International journal of surgery (London, England) · 2025
Water hardness and digestive diseases: a large-scale population-based prospective cohort study.
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He Qida, Sun Mengtong, Huang Jingting, Wang Qi, Adamkiewicz Gary, Shen Yueping, Li Linyan
Аннотация
BACKGROUND: Water hardness, which refers to the level of dissolved calcium and magnesium salts, is of significant public health concern due to its potential impact on health. The association between water hardness and digestive diseases remains underexplored, with limited evidence from small-scale clinical studies. Given the rising prevalence of digestive disorders worldwide, large-scale cohort studies are needed to address this gap in the literature.
METHODS: This study aims to explore the link between domestic water hardness and the risk of digestive disorders, leveraging data from 356 000 individuals within a large prospective cohort study. Water hardness was assessed through regional data on CaCO 3 concentrations, categorized into soft, moderately hard, hard, and very hard water based on United States Geological Survey standards. The primary outcome of interest was incident cases of a composite of digestive system diseases. Cox proportional hazard regression models were employed to evaluate the association between water hardness and the risk of 16 digestive diseases.
RESULTS: Our study revealed a nonlinear association between water hardness and digestive health. Higher levels of water hardness (>180 mg/L CaCO 3 ) were inversely associated with the risk of several digestive conditions, including dyspepsia, constipation, and gallbladder disease, when compared to exposure to soft water. Conversely, exposure to moderately hard water (60-120 mg/L CaCO 3 ) was linked to increased risks of conditions such as peptic ulcer and gastroesophageal reflux disease.
CONCLUSIONS: This study provides important insights into the epidemiological associations between drinking water hardness and various digestive system diseases, suggesting that water quality may have potential impacts on public health.
METHODS: This study aims to explore the link between domestic water hardness and the risk of digestive disorders, leveraging data from 356 000 individuals within a large prospective cohort study. Water hardness was assessed through regional data on CaCO 3 concentrations, categorized into soft, moderately hard, hard, and very hard water based on United States Geological Survey standards. The primary outcome of interest was incident cases of a composite of digestive system diseases. Cox proportional hazard regression models were employed to evaluate the association between water hardness and the risk of 16 digestive diseases.
RESULTS: Our study revealed a nonlinear association between water hardness and digestive health. Higher levels of water hardness (>180 mg/L CaCO 3 ) were inversely associated with the risk of several digestive conditions, including dyspepsia, constipation, and gallbladder disease, when compared to exposure to soft water. Conversely, exposure to moderately hard water (60-120 mg/L CaCO 3 ) was linked to increased risks of conditions such as peptic ulcer and gastroesophageal reflux disease.
CONCLUSIONS: This study provides important insights into the epidemiological associations between drinking water hardness and various digestive system diseases, suggesting that water quality may have potential impacts on public health.