Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China

Abstract Background and aims Air pollution poses significant risks to human health, but its impact on gastrointestinal (GI) health remains underexplored. This study assesses the long-term effects of air pollution on GI diseases using data from the China Health and Retirement Longitudinal Study (CHAR...

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Main Authors: Yanqi Kou, Shicai Ye, Weimin Du, Zhuoyan Lu, Ke Yang, Liping Zhan, Yujie Huang, Ling Qin, Yuping Yang
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21910-5
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author Yanqi Kou
Shicai Ye
Weimin Du
Zhuoyan Lu
Ke Yang
Liping Zhan
Yujie Huang
Ling Qin
Yuping Yang
author_facet Yanqi Kou
Shicai Ye
Weimin Du
Zhuoyan Lu
Ke Yang
Liping Zhan
Yujie Huang
Ling Qin
Yuping Yang
author_sort Yanqi Kou
collection DOAJ
description Abstract Background and aims Air pollution poses significant risks to human health, but its impact on gastrointestinal (GI) health remains underexplored. This study assesses the long-term effects of air pollution on GI diseases using data from the China Health and Retirement Longitudinal Study (CHARLS). Methods This nationwide cohort study utilized CHARLS data from participants recruited in 2011, followed by surveys in 2013, 2015, 2018, and 2020. Long-term exposure to PM2.5, PM10, SO2, NO2, CO, and O3 was assessed using geocoded residential addresses linked to air quality data. Cox proportional hazards models and subgroup interaction analyses were used to evaluate associations between pollutants and GI disease incidence, adjusting for demographic and behavioral confounders. Results The incidence of GI disease was 21.4% among participants. Long-term exposure to PM2.5 (HR = 1.38, 95% CI: 1.33–1.44), PM10 (HR = 1.31, 95% CI: 1.26–1.36), SO2 (HR = 1.74, 95% CI: 1.68–1.81), NO2 (HR = 1.21, 95% CI: 1.17–1.25), CO (HR = 1.48, 95% CI: 1.42–1.54), and O3 (HR = 0.56, 95% CI: 0.54–0.59) was significantly associated with GI disease. Interaction analyses showed that the effects of pollutants varied by region, residence, smoking, and alcohol use. Urban residents and those living in specific regions experienced stronger associations, likely due to higher pollution levels and different environmental factors. Smokers and alcohol users were also more susceptible to the adverse effects of pollutants. Conclusions Long-term exposure to multiple air pollutants increases the risk of GI diseases, while ozone may potentially offer some protective effects. Public health measures to reduce air pollution, especially in urban areas, and to protect high-risk groups are urgently needed.
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issn 1471-2458
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spelling doaj-art-2d78d8b20640435092fe5fc2f6463ada2025-08-20T02:56:21ZengBMCBMC Public Health1471-24582025-03-0125111210.1186/s12889-025-21910-5Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in ChinaYanqi Kou0Shicai Ye1Weimin Du2Zhuoyan Lu3Ke Yang4Liping Zhan5Yujie Huang6Ling Qin7Yuping Yang8Department of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityThe First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and TechnologyDepartment of Gastroenterology, Affiliated Hospital of Guangdong Medical University, Guangdong Medical UniversityAbstract Background and aims Air pollution poses significant risks to human health, but its impact on gastrointestinal (GI) health remains underexplored. This study assesses the long-term effects of air pollution on GI diseases using data from the China Health and Retirement Longitudinal Study (CHARLS). Methods This nationwide cohort study utilized CHARLS data from participants recruited in 2011, followed by surveys in 2013, 2015, 2018, and 2020. Long-term exposure to PM2.5, PM10, SO2, NO2, CO, and O3 was assessed using geocoded residential addresses linked to air quality data. Cox proportional hazards models and subgroup interaction analyses were used to evaluate associations between pollutants and GI disease incidence, adjusting for demographic and behavioral confounders. Results The incidence of GI disease was 21.4% among participants. Long-term exposure to PM2.5 (HR = 1.38, 95% CI: 1.33–1.44), PM10 (HR = 1.31, 95% CI: 1.26–1.36), SO2 (HR = 1.74, 95% CI: 1.68–1.81), NO2 (HR = 1.21, 95% CI: 1.17–1.25), CO (HR = 1.48, 95% CI: 1.42–1.54), and O3 (HR = 0.56, 95% CI: 0.54–0.59) was significantly associated with GI disease. Interaction analyses showed that the effects of pollutants varied by region, residence, smoking, and alcohol use. Urban residents and those living in specific regions experienced stronger associations, likely due to higher pollution levels and different environmental factors. Smokers and alcohol users were also more susceptible to the adverse effects of pollutants. Conclusions Long-term exposure to multiple air pollutants increases the risk of GI diseases, while ozone may potentially offer some protective effects. Public health measures to reduce air pollution, especially in urban areas, and to protect high-risk groups are urgently needed.https://doi.org/10.1186/s12889-025-21910-5Air pollutionsGastrointestinal diseasesLongitudinal studyPublic healthCHARLS
spellingShingle Yanqi Kou
Shicai Ye
Weimin Du
Zhuoyan Lu
Ke Yang
Liping Zhan
Yujie Huang
Ling Qin
Yuping Yang
Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
BMC Public Health
Air pollutions
Gastrointestinal diseases
Longitudinal study
Public health
CHARLS
title Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
title_full Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
title_fullStr Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
title_full_unstemmed Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
title_short Long-term exposure to air pollution and gastrointestinal disease: findings from a nationwide cohort study in China
title_sort long term exposure to air pollution and gastrointestinal disease findings from a nationwide cohort study in china
topic Air pollutions
Gastrointestinal diseases
Longitudinal study
Public health
CHARLS
url https://doi.org/10.1186/s12889-025-21910-5
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