OBJECTIVES: Ambient air pollution is a major public health concern worldwide, while most evidence primarily focuses on objective measures of the impacts of air pollution on health. Few has attempted to quantify this relationship between ambient air pollution and HRQoL, although the association is very important to public health decision-making. This study aims to explored the association between the long-term exposure to ambient air pollution and HRQoL among older adults in China.

METHODS: We analysed the data of 5,717 adults age 65 years or older from Sixth Health Service Survey (SHSS) in Shandong province, China. Those respondents self-reported their sociodemographic information and health behaviors. HRQoL was estimated using EQ-5D-3L. Air pollution data from ChinaHighAirPollutants (CHAP), an open-access database, including PM2.5, PM10, and SO2. Long-term air pollution exposure was quantified as 5-year average concentration.

RESULTS: Among 5,717 respondents, 2,969 were female. Annual concentrations of three air pollutants were well above the standards set by China. Three air pollutants exhibited negatively correlated with EQ-5D score while were not significant with VAS score. As air pollutant concentrations increase, the health utility of older adults decreases significantly. each 1 μg/m3 increase in PM2.5, PM10, and SO2 was associated with a 0.002 (p=0.001), 0.001 (p=0.003), and 0.002 (p=0.002) decrease in EQ-5D-3L score, respectively. In five health dimensions, PM2.5 had a negative association with pain/discomfort (p=0.033) and anxiety/depression (p=0.025). Only anxiety/depression shows a significant negative relation with PM10 (p=0.009). For SO2, a significant association only exists in the pain/discomfort dimension (p=0.012).

CONCLUSIONS: We found long-term air pollution exposure is associated with worse HRQoL among old adults, especially in the dimensions of pain/discomfort and anxiety/depression.