Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults

Abstract While ambient fine particulate matter (PM2.5) and ozone (O3) 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 co...

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Main Authors: Yuxi Tan, Qianqian Xiang, Yalin Zhang, Jiajun Shen, Minjin Peng, Xiaojie Sun, Ting Cai, Yunquan Zhang
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23885-9
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author Yuxi Tan
Qianqian Xiang
Yalin Zhang
Jiajun Shen
Minjin Peng
Xiaojie Sun
Ting Cai
Yunquan Zhang
author_facet Yuxi Tan
Qianqian Xiang
Yalin Zhang
Jiajun Shen
Minjin Peng
Xiaojie Sun
Ting Cai
Yunquan Zhang
author_sort Yuxi Tan
collection DOAJ
description Abstract While ambient fine particulate matter (PM2.5) and ozone (O3) 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 PM2.5 and O3 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 PM2.5 and O3 on PF, adjusting for multiple covariates including sociodemographic, behavioral, and health status. Stratified analyses were performed to compare the effects of PM2.5 under low- and high-level O3 groups and the effects of O3 under low- and high-level PM2.5 groups. Additive interactive effects were testified by introducing a 2 × 2-level dummy variable to model the joint exposure of PM2.5 and O3. Each 10-µg/m³ increase in PM2.5 and O3 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 PM2.5 and O3 at higher co-pollutant levels (PM2.5: −0.448 [−0.522, −0.373]; O3: −0.796 [−1.070, −0.522]) than at lower levels (PM2.5: −0.608 [−0.708, −0.507]; O3: −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 PM2.5 and O3 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 PM2.5 and O3 on impaired PF in middle-aged and elderly people.
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spelling doaj-art-b95dc9fa241348d79bca58cb957d7f812025-08-20T03:42:10ZengBMCBMC Public Health1471-24582025-08-0125111110.1186/s12889-025-23885-9Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adultsYuxi Tan0Qianqian Xiang1Yalin Zhang2Jiajun Shen3Minjin Peng4Xiaojie Sun5Ting Cai6Yunquan Zhang7School of Public Health, Wuhan University of Science and TechnologyHubei Provincial Center for Disease Control and PreventionSchool of Public Health, Wuhan University of Science and TechnologySchool of Public Health, Wuhan University of Science and TechnologyDepartment of Outpatient, Hubei Provincial Clinical Research Center for Precision Diagnosis and Treatment of Liver Cancer, Taihe Hospital, Hubei University of MedicineDepartment of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and TechnologyHubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and TechnologySchool of Public Health, Wuhan University of Science and TechnologyAbstract While ambient fine particulate matter (PM2.5) and ozone (O3) 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 PM2.5 and O3 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 PM2.5 and O3 on PF, adjusting for multiple covariates including sociodemographic, behavioral, and health status. Stratified analyses were performed to compare the effects of PM2.5 under low- and high-level O3 groups and the effects of O3 under low- and high-level PM2.5 groups. Additive interactive effects were testified by introducing a 2 × 2-level dummy variable to model the joint exposure of PM2.5 and O3. Each 10-µg/m³ increase in PM2.5 and O3 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 PM2.5 and O3 at higher co-pollutant levels (PM2.5: −0.448 [−0.522, −0.373]; O3: −0.796 [−1.070, −0.522]) than at lower levels (PM2.5: −0.608 [−0.708, −0.507]; O3: −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 PM2.5 and O3 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 PM2.5 and O3 on impaired PF in middle-aged and elderly people.https://doi.org/10.1186/s12889-025-23885-9PM2.5OzoneLong-term exposurePhysical functionCHARLSInteractive effect
spellingShingle Yuxi Tan
Qianqian Xiang
Yalin Zhang
Jiajun Shen
Minjin Peng
Xiaojie Sun
Ting Cai
Yunquan Zhang
Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
BMC Public Health
PM2.5
Ozone
Long-term exposure
Physical function
CHARLS
Interactive effect
title Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
title_full Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
title_fullStr Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
title_full_unstemmed Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
title_short Impaired physical function in relation to later-life exposure to ambient fine particulate matter and ozone among Chinese middle-aged and older adults
title_sort impaired physical function in relation to later life exposure to ambient fine particulate matter and ozone among chinese middle aged and older adults
topic PM2.5
Ozone
Long-term exposure
Physical function
CHARLS
Interactive effect
url https://doi.org/10.1186/s12889-025-23885-9
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