Tan Yuxi, Xiang Qianqian, Zhang Yalin, Shen Jiajun, Peng Minjin, Sun Xiaojie, Cai Ting, Zhang Yunquan
School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, 430065, China.
Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
BMC Public Health. 2025 Aug 2;25(1):2616. doi: 10.1186/s12889-025-23885-9.
While ambient fine particulate matter (PM) and ozone (O) are extensively associated with population health, no studies have yet assessed the potential association between concurrent exposure to these two pollutants and physical function (PF) in middle-aged and elderly individuals. By collecting data from three phases of the China Health and Retirement Longitudinal Study (CHARLS), we included 8834 follow-up observations from 4110 participants aged 45 years and older who had undergone at least two physical examinations between 2011 and 2015. PF scores of enrolled participants were assessed through four objective tests including grip strength, balance, walking speed, and repeated chair stands. Annual average concentrations of PM and O prior to physical tests were assigned to participants at the prefecture-level residence in each survey. A linear mixed-effects model was used to evaluate the effects of long-term exposure to PM and O on PF, adjusting for multiple covariates including sociodemographic, behavioral, and health status. Stratified analyses were performed to compare the effects of PM under low- and high-level O groups and the effects of O under low- and high-level PM groups. Additive interactive effects were testified by introducing a 2 × 2-level dummy variable to model the joint exposure of PM and O. Each 10-µg/m³ increase in PM and O exposure was associated with a declined PF score of -0.561 points (95% confidence interval: -0.617, -0.506) and -1.154 points (-1.341, -0.968), respectively. Stratified analyses for co-pollutants indicated weakened effects of PM and O at higher co-pollutant levels (PM: -0.448 [-0.522, -0.373]; O: -0.796 [-1.070, -0.522]) than at lower levels (PM: -0.608 [-0.708, -0.507]; O: -1.293 [-1.612, -0.974]). Despite greater effects in the case of simultaneous high-level exposures to both pollutants, we did not identify any evidence for additive interactive effects of co-exposures to PM and O in the total and age- and sex-subgroup populations. This study provided novel evidence for the independent and modifying effects of long-term exposure to PM and O on impaired PF in middle-aged and elderly people.
虽然环境细颗粒物（PM）和臭氧（O₃）与人群健康广泛相关，但尚无研究评估这两种污染物同时暴露与中老年个体身体功能（PF）之间的潜在关联。通过收集中国健康与养老追踪调查（CHARLS）三个阶段的数据，我们纳入了4110名年龄在45岁及以上参与者的8834条随访观测数据，这些参与者在2011年至2015年间至少接受了两次体格检查。通过握力、平衡、步行速度和重复起坐四项客观测试评估入组参与者的PF得分。每次调查时，将体格检查前PM和O₃的年平均浓度分配给参与者在地级市的居住地。使用线性混合效应模型评估长期暴露于PM和O₃对PF的影响，并对包括社会人口学、行为和健康状况在内的多个协变量进行调整。进行分层分析以比较低O₃水平组和高O₃水平组中PM的影响以及低PM水平组和高PM水平组中O₃的影响。通过引入一个2×2水平的虚拟变量来模拟PM和O₃的联合暴露，验证相加交互作用。PM和O₃暴露每增加10μg/m³，PF得分分别下降-0.561分（95%置信区间：-0.617，-0.506）和-1.154分（-1.341，-0.968）。对共同污染物的分层分析表明，与较低水平（PM：-0.608 [-0.708，-0.507]；O₃：-1.293 [-1.612，-0.974]）相比，较高共同污染物水平下PM和O₃的影响减弱（PM：-0.448 [-0.522，-0.373]；O₃：-0.796 [-1.070，-0.522]）。尽管两种污染物同时高水平暴露时影响更大，但在总体人群以及年龄和性别亚组人群中，我们未发现PM和O₃共同暴露存在相加交互作用的任何证据。本研究为长期暴露于PM和O₃对中老年人群PF受损的独立和修正作用提供了新证据。
