Self-reported household moldy odor and risk of all-cause mortality among older adults: a prospective cohort study in China

Household moldy odor exposure is a major source of indoor air pollution and contributes substantially to the global burden of disease. However, population-based evidence on its association with all-cause mortality among older adults remains scarce. We therefore aimed to investigate this relationship in a cohort of older Chinese adults. We used data from 5,961 older adults who participated in the Chinese Longitudinal Healthy Longevity Survey between 2011 and 2018. Household moldy odor exposure was ascertained using self-reported questionnaires. We applied Cox proportional hazards regression models to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) and population attributable fractions (PAFs) for the association between household moldy odor exposure and all-cause mortality. Subgroup analysis, interaction analysis, and sensitivity analysis were further performed. During 89,405 person-years of follow-up, 3,731 all-cause deaths were documented. In fully adjusted Cox models, household moldy odor exposure was associated with a higher risk of all-cause mortality compared with no exposure (HR = 1.13, 95% CI: 1.02–1.25; P < 0.05; PAF = 2.52%, 95% CI: 0.40% − 4.73%; E -value = 1.51). Subgroup analyses indicated that the association was more pronounced among participants from rural areas (HR = 1.22, 95% CI: 1.06–1.41; P < 0.05). No significant interaction was identified (All P > 0.05). A series of sensitivity analyses indicated that the primary findings were relatively robust. Our findings suggest that household moldy odor exposure may be associated with an increased risk of all-cause mortality among older adults. Further multicentre studies are warranted to corroborate these observations. Not applicable.