Jialong Wu1, Bing Guo1, Han Guan2, Fei Mi3, Jingru Xu4, Yajie Li5, Haojiang Zuo1, Lei Wang1, Shiyu Feng1, Jing Wei6, Gongbo Chen7, Shanshan Li8, Yonglan Wei9, Yuming Guo8, Xing Zhao1. 1. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China. 2. School of Public Health, the key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 550004, China. 3. School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China. 4. Chongqing Municipal Center for Disease Control and Prevention, Chongqing 400042, China. 5. Tibet Center for Disease Control and Prevention, Lhasa, Tibet 850002, China. 6. Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, The University of Iowa, Iowa City, IA 52242, USA. 7. Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China. 8. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia. 9. Chengdu Center for Disease Control &Prevention, Chengdu, Sichuan 610047, China.
Abstract
CONTEXT: Evidence regarding the association of long-term exposure to air pollution on bone strength or osteoporosis is rare, especially in highly polluted low- and middle-income countries. Little is known about whether the association between air pollution and bone strength changes at different bone strength distributions. OBJECTIVE: Using the baseline data from the China Multi-Ethnic Cohort, we investigated the association between long-term air pollution exposure and bone strength. METHODS: We used multiple linear models to estimate the association between air pollution and bone strength, and we conducted quantile regression models to investigate the variation of this association in the distribution of bone strength. The 3-year concentrations of PM1, PM2.5, PM10, and NO2 for each participant were assessed using spatial statistical models. Bone strength was expressed by the calcaneus quantitative ultrasound index (QUI) measured by quantitative ultrasound, with higher QUI values indicating greater bone strength. RESULTS: A total of 66 598 participants were included. Our analysis shows that every 10 μg/m3 increase in 3-year average PM1, PM2.5, PM10, and NO2 was associated with -5.38 units (95% CI: -6.17, -4.60), -1.89 units (95% CI: -2.33, -1.44), -0.77 units (95% CI: -1.08, -0.47), and -2.02 units (95% CI: -2.32, -1.71) changes in the QUI, respectively. In addition, populations with higher bone strength may be more susceptible to air pollution. CONCLUSION: Long-term exposure to PM1, PM2.5, PM10, and NO2 was significantly associated with decreased bone strength in southwestern China adults. Air pollution exposure has a more substantial adverse effect on bones among populations with higher bone strength.
CONTEXT: Evidence regarding the association of long-term exposure to air pollution on bone strength or osteoporosis is rare, especially in highly polluted low- and middle-income countries. Little is known about whether the association between air pollution and bone strength changes at different bone strength distributions. OBJECTIVE: Using the baseline data from the China Multi-Ethnic Cohort, we investigated the association between long-term air pollution exposure and bone strength. METHODS: We used multiple linear models to estimate the association between air pollution and bone strength, and we conducted quantile regression models to investigate the variation of this association in the distribution of bone strength. The 3-year concentrations of PM1, PM2.5, PM10, and NO2 for each participant were assessed using spatial statistical models. Bone strength was expressed by the calcaneus quantitative ultrasound index (QUI) measured by quantitative ultrasound, with higher QUI values indicating greater bone strength. RESULTS: A total of 66 598 participants were included. Our analysis shows that every 10 μg/m3 increase in 3-year average PM1, PM2.5, PM10, and NO2 was associated with -5.38 units (95% CI: -6.17, -4.60), -1.89 units (95% CI: -2.33, -1.44), -0.77 units (95% CI: -1.08, -0.47), and -2.02 units (95% CI: -2.32, -1.71) changes in the QUI, respectively. In addition, populations with higher bone strength may be more susceptible to air pollution. CONCLUSION: Long-term exposure to PM1, PM2.5, PM10, and NO2 was significantly associated with decreased bone strength in southwestern China adults. Air pollution exposure has a more substantial adverse effect on bones among populations with higher bone strength.