饮用水质量是否为自述前臂骨折的危险因素？挪威队列研究。

Is the quality of drinking water a risk factor for self-reported forearm fractures? Cohort of Norway.

机构信息

Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403, Oslo, Norway.

出版信息

Osteoporos Int. 2013 Feb;24(2):541-51. doi: 10.1007/s00198-012-1989-7. Epub 2012 May 9.

DOI:10.1007/s00198-012-1989-7

PMID:22569744

Abstract

SUMMARY

Compared to pH ≥7.0 in Norwegian municipal drinking water, pH <7.0 increased the risk of forearm fractures in the population-based Cohort of Norway (CONOR; n = 127,272). The association was attenuated (p > 0.05) after adjustments for indicators of bacteria and organic matter, which may signify an association between poor drinking water and bone health.

INTRODUCTION

The Norwegian population has the highest rate of fractures ever reported. A large variation in fracture rate both between and within countries indicates that an environmental factor, such as the quality of drinking water, could be one of the causes of the disparities. Our aim was to investigate a possible association between pH (an important parameter for water quality) and self-reported forearm fracture and to examine whether other water quality factors could account for this association.

METHODS

Using Geographic Information Systems, information on the quality of drinking water was linked to CONOR (n = 127,272; mean age, 50.2 ± 15.8 years), a database comprising ten regional epidemiological health surveys from across the country in the time period 1994-2003.

RESULTS

The highest risk of forearm fracture was found at a pH of around 6.75, with a decreasing risk toward both higher and lower pH values. The increased adjusted odds of forearm fracture in men consuming municipal drinking water with pH <7.0 compared to water with pH ≥7.0 was odds ratio (OR) = 1.19 (95 % CI, 1.14, 1.25), and the corresponding increased odds in women was OR = 1.14 (95 % CI, 1.08, 1.19). This association was attenuated (p > 0.05) after further adjustments for other water quality factors (color grade, intestinal enterococci, and Clostridium perfringens).

CONCLUSIONS

Our findings indicate a higher risk of fracture when consuming water of an acidic pH; however, the risk does not only seem to be due to the acidity level per se, but also to other aspects of water quality associated with pH.

摘要

与挪威市政饮用水 pH 值≥7.0 相比，pH 值<7.0 增加了人群中挪威队列研究（CONOR；n=127272）的前臂骨折风险。在调整了细菌和有机物指标后，这种关联减弱（p>0.05），这可能表明饮用水质量差与骨骼健康之间存在关联。

引言

挪威人口的骨折率是有记录以来最高的。骨折率在国家之间和国家内部的巨大差异表明，环境因素（如饮用水质量）可能是造成这种差异的原因之一。我们的目的是调查 pH 值（水质的一个重要参数）与自我报告的前臂骨折之间是否存在关联，并研究其他水质因素是否可以解释这种关联。

方法

使用地理信息系统，将饮用水质量信息与 CONOR（n=127272；平均年龄 50.2±15.8 岁）相关联，CONOR 是一个由全国十个地区流行病学健康调查组成的数据库，调查时间为 1994-2003 年。

结果

pH 值约为 6.75 时，前臂骨折风险最高，向更高或更低 pH 值方向风险逐渐降低。与 pH 值≥7.0 的市政饮用水相比，男性饮用 pH 值<7.0 的市政饮用水时前臂骨折的校正后优势比（OR）为 1.19（95%CI，1.14，1.25），女性的相应比值为 OR=1.14（95%CI，1.08，1.19）。进一步调整其他水质因素（颜色等级、肠道肠球菌和产气荚膜梭菌）后，这种关联减弱（p>0.05）。