Dust-borne emerging contaminants: an underrecognized risk factor for non-communicable diseases in older Chinese adults

Given global aging and the growing burden of non-communicable diseases (NCDs), identifying environmental risk factors in older adults is critical. This study investigated the associations between dust-borne emerging contaminant (EC) exposures and several high-incidence NCDs in older adults. 137 province-level dust measurements of microplastics, liquid crystal monomers, organophosphate esters, and per- and polyfluoroalkyl substances across 23 provinces were used to estimate exposure levels for 14 466 Chinese participants (mean age 84.7). Propensity score-adjusted logistic regression showed significantly higher odds of NCDs at the third vs. first tertile of specific exposure, including hypertension [polyethylene terephthalates: odds ratio (OR), 1.28; 95% confidence interval (CI), (1.16-1.41), etc.], heart disease [perfluoroalkyl carboxylic acids (PFCAs) (C4-C12): 1.25 (1.04-1.49), etc.], cataract [organophosphate triesters: 1.61 (1.32-1.96), etc.], stroke [polycarbonates: 1.30 (1.06-1.58), etc.], respiratory diseases [organophosphate triesters: 1.57 (1.27-1.94), etc.], and arthritis [PFCAs (C4-C12): 1.73 (1.34-2.24), etc.]. G-computation estimated 6-13% absolute increases in disease probability (∼60-130 additional cases per 1000) from low- to high-exposure scenarios. Subgroup analyses suggested stronger associations among females, the oldest participants, and eastern residents. These pilot findings demonstrate dust-borne ECs as an underrecognized health risk for older adults and warrant further investigation. Adopting precautionary principles prevents studies and regulations from remaining confined to criteria air pollutants. An interactive online dashboard provides full results.