Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China

Abstract Background Long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) are linked to thyroid nodules in adults, but epidemiological evidence in children and adolescents and adjustments for key confounders are lacking. This study aimed to explore the association betwe...

Full description

Saved in:
Bibliographic Details
Main Authors: Mao Liu, Pei-hua Wang, Yun-jie Ye, Li Shang, Yu-ting Xia, Yang Wang, Zhen Ding, Yan Xu
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Environmental Health
Subjects:
Online Access:https://doi.org/10.1186/s12940-025-01172-9
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849726094483128320
author Mao Liu
Pei-hua Wang
Yun-jie Ye
Li Shang
Yu-ting Xia
Yang Wang
Zhen Ding
Yan Xu
author_facet Mao Liu
Pei-hua Wang
Yun-jie Ye
Li Shang
Yu-ting Xia
Yang Wang
Zhen Ding
Yan Xu
author_sort Mao Liu
collection DOAJ
description Abstract Background Long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) are linked to thyroid nodules in adults, but epidemiological evidence in children and adolescents and adjustments for key confounders are lacking. This study aimed to explore the association between long-term exposure to PM2.5 and the prevalence of thyroid nodules in school-aged children and adolescents. Methods A cross-sectional study including 10,739 primary and junior high school students was conducted in Jiangsu Province, China, in 2021. Annual PM2.5 concentrations were estimated by a satellite based space-time model based on machine learning. Individual exposure concentrations were assigned according to the school addresses of the participants. High-resolution diagnostic ultrasound imaging was used to detect the thyroid nodules. After adjustment for covariates, the link between the two-year (2019–2020) average PM2.5 concentrations and thyroid nodules was estimated using a generalized linear mixed-effects model. The concentration-response (C-R) curves were smoothed using a restricted cubic spline function. Stratified analyses were performed to evaluate the modification effects of covariates on associations. Results The average age of the 10,067 participants (51.9% boys) was 11 years, with a thyroid nodule prevalence of 30.5%. A non-linear positive correlation was found between the increase in prevalence of thyroid nodules and two-year average exposure concentration of PM2.5. The C-R relationship curve between thyroid nodules and PM2.5 had a J-shaped structure with a threshold value of 39.7 µg/m3. Following covariates adjustment, the odds ratio (OR) and 95% confidence interval (CI) linked to thyroid nodules were 1.515 (1.199, 1.915) for per standard deviation (SD) increase in two-year average PM2.5 concentrations (> 39.7 µg/m3). The sex-specific associations found among adults were not observed in our stratified analyses. Conclusions Our findings demonstrated that long-term exposure to PM2.5 was associated with a higher prevalence of thyroid nodules in children and adolescents. Strategies that consistently reduce PM2.5 pollution levels to ease the burden of non-communicable diseases have important public health implications.
format Article
id doaj-art-1e2ea46943f74ac7996bdcf2643f81e4
institution DOAJ
issn 1476-069X
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series Environmental Health
spelling doaj-art-1e2ea46943f74ac7996bdcf2643f81e42025-08-20T03:10:18ZengBMCEnvironmental Health1476-069X2025-04-0124111210.1186/s12940-025-01172-9Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern ChinaMao Liu0Pei-hua Wang1Yun-jie Ye2Li Shang3Yu-ting Xia4Yang Wang5Zhen Ding6Yan Xu7Jiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionJiangsu Provincial Center for Disease Control and PreventionAbstract Background Long-term exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) are linked to thyroid nodules in adults, but epidemiological evidence in children and adolescents and adjustments for key confounders are lacking. This study aimed to explore the association between long-term exposure to PM2.5 and the prevalence of thyroid nodules in school-aged children and adolescents. Methods A cross-sectional study including 10,739 primary and junior high school students was conducted in Jiangsu Province, China, in 2021. Annual PM2.5 concentrations were estimated by a satellite based space-time model based on machine learning. Individual exposure concentrations were assigned according to the school addresses of the participants. High-resolution diagnostic ultrasound imaging was used to detect the thyroid nodules. After adjustment for covariates, the link between the two-year (2019–2020) average PM2.5 concentrations and thyroid nodules was estimated using a generalized linear mixed-effects model. The concentration-response (C-R) curves were smoothed using a restricted cubic spline function. Stratified analyses were performed to evaluate the modification effects of covariates on associations. Results The average age of the 10,067 participants (51.9% boys) was 11 years, with a thyroid nodule prevalence of 30.5%. A non-linear positive correlation was found between the increase in prevalence of thyroid nodules and two-year average exposure concentration of PM2.5. The C-R relationship curve between thyroid nodules and PM2.5 had a J-shaped structure with a threshold value of 39.7 µg/m3. Following covariates adjustment, the odds ratio (OR) and 95% confidence interval (CI) linked to thyroid nodules were 1.515 (1.199, 1.915) for per standard deviation (SD) increase in two-year average PM2.5 concentrations (> 39.7 µg/m3). The sex-specific associations found among adults were not observed in our stratified analyses. Conclusions Our findings demonstrated that long-term exposure to PM2.5 was associated with a higher prevalence of thyroid nodules in children and adolescents. Strategies that consistently reduce PM2.5 pollution levels to ease the burden of non-communicable diseases have important public health implications.https://doi.org/10.1186/s12940-025-01172-9ChildrenThyroid nodulePM2.5
spellingShingle Mao Liu
Pei-hua Wang
Yun-jie Ye
Li Shang
Yu-ting Xia
Yang Wang
Zhen Ding
Yan Xu
Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
Environmental Health
Children
Thyroid nodule
PM2.5
title Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
title_full Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
title_fullStr Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
title_full_unstemmed Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
title_short Association between long-term exposure to PM2.5 and thyroid nodules in school-aged children and adolescents: a cross-sectional study in Eastern China
title_sort association between long term exposure to pm2 5 and thyroid nodules in school aged children and adolescents a cross sectional study in eastern china
topic Children
Thyroid nodule
PM2.5
url https://doi.org/10.1186/s12940-025-01172-9
work_keys_str_mv AT maoliu associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT peihuawang associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT yunjieye associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT lishang associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT yutingxia associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT yangwang associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT zhending associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina
AT yanxu associationbetweenlongtermexposuretopm25andthyroidnodulesinschoolagedchildrenandadolescentsacrosssectionalstudyineasternchina