BACKGROUND: Improving water supply quality could be essential for disease prevention strategy that promotes human health. The study aims to investigate the relationship between drinking water quality and the occurrence of osteoporosis in Gaza Strip.

METHODS: A case-control study design was used, and a multistage sampling method was employed at the main orthopedic clinic. Participants included 200 individuals diagnosed with osteoporosis and 200 without osteoporosis. All subjects underwent a DEXA scan, and drinking water samples for chemical analysis were done. A structured face-to-face interview was conducted. Statistical analysis was performed using SPSS 26, and both descriptive and inferential statistics (chi-square and binary logistic regression) were used.

RESULTS: Factors such as the source of drinking and cooking water, lifestyle, and socioeconomic status were found important in the occurrence of osteoporosis. The source of drinking, cooking water, lifestyle, and socioeconomic played a significant impact in the development of osteoporosis. Bivariate analysis revealed that a number of factors, including female gender, low physical activity, older age (41–50), inadequate education, drinking and cooking water source, and older age (41–50), had a statistically significant association with osteoporosis. With the exception of Mg (>PH =.105, Ca =.102, Mg =.046), the chemical water quality parameter had an impact on the occurrence of osteoporosis but did not achieve a significant difference. Osteoporosis was less likely to occur in people who were obese. Age, obesity, and the lack of magnesium in drinking water were independent predictors of osteoporosis.

CONCLUSIONS: The study has identified the need for preventive measures to improve drinking water quality to reduce the incidence of various health conditions, including osteoporosis.

KEYWORDS: Water quality, osteoporosis, Gaza Strip