Correlation between Water Environment and Prevalence of Nontuberculous Mycobacteria Pulmonary Disease: A Case-Control Study.

Objective: Nontuberculous mycobacteria (NTM) prevalence in water systems has raised concerns about Nontuberculous Mycobacteria Pulmonary Disease (NTM-PD). Understanding the relationship between NTM-PD, drinking water distribution systems (DWDS), and other epidemiological factors is crucial for public health.
Methods: A case-control study was conducted at the Inpatient Department of Tuberculosis Department of Shanghai Pulmonary Hospital. Subjects were divided into the NTM-PD group (n = 314) and pulmonary tuberculosis (PTB) group (n = 308) at a 1:1 ratio. Data was collected through questionnaires covering general information, depression (Self-Rating Depression Scale, SDS), and anxiety (Self-Rating Anxiety Scale, SAS). Multivariate unconditional logistic regression analysis was employed for the study.
Results: The average age of NTM-PD patients was 55.26±14.44, with clinical symptoms including chest tightness, shortness of breath, hemoptysis, fever, and expectoration. Risk factors for NTM-PD included age (>60 years old, OR=1.042), gender (female, OR = 3.089), secondary water supply system (OR = 7.813), occupation (farmer/flower farmer, OR=2.676), depression (OR = 2.956), recurrent bronchiectasis (OR = 6.314), chronic obstructive pulmonary disease (COPD, OR = 2.704), and autoimmune disease (OR = 13.588) (P < .05). Use of household water purifiers was identified as a protective factor (OR = 0.128, P < .001).
Conclusion: DWDS, drinking water mode, soil-related occupation, bronchiectasis, COPD, age, sex, and depression were closely related to the risk of NTM-PD. It is suggested to pay attention to water hygiene and illness progress and regulate mood to prevent NTM-PD in daily life.