Li Zhongshan, Qu Qi, Wang Zhiyu, Mou Shuanglin, Jiang Rui, Zhu Wensheng
College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China.
Medical School, Hubei Minzu University, Enshi, China.
Front Public Health. 2025 Jan 30;13:1511215. doi: 10.3389/fpubh.2025.1511215. eCollection 2025.
Ethylene oxide (EO) is widely used as a disinfectant and is also a common environmental pollutant. Exposure to EO has been associated with various systemic diseases, posing crucial health risks. However, EO is frequently employed as a sterilizing agent in orthopedics, while its association with the risk of skeletal system diseases remains insufficiently evaluated. This study aims to investigate the association between EO exposure and the risk of Osteoarthritis (OA), a prevalent orthopedic condition.
A total of 3,386 participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2017-2018 cycles, including 952 individuals with OA. Box plots assessed EO concentration differences between OA and non-OA groups. Weighted logistic regression models and restricted cubic spline (RCS) models were used to evaluate the relationship between EO exposure and OA risk. Subgroup analysis and interaction test explored variations in the association across different characteristics.
No significant difference in EO concentrations was found between OA and non-OA groups. In multivariate logistic regression, high EO level exposure was significantly associated with increased OA risk. Additionally, a nonlinear U-shaped and J-shaped association was observed in the unadjusted and adjusted RCS models, respectively. Subgroup analysis revealed that the association between EO exposure and OA risk was more pronounced in the 20-40 and 40-65 age groups, never smokers (Not at all), and those with low calcium levels (< 8.5 mg/dL) or low vitamin D levels (< 75 nmol/L).
EO exposure is associated with OA risk, exhibiting a J-shaped relationship, with this association being particularly pronounced in individuals under 65 years old or those with low calcium or vitamin D levels. Further prospective studies are needed to examine the association between EO exposure and OA risk.
环氧乙烷（EO）被广泛用作消毒剂，也是一种常见的环境污染物。接触环氧乙烷与多种全身性疾病有关，构成重大健康风险。然而，环氧乙烷在骨科中经常用作灭菌剂，而其与骨骼系统疾病风险的关联仍未得到充分评估。本研究旨在调查环氧乙烷暴露与骨关节炎（OA）风险之间的关联，骨关节炎是一种常见的骨科疾病。
从2013 - 2014年和2017 - 2018年周期的美国国家健康与营养检查调查（NHANES）中选取了3386名参与者，其中包括952名骨关节炎患者。箱线图评估了骨关节炎组和非骨关节炎组之间的环氧乙烷浓度差异。使用加权逻辑回归模型和受限立方样条（RCS）模型来评估环氧乙烷暴露与骨关节炎风险之间的关系。亚组分析和交互作用检验探讨了不同特征下关联的差异。
骨关节炎组和非骨关节炎组之间的环氧乙烷浓度没有显著差异。在多变量逻辑回归中，高环氧乙烷水平暴露与骨关节炎风险增加显著相关。此外，在未调整和调整后的RCS模型中分别观察到非线性U形和J形关联。亚组分析显示，环氧乙烷暴露与骨关节炎风险之间的关联在20 - 40岁和40 - 65岁年龄组、从不吸烟者（完全不吸烟）以及钙水平低（< 8.5 mg/dL）或维生素D水平低（< 75 nmol/L）的人群中更为明显。
环氧乙烷暴露与骨关节炎风险相关，呈现J形关系，这种关联在65岁以下个体或钙或维生素D水平低的个体中尤为明显。需要进一步的前瞻性研究来检验环氧乙烷暴露与骨关节炎风险之间的关联。
