable geological environment). Due to this reason the health status of residents in the Krupina district is in the long-term horizon one of the most unfavourable within the whole Slovak territory. The project aims to improve the health status of residents through implementation of the following partial goals defined as key project deliverables: – compilation of data set of environmental indicators (chemical elements/components) for two main compartments of geological environment (groundwater/drinking water and soils), – compilation of data set of health indicators (indicators of demographic growth and health state of population), – assessment of the impact of geological environment on the health state of the resident population through the linking of environmental and health datasets, – biomonitoring – analysis of chemical contents of critical elements in hair, nails and measurements of arterial stiffness for a group of respondents, to confirm the causal relationship between geological environment and health state of residents, – the evaluation of life style and health-care accessibility on health state of residents in Krupina district, – implementation of remedial measures into practice – mainly educative and training activities, particular technological actions – water re-carbonization – addition of carbonate rock into individual local wells, and legislative measurements – proposal of limit values for the influential elements in drinking water on human health. The project was implemented within the LIFE+ programme Environment, sub-programme Environment Policy and Governance. All the project objectives are successfully implemented. Project administration was based on project management and coordination in accordance with the project proposal and LIFE+ rules, including monitoring of the project progress and planning project tasks through monthly organized consultative meetings, annual sessions of the steering committee and regular reporting (reports to EC, annual monitoring reports). During the project implementation we did not face any serious problem in management process. All EC requests and comments related to reports and monitoring visits were included and explained in respective projects reports (Inception report, Progress report No. 1). Answers on EC letter concerning Mid-term report are included in annexes 8.1. Our answers and corrections were in all cases fully accepted by the Commission. There was one amendment to the Grant Agreement requested by the coordinating beneficiary and accepted by the EC related to the reorganization of the State administration of the Slovak Republic (valid from the 01/10/2013), and subsequent change in legal status of one of the associated beneficiaries of the project LIFE FOR KRUPINA (the District Office for 3 Environment Zvolen - OU ZP Zvolen was abolished with date 01/10/2013 corresponding to project start). The amendment to the grant agreement was based on partnership modification consisting in the replacement of one of the associated beneficiaries – OU ZP Zvolen by ŠGÚDŠ (coordinating beneficiary), assuming all rights, duties, responsibilities and financial means. All project actions were implemented in accordance with the project plan. Project timetable for respective actions was due to objective reasons (repeated collection of hair and nail samples, repeated measurements of arterial stiffness) slightly modified. During the project implementation we did not face any obstacle (technical/legislative/scientific/time related) that could affect the successful implementation of project goals/actions. Technical part of the project consists in 7 main technical actions: Action B1: Compilation of data set of environmental indicators Action B2: Compilation of data set of health indicators Action B3: Linking of environmental and health indicators Action B4: Biomonitoring Action B5: Evaluation of lifestyle and health-care accessibility Action B6: Environmental-health analysis Action B7: Realization of measures As expected, the unfavourable health status of residents of the Krupina district associated to unfavourable geological environment was confirmed by detail analysis of compiled environmental and health indicators and their linking. The health status of population is determined beside the environmental factors (water, air quality etc.) mainly by the lifestyle (type of work, way of life) and level/accessibility of the health-care. Based on the project results (achieved within the action B5) we can conclude that the lifestyle as well as level of health-care in the Krupina district is comparable to the other Slovak districts and they do not have a substantial impact on the impaired health status of resident population. The results of the action B4 “Biomonitoring” brought very significant findings related to the arterial stiffness of residents. The measurements of arterial stiffness were realized in two stages (for the second stage we additionally asked approval from the EC) in a sample of residents supplied by soft drinking water (Ca and Mg deficit contents) and harder water (adequate Ca and Mg contents). “The absolute difference” between the real and arterial age in the case of two evaluated groups of respondents (soft vs. harder water) was in average nearly 5 years. It means that those respondents drinking soft water had significantly worse status of vascular system. The analyses of hair and nail samples of residents confirmed relatively high variability of Ca, Mg, Na, K and Si contents at comparable levels with similar studies performed in other countries. The world literature describes cases when people drinking water with deficient Ca and Mg contents have often increased contents of these elements in their hair. This effect is related to the nutritional imbalance of the essential elements within the human organism due to the deficiency of Ca and/or Mg, leading to the Ca and/or Mg precipitation and accumulation in soft tissues such as hair. Our results also indicate similar trend. Based on the elaboration of environmental-health analysis we can conclude that the world literature documents very high number of studies reporting the impact of Ca and Mg deficit in drinking water on mortality from cardiovascular and oncological