Shen Shisi, Ma Ning, Wu Tingting, Xiong Yang, Yang Jialu, Wu Xiaoai, Xiang Xianhong
Departments of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
School of Public Health, Capital Medical University, Beijing, China.
J Glob Health. 2025 Sep 12;15:04120. doi: 10.7189/jogh.15.04120.
Few studies have reported on the association between drinking habits, water sources and all-cause mortality among the elderly, who are susceptible to toxic environmental factors. We aimed to address this gap by conducting a longitudinal study among the Chinese population.
We conducted a 16-year longitudinal study using data of individuals aged >65 years at baseline enrolled in the Chinese Longitudinal Healthy Longevity Study. A formal questionnaire was used to collect data on drinking habits and water sources. The former to whether participants consumed boiled or unboiled water, while the latter queried the use of well water, surface water, spring water, and tap water. We used Cox proportional hazard adjusted for sociodemographic factors, lifestyle, and common diseases to calculate the risk of all-cause mortality associated with drinking water. We further conducted subgroup analyses to evaluate potential interaction effects.
We used data on 15 664 individuals, among whom 4472 men and 6166 women died from any reason. Participants who drank unboiled water were more likely than those who drank boiled water to eventually reach a high risk of all-cause mortality (hazard ratio (HR) = 1.14; 95% confidence interval (CI) = 1.06-1.23). Compared to drinking well water, drinking tap water in childhood (HR = 0.80; 95% CI = 0.68-0.95), being around 60 years of age (HR = 0.81; 95% CI = 0.76-0.86), and at present (HR = 0.90; 95% CI = 0.86-0.95) were all associated with lower risks of all-cause mortality. Drinking surface water in childhood was also related to a lower risk of all-cause mortality (HR = 0.94; 95% CI = 0.90-0.98). However, drinking spring water was not associated with all-cause mortality across the entire lifespan in the total sample.
Drinking unboiled water was associated with a higher risk of all-cause mortality. In comparison to well water, tap water emerged as a safer and healthier option for the elderly Chinese population throughout their whole life cycle.
很少有研究报道饮酒习惯、水源与老年人全因死亡率之间的关联，而老年人易受有毒环境因素影响。我们旨在通过在中国人群中开展一项纵向研究来填补这一空白。
我们利用中国健康与养老追踪调查中基线年龄>65岁个体的数据进行了一项为期16年的纵向研究。使用正式问卷收集饮酒习惯和水源的数据。前者询问参与者饮用的是开水还是生水，后者询问井水、地表水、泉水和自来水的使用情况。我们使用经社会人口学因素、生活方式和常见疾病调整的Cox比例风险模型来计算与饮用水相关的全因死亡率风险。我们进一步进行亚组分析以评估潜在的交互作用。
我们使用了15664名个体的数据，其中4472名男性和6166名女性死于任何原因。饮用生水的参与者比饮用开水的参与者最终达到全因死亡率高风险的可能性更大（风险比（HR）=1.14；95%置信区间（CI）=1.06-1.23）。与饮用井水相比，儿童期饮用自来水（HR=0.80；95%CI=0.68-0.95）、60岁左右（HR=0.81；95%CI=0.76-0.86）以及目前饮用自来水（HR=0.90；95%CI=0.86-0.95）均与全因死亡率风险较低相关。儿童期饮用地表水也与全因死亡率风险较低相关（HR=0.94；95%CI=0.90-0.98）。然而，在总样本中，饮用泉水在整个生命周期内与全因死亡率无关。
饮用生水与全因死亡率较高相关。与井水相比，自来水在整个生命周期中对中国老年人群体来说是更安全、更健康的选择。
