Association of household solid fuel use and long-term exposure to PM2.5 with arthritis in middle-aged and older population in China: A cohort study
Association of household solid fuel use and long-term exposure to PM2.5 with arthritis in middle-aged and older population in China: A cohort study
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DOI：
10.1016/j.ecoenv.2021.113104
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发表时间：
2021-12-23
影响因子：
6.8
通讯作者：
Yan, Yu-Xiang
中科院分区：
文献类型：
--
作者：
Liu, Yu-Hong;Lu, Ya-Ke;Yan, Yu-Xiang
空气污染物是关节炎常见的可改变危险因素。基于中国中老年人群队列研究探讨空气污染对关节炎的纵向影响。数据来自2011年至2018年中国健康与退休追踪研究（CHARLS）。共有7449名45岁及以上的参与者参与了我们的研究。采用广义线性混合模型分别研究家庭空气污染和室外空气污染对关节炎的单独和联合影响。我们发现空气污染与关节炎发病率之间存在密切相关。与清洁燃料相比，主要使用固体燃料烹饪的个人患关节炎的风险更高（OR= 1.15；95% CI：1.08-1.23）。基于组的轨迹模型确定了四个轨迹组，与“高-快速减少”组相比，“中-中度减少”、“低-缓慢减少”和“低-稳定”组的关节炎事件调整 OR 分别为 1.36 (95% CI, 1.03-1.79)、1.36 (95% CI, 1.01-1.83) 和 1.81 (95% CI, 1.30-2.52），分别。这些关联在 65 岁以下的参与者中普遍较高。此外，固体燃料的使用和 PM2.5 暴露对关节炎具有加性和乘性效应。结果表明，固体燃料的使用和长期接触 PM2.5 与关节炎的发病率较高有关。因此，有必要限制固体燃料的使用来减少家庭空气污染，并制定更有力的环保政策来降低PM2.5浓度。
Air pollutants are common modifiable risk factors for arthritis. To explore the longitudinal effects of air pollution on arthritis based on a cohort study in middle-aged and elder people of China. Data was obtained from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. A total of 7449 participants aged 45 years and older were involved in our study. The generalized linear mixed models were conducted to examine the separate and joint effects of household air pollution and outdoor air pollution on arthritis, respectively. We found a strong significant association between air pollution and arthritis incidence. Individuals cooking primarily with solid fuel were more likely in higher risk of arthritis compared with cleaner fuel (OR= 1.15; 95% CI: 1.08-1.23). The group-based trajectory model identified four trajectory groups, compared with group "High-Decreasing rapidly", adjusted ORs of incident arthritis for group "Middle-Decreasing moderately", "Low-Decreasing slowly" and "Low-Stably" were 1.36 (95% CI, 1.03-1.79), 1.36 (95% CI, 1.01-1.83) and 1.81 (95% CI, 1.30-2.52), respectively. These associations were generally higher in participants younger than 65 years. In addition, solid fuel use and PM2.5 exposure had additive and multiplicative effects on arthritis. The results suggested that solid fuel use and long-term PM2.5 exposure were associated with a higher incidence of arthritis. Therefore, it is necessary to restrict solid fuel use to reduce household air pollution and make stronger environmental protection policies to reduce PM2.5 concentration.