Long-term exposure to air pollution might increase prevalence of osteoporosis in Chinese rural population

Objectives: The associations of long-term exposure to air pollution with osteoporosis are rarely reported, especially in rural China. This study aimed to explore the association among rural Chinese population. Methods: A total of 8033 participants (18–79 years) derived from the Henan Rural Cohort Study (n = 39,259) were included in this cross-sectional study. Exposure to air pollutants was estimated using machine learning algorithms with satellite remote sensing, land use information, and meteorological data [including particulate matter with aerodynamic diameters ≤1.0 μm (PM₁), ≤2.5 μm (PM_2.5), and ≤10 μm (PM₁₀), and nitrogen dioxide (NO₂)]. The bone mineral density of each individual was measured by using ultrasonic bone density apparatus and osteoporosis was defined based on the T-score ≤ −2.5. Multiple logistic regression models were used to examine the association of air pollution and osteoporosis prevalence. Results: We observed that per 1 μg/m³ increase in PM₁, PM_2.5, PM₁₀ and NO₂ were associated with a 14.9%, 14.6%, 7.3%, and 16.5% elevated risk of osteoporosis. Compared with individuals in the first quartile, individuals in the fourth quartile had higher odds ratio (OR) of osteoporosis (P-trend < 0.001), the ORs (95% confidence interval) were 2.08 (1.72, 2.50) for PM₁, 2.28 (1.90, 2.74) for PM_2.5, 1.93 (1.60, 2.32) for PM₁₀, and 2.02 (1.68, 2.41) for NO₂. It was estimated that 20.29%–24.36% of osteoporosis cases could be attributable to air pollution in the rural population from China. Conclusions: Long-term exposure to air pollutants were positively associated with high-risk of osteoporosis, indicated that improving air quality may be beneficial to improve rural residents health.