Long-term Ambient Air Pollution and the Risk of Musculoskeletal Diseases: A Prospective Cohort Study

Abstract

Evidence of the associations of air pollution and musculoskeletal diseases is inconsistent. This study aimed to examine the associations between air pollutants and the risk of incident musculoskeletal diseases, such as degenerative joint diseases (n = 38,850) and inflammatory arthropathies (n = 20,108). An air pollution score was constructed to assess the combined effect of PM_2.5, PM_2.5-10, NO₂, and NO_X. Cox proportional hazard model was applied to assess the relationships between air pollutants and the incidence of each musculoskeletal disease. The air pollution scores exhibited the modest association with an increased risk of osteoporosis (HR = 1.006, 95% CI: 1.002-1.011). Among the individual air pollutants, PM_2.5 and PM_2.5-10 exhibited the most significant effect on elevated risk of musculoskeletal diseases, such as PM_2.5 on osteoporosis (HR = 1.064, 95% CI: 1.020-1.110), PM_2.5-10 on inflammatory arthropathies (HR = 1.059, 95% CI: 1.037-1.081). Females were found to have a higher risk of incident musculoskeletal diseases when exposed to air pollutants. Individuals with extreme BMI or lower socioeconomic status had a higher risk of developing musculoskeletal diseases. Our findings reveal that long-term exposure to ambient air pollutants may contribute to an increased risk of musculoskeletal diseases.

Environmental Implication

To mitigate the environmental impact of hazardous air pollutants, cost-effective strategies are crucial. However, the toxicity of air pollutants poses challenges to traditional remediation methods. Our study employed an innovative approach by constructing an air pollution score and assessing its impact on musculoskeletal diseases. This research sheds light on the need for reevaluating air pollutant categorization as hazardous materials and emphasizes the significance of targeted interventions to mitigate the elevated risk of musculoskeletal diseases, particularly among vulnerable populations. These findings have vital implications for environmental policy and public health, urging a reexamination of air quality regulations.