Long-term exposure to air pollution and risk of Sarcopenia in adult residents of Taiwan: a nationwide retrospective cohort study

Ssu-Wen Chen; Chih-Ying Lin; Chiu-Ying Chen; Cheng-Li Lin; Tsai-Ling Hsieh; Fuu-Jen Tsai; Kuang-Hsi Chang

doi:10.1186/s12889-023-17091-8

Long-term exposure to air pollution and risk of Sarcopenia in adult residents of Taiwan: a nationwide retrospective cohort study

BMC Public Health. 2023 Nov 6;23(1):2172. doi: 10.1186/s12889-023-17091-8.

Authors

Ssu-Wen Chen^#¹, Chih-Ying Lin^#², Chiu-Ying Chen², Cheng-Li Lin^{3

4}, Tsai-Ling Hsieh^{5

6}, Fuu-Jen Tsai^{7

8

9

10}, Kuang-Hsi Chang^{11

12

13}

Affiliations

¹ Department of Family Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan.
² Department of Public Health, China Medical University, Taichung, 404, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan.
⁴ College of Medicine, China Medical University, Taichung, 404, Taiwan.
⁵ Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan.
⁶ Department of Otolaryngology, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan.
⁷ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 404, Taiwan.
⁸ Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan.
⁹ Division of Medical Genetics, China Medical University Children's Hospital, Taichung, 404, Taiwan.
¹⁰ Department of Biotechnology and Bioinformatics, Asia University, Taichung, 413, Taiwan.
¹¹ Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, 435, Taiwan. kuanghsichang@gmail.com.
¹² Center for General Education, China Medical University, Taichung, 404, Taiwan. kuanghsichang@gmail.com.
¹³ General Education Center, Nursing and Management, Jen-Teh Junior College of Medicine, Miaoli, 356, Taiwan. kuanghsichang@gmail.com.

^# Contributed equally.

Abstract

Background: Sarcopenia is an age-related, multifactorial syndrome. Previous studies have shown that air pollutants are associated with inflammation and oxidative stress. However, the association between long-term exposure to air pollution and sarcopenia is not completely understood.

Methods: The Taiwan National Health Research Database (NHIRD) contains medical records of almost all Taiwanese residents. Daily air pollution data collected by the Taiwan Environmental Protection Agency was used to analyze concentrations of sulfur oxide (SO₂), carbon monoxide (CO), nitrogen monoxide (NO), nitrogen dioxide (NO₂), and particulate matter (PM_2.5, PM₁₀). The databases were merged according to the insurants' living area and the location of the air quality monitoring station. We categorized the pollutants into quartiles (Q1, Q2, Q3, and Q4).

Results: Our study population consisted of 286,044 patients, among whom 54.9% were female and 45.1% were male. Compared to Q1 levels of pollutants, Q4 levels of SO₂ (adjusted hazard ratio [aHR] = 8.43; 95% confidence interval [CI] = 7.84, 9.07); CO (aHR = 3.03; 95%CI = 2.83, 3.25); NO (aHR = 3.47; 95%CI = 3.23, 3.73); NO₂ (aHR = 3.72; 95%CI = 3.48, 3.98); PM_2.5 (aHR = 21.9; 95% CI = 19.7, 24.5) and PM₁₀ (aHR = 15.6; 95%CI = 14.1, 17.4) increased risk of sarcopenia.

Conclusions: Our findings indicated a significantly increased risk of sarcopenia in both male and female residents exposed to high levels of air pollutants.

Keywords: Adult residents; Air pollution; Cohort study; Sarcopenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollutants* / analysis
Air Pollution* / adverse effects
Environmental Exposure / adverse effects
Environmental Pollutants*
Female
Humans
Male
Nitrogen Dioxide / analysis
Particulate Matter / analysis
Retrospective Studies
Sarcopenia* / chemically induced
Sulfur Dioxide / analysis
Taiwan / epidemiology

Substances

Nitrogen Dioxide
Air Pollutants
Particulate Matter
Environmental Pollutants
Sulfur Dioxide