Objective: To examine the association between long-term exposure to ambient PM(2.5) combined with indoor air pollution and handgrip strength among people aged 50 and over. Methods: Data were from the first wave of World Health Organization Study on global AGEing and adult health in China. Ambient annual concentration of PM(2.5) was estimated by using the satellite data we also investigated the use of fuels and chimneys as indoor air pollution. A two-level (individual level and community level) linear model was applied to examine the association between long-term exposure to ambient PM(2.5) combined with indoor air pollution and the handgrip strength. Results: A total of 13 175 individuals aged 50 years and over were included for analysis. The handgrip strength was (26.67±0.54) kg. Ambient PM(2.5) was found to be significantly associated with the risk of decreased handgrip strength. Outdoor PM(2.5) concentration was negatively correlated with handgrip strength (β=-0.23, 95%CI: -0.31 - -0.14) decrease in handgrip strength after adjusting for gender, age, residence, education, household assets, intake of vegetables and fruits, smoking and drinking, physical activity. In rural area, compared to those who used solid fuel, use of clean fuel increased (β=1.41, 95%CI: 0.36-2.46) handgrip strength. But in urban area, we did not find any statistically significant association between the use of clean fuel and handgrip strength (β=0.19, 95%CI: -0.95-1.32). Conclusion: This study found that long-term exposure to ambient PM(2.5) combined with indoor air pollution was significantly associated with low handgrip strength among people aged 50 years and over, this suggested that ambient PM(2.5) might serve as one of the risk factors for low physical function seen in the people aged 50 years and over.
目的： 分析室内、外空气污染与≥50岁人群手握力的关联。 方法： 采用WHO全球老龄化与成人健康研究中国项目第一轮基线调查，室外空气污染以PM(2.5)平均浓度（基于卫星遥感数据进行估计）进行描述，室内空气污染通过燃料和烟囱使用情况进行描述，采用两水平（个体层面和社区层面）线性模型分析室内、外空气污染与中国≥50岁人群手握力的关系。 结果： 共纳入13 175名≥50岁中老年人。手握力为（26.67±0.54）kg。调整性别、年龄、居住地区、文化程度、家庭经济水平、水果蔬菜摄入状况、吸烟、饮酒和体力活动后，室外PM(2.5)浓度与手握力呈负相关（β=-0.23，95%CI：-0.31~-0.14）。在农村，相比使用固体燃料（非清洁），使用清洁燃料可以提高手握力值（β=1.41，95%CI：0.36~2.46）。但在城市地区，未发现使用清洁燃料对手握力值有显著影响（β=0.19，95%CI：-0.95~1.32）。 结论： 室外PM(2.5)与室内污染合并暴露与≥50岁人群低手握力显著相关，提示了慢性长期空气污染暴露有可能是我国中老年人较低机体功能的重要危险因素之一。.
Keywords: Air pollution; Handgrip strength.