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

Dou Qiao, Jun Pan, Gongbo Chen, Hao Xiang, Runqi Tu, Xia Zhang, Xiaokang Dong, Yan Wang, Zhicheng Luo, Huiling Tian, Zhenxing Mao, Wenqian Huo, Gongyuan Zhang, Shanshan Li, Yuming Guo, Chongjian Wang

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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 (PM2.5), 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, PM2.5, 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 PM2.5, 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.

Original languageEnglish
Article number109264
Number of pages8
JournalEnvironmental Research
Publication statusPublished - Apr 2020


  • Air pollutants
  • Osteoporosis
  • Particulate matter
  • PM
  • Rural population

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