Abstract
BACKGROUND: Given the limited research on the association between air pollutants and musculoskeletal diseases (MDs), our study aimed to examine how exposure to air pollutants influenced the risk of developing musculoskeletal disorders. METHODS: We extracted daily air pollutants and musculoskeletal diseases data from 2019 to 2022 in Yangzhou. The combined effects of air pollutants particulate matte 2.5 (PM(2.5)), PM(10), nitrogen dioxide (NO(2)), sulphur dioxide (SO(2)), ozone (O(3)) and nitric oxide (NO) were comprehensively assessed. Logistic regression modelling was firstly applied to evaluate the association between air pollutants and the incidence of MDs. The joint effect of multiple air pollutants was further explored using Bayesian kernel machine regression (BKMR) modelling. In order to deeply investigate the risk effects of heavy metals in PM(2.5) on MDs, we also explored the association between heavy metals in PM(2.5) and MDs. RESULTS: Among the individual air pollutants, SO(2) (OR = 2.13, 95% CI: 1.08-4.24) and O(3) (OR = 1.71, 95% CI: 1.13-2.62) had the most significant effects on the elevated risk of MDs. It was found that SO(2), O(3) and PM(10) had a positive joint effect on the risk of developing MDs when the levels of other air pollutants were higher than the 55th percentile. Furthermore, the logistic regression and BKMR model analyses showed that the heavy metals Selenium (Se, OR = 0.39, 95% CI: 0.22-0.68), Cadmium (Cd, OR = 0.62, 95% CI. 95% CI: 0.40-0.97), Antimony (Sb, OR = 0.51, 95% CI: 0.29-0.88), and Thallium (Tl, OR = 0.55, 95% CI: 0.35-0.85) exerted a negative joint effect on the risk of developing MDs. CONCLUSION: Our findings indicated that short-term exposure to ambient air pollutants may elevate the risk of MDs, with particular attention warranted to the health impacts of SO(2) and O(3) emissions in urban areas. In addition, the heavy metals in PM(2.5) exerted negative relationship with the risks of MDs, which provided the new sights of the protective role of heavy metals against bone disease.