Which of the following is a health risk associated with high levels of manganese in drinking water?

High levels of manganese in drinking water are primarily associated with neurological damage. Manganese is an essential trace element, but excessive exposure, particularly through drinking water, can lead to harmful effects on the nervous system. Prolonged exposure to elevated manganese levels has been linked to neurotoxic effects similar to those seen in conditions like Parkinson's disease, with symptoms that can include tremors, difficulty walking, and other motor function impairments.

Understanding the biological impact of manganese is critical in evaluating water quality and setting regulatory standards for safe consumption levels. In contrast, the other options—respiratory issues, cardiovascular disease, and liver damage—are not typically associated with manganese toxicity at relevant exposure levels in potable water, making them less relevant in this context.