Background: Health effects of air pollution on anaemia have been scarcely studied worldwide. We aimed to explore the associations of long-term exposure to ambient air pollutants with anaemia prevalence and haemoglobin levels in Chinese older adults. Methods: We used two-level linear regression models and modified Poisson regression with robust error variance to examine the associations of particulate matter (PM) and nitrogen dioxide (NO₂) on haemoglobin concentrations and the prevalence of anaemia, respectively, among 10,611 older Chinese adults enrolled in World Health Organization (WHO) Study on global AGEing and adult health (SAGE) China. The average community exposure to ambient air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM₁₀), 2.5 μm or less (PM_2.5), 1 μm or less (PM₁) and nitrogen dioxide (NO₂)) for each participant was estimated using a satellite-based spatial statistical model. Haemoglobin levels were measured for participants from dried blood spots. The models were controlled for confounders. Results: All the studied pollutants were significantly associated with increased anaemia prevalence in single pollutant model (e.g., the prevalence ratios associated with an increase in inter quartile range in three years moving average PM₁₀ (1.05; 95% CI: 1.02–1.09), PM_2.5 (1.11; 95% CI: 1.06–1.16), PM₁ (1.13; 95% CI: 1.06–1.20) and NO₂ (1.42; 95% CI: 1.34–1.49), respectively. These air pollutants were also associated with lower concentrations of haemoglobin: PM₁₀ (−0.53; 95% CI: −0.67, −0.38); PM_2.5 (−0.52; 95% CI: −0.71, −0.33); PM₁ (−0.55; 95% CI: −0.69, −0.41); NO₂ (−1.71; 95% CI: −1.85, −1.57) respectively. Conclusions: Air pollution exposure was significantly associated with increased prevalence of anaemia and decreased haemoglobin levels in a cohort of older Chinese adults.

Background: Long-term exposure to ambient air pollution leads to respiratory morbidity and mortality; however, the evidence of the effect on lung function and chronic obstructive pulmonary disease (COPD) in older adult populations is inconsistent. Objective: To address this knowledge gap, we investigated the associations between particulate matter (PM), nitrogen dioxide (NO₂) exposure and lung function, as well as COPD prevalence, in older Chinese adults. Methods: We used data from the WHO Study on global AGEing and adult health (SAGE) China Wave 1, which includes 11, 693 participants from 64 townships in China. A cross-sectional analysis explored the association between satellite-based air pollution exposure estimates (PM with an aerodynamic diameter of ≤10 µm [PM₁₀], ≤2.5 µm [PM_2.5] and NO₂) and forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), the FEV₁/FVC ratio and COPD (defined as post-bronchodilator FEV₁/FVC <70%). Data on lung function changes were further stratified by COPD status. Results: Higher exposure to each pollutant was associated with lower lung function. An IQR (26.1 µg/m³) increase in PM_2.5 was associated with lower FEV₁ (−71.88 mL, 95% CI –92.13 to –51.64) and FEV₁/FVC (−2.81, 95% CI −3.37 to –2.25). For NO₂, an IQR increment of 26.8 µg/m³ was associated with decreases in FEV₁ (−60.12 mL, 95% CI –84.00 to –36.23) and FVC (−32.33 mL, 95% CI –56.35 to –8.32). A 31.2 µg/m³ IQR increase in PM₁₀ was linked to reduced FEV₁ (−8.86 mL, 95% CI −5.40 to 23.11) and FEV₁/FVC (−1.85, 95% CI −2.24 to –1.46). These associations were stronger for participants with COPD. Also, COPD prevalence was linked to higher levels of PM_2.5 (POR 1.35, 95% CI 1.26 to 1.43), PM₁₀ (POR 1.24, 95% CI 1.18 to 1.29) and NO₂ (POR 1.04, 95% CI 0.98 to 1.11). Conclusion: Ambient air pollution was associated with lower lung function, especially in individuals with COPD, and increased COPD prevalence in older Chinese adults.

There is an established association between air pollution and cardiovascular disease (CVD), which is likely to be mediated by systemic inflammation. The present study evaluated links between long-term exposure to ambient air pollution and high-sensitivity C reactive protein (hs-CRP) in an older Chinese adult cohort (n = 7915) enrolled in the World Health Organization (WHO) study on global aging and adult health (SAGE) China Wave 1 in 2008–2010. Multilevel linear and logistic regression models were used to assess the associations of particulate matter (PM) and nitrogen dioxide (NO₂) on log-transformed hs-CRP levels and odds ratios of CVD risk derived from CRP levels adjusted for confounders. A satellite-based spatial statistical model was applied to estimate the average community exposure to outdoor air pollutants (PM with an aerodynamic diameter of 10 μm or less (PM₁₀), 2.5 μm or less (PM_2.5), and 1 μm or less (PM₁) and NO₂) for each participant of the study. hs-CRP levels were drawn from dried blood spots of each participant. Each 10 μg/m³ increment in PM₁₀, PM_2.5, PM₁, and NO₂ was associated with 12.8% (95% confidence interval; (CI): 9.1, 16.6), 15.7% (95% CI: 10.9, 20.8), 10.2% (95% CI: 7.3, 13.2), and 11.8% (95% CI: 7.9, 15.8) higher serum levels of hs-CRP, respectively. Our findings suggest that air pollution may be an important factor in increasing systemic inflammation in older Chinese adults.

Over the past decades, air pollution has become one of the critical environmental health issues in China. The present study aimed to evaluate links between ambient air pollution and the prevalence of type 2 diabetes mellitus (T2DM) and the levels of glycosylated hemoglobin (HbA1c). A multilevel linear and logistic regression was used to assess these associations among 7,770 participants aged ≥50 years from the WHO Study on global AGEing and adult health (SAGE) in China in 2007-2010. The average exposure to each of pollutants (particulate matter with an aerodynamic diameter of ≤10 μm/≤2.5 μm/≤1 μm [PM₁₀/PM_2.5/PM₁] and nitrogen dioxide [NO₂]) was estimated using a satellite-based spatial statistical model. In logistic models, a 10 µg/m³ increase in PM₁₀ and PM_2.5 was associated with increased T2DM prevalence (Prevalence Odds Ratio, POR: 1.27; 95% CI: 1.11, 1.45 and POR: 1.23; 95% CI: 1.03, 1.46). Similar increments in PM₁₀, PM_2.5, PM₁ and NO₂ were associated with increase in HbA1c levels of 1.8% (95% CI: 1.3, 2.3), 1.3% (95% CI: 1.1, 1.5), 0.7% (95% CI: 0.1, 1.3), and 0.8% (95% CI: 0.4, 1.2), respectively. In a large cohort of older Chinese adults, air pollution was liked to both higher T2DM prevalence and elevated HbA1c levels.