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<p>Sudden unexplained death (SUD) has been reported in localized rural settings worldwide, raising questions about whether drinking-water geochemistry may contribute to population-level health anomalies. The enigmatic occurrence of sudden unexplained death (SUD) in villages of the Ailao Mountains, China, represents one such case, yet the role of drinking water chemistry remains poorly constrained. This study presents the first comparative hydrochemical and health-risk assessment of drinking water from SUD-affected villages (SUDV) and neighboring non-affected villages (NSUDV), aimed at evaluating the potential role of groundwater geochemistry. A total of 63 water samples were analyzed for major ions and trace elements. Results show that waters from both village types are predominantly low-mineralization Ca–HCO<sub>3</sub> type, controlled by carbonate weathering, with negligible anthropogenic influence, and all measured parameters comply with Chinese drinking water standards. Multivariate analyses reveal no fundamental compositional differences between SUDV and NSUDV waters. Critically, health risk assessments indicate negligible non-carcinogenic and carcinogenic risks for all SUDV samples, whereas a subset of NSUDV samples exhibits low-to-moderate risks primarily associated with geogenic arsenic and lithium. An Integrated Water Quality Index classifies all SUDV waters as excellent. These findings provide robust geochemical evidence excluding conventional groundwater contamination or elemental toxicity as the direct cause of the SUD phenomenon, thereby redirecting etiological inquiry toward interdisciplinary integration of genetic, biomedical, and other environmental cofactors.</p>

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Comparative hydrochemistry and health-risk assessment of drinking water in sudden-death–affected villages of the Ailao Mountains, China

  • 期刊论文

  • 发表日期：

    2026年3月8日

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  • Yangchun Han,
  • Shixi Zhang,
  • Litao Hao,
  • Kun Zheng,
  • Yifan He,
  • Kunli Luo

摘要

Sudden unexplained death (SUD) has been reported in localized rural settings worldwide, raising questions about whether drinking-water geochemistry may contribute to population-level health anomalies. The enigmatic occurrence of sudden unexplained death (SUD) in villages of the Ailao Mountains, China, represents one such case, yet the role of drinking water chemistry remains poorly constrained. This study presents the first comparative hydrochemical and health-risk assessment of drinking water from SUD-affected villages (SUDV) and neighboring non-affected villages (NSUDV), aimed at evaluating the potential role of groundwater geochemistry. A total of 63 water samples were analyzed for major ions and trace elements. Results show that waters from both village types are predominantly low-mineralization Ca–HCO3 type, controlled by carbonate weathering, with negligible anthropogenic influence, and all measured parameters comply with Chinese drinking water standards. Multivariate analyses reveal no fundamental compositional differences between SUDV and NSUDV waters. Critically, health risk assessments indicate negligible non-carcinogenic and carcinogenic risks for all SUDV samples, whereas a subset of NSUDV samples exhibits low-to-moderate risks primarily associated with geogenic arsenic and lithium. An Integrated Water Quality Index classifies all SUDV waters as excellent. These findings provide robust geochemical evidence excluding conventional groundwater contamination or elemental toxicity as the direct cause of the SUD phenomenon, thereby redirecting etiological inquiry toward interdisciplinary integration of genetic, biomedical, and other environmental cofactors.