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...
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BMC
2025-04-01
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| Series: | Environmental Health |
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| Online Access: | https://doi.org/10.1186/s12940-025-01172-9 |
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| 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 |
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