Exposure to air pollution and non-neoplastic digestive system diseases: findings from the China health and retirement longitudinal study

Objectives Increasing concern about air pollution’s impact on public health underscores the need to understand its effects on non-neoplastic digestive system diseases (NNDSD). This study explores the link between air pollution and NNDSD in China. Methods We conducted a national cross-sectional study using 2015 data from the China Health and Retirement Longitudinal Study (CHARLS), involving 13,046 Chinese adults aged 45 and above from 28 provinces. Satellite-based spatiotemporal models estimated participants’ exposure to ambient particulate matter (3-year average). An analysis of logistic regression models was conducted to estimate the association between air pollutants [particulate matter with a diameter ≤ 2.5 μm (PM 2.5 ) or ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), ozone (O 3 ), and carbon monoxide (CO)] and NNDSD. Interaction analyses were conducted to examine potential modifiers of these associations. Results The prevalence of NNDSD among participants was 26.29%. After adjusted for multivariate factors, we observed a 6% [odd ratio (OR) = 1.06, 95% confidence interval (CI): 0.94, 1.19], 23% (OR = 1.23, 95% CI: 1.09, 1.38), 26% (OR = 1.26, 95% CI: 1.12, 1.41), 30% (OR = 1.30, 95% CI: 1.16, 1.46), 13% (OR = 1.13, 95% CI: 1.01, 1.27) and 27% (OR = 1.27, 95% CI: 1.13, 1.43) increase in NNDSD risk with an interquartile range increase in PM 2.5 (23.36 μg/m 3 ), PM 10 (50.33 μg/m 3 ), SO 2 (17.27 μg/m 3 ), NO 2 (14.75 μg/m 3 ), O 3 (10.80 μg/m 3 ), and CO (0.42 mg/m 3 ), respectively. Interaction analyses showed that PM 2.5 , SO 2 , and O 3 had stronger effects on NNDSD risk among older adults, highly educated individuals, smokers, and married people, respectively. Conclusion This study demonstrates that long-term exposure to PM 2.5 , PM 10 , SO 2 , NO 2 , O 3 , and CO is positively associated with NNDSD risk in Chinese adults aged 45 and above. Implementing intervention strategies to enhance air quality is essential for reducing the burden of NNDSD.