Abstract
Several studies have assessed the influence of several often-ignored environmental factors on low back pain (LBP), but the effects of environmental polycyclic aromatic hydrocarbon (PAH) exposure on LBP are unclear. During the 2001–2004 cycle of the National Health and Nutrition Examination Survey (NHANES), our study was given to a representative sample of US participants older than 20 (N = 2743). Environmental PAH exposure was calculated using urinary PAH metabolite concentrations. Weighted logistic regression was performed to assess the connection between PAH levels and LBP, with mediation analysis utilised to explore the underlying mechanism. Levels of 1-hydroxynaphthalene (1-OHNa), 2-hydroxynaphthalene (2-OHNa) and total PAHs had a statistically significant positive association with LBP. The odds ratios per 1-unit increase for log-transformed levels of urinary 1-OHNa, 2-OHNa, and total PAHs with LBP were 1.01 (95% CI 1.02–1.19), 1.19 (95% CI 1.04–1.36) and 1.16 (95% CI 1.03–1.32), respectively. The results revealed a strong dose–response association between 1-OHNa, 2-OHNa, total PAHs, and LBP risk. Subgroup analysis indicated that 2&3-OHPh may increase the risk of LBP in the lower family income subgroup. Gamma-glutamyl transaminase (GGT), known as a biomarker of oxidative stress, was strongly related to PAHs. The relationship between total PAHs and LBP was mediated in part by GGT. Our study demonstrates associations between environmental PAH exposure and LBP that need more research to determine the precise effects of various PAH compounds on LBP.
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Data and material availability
The data used in this study can be downloaded for free in NHANES. The codes for the R programs are available on GitHub (https://github.com/xiaojiang1997/LBP).
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Acknowledgements
The authors would like to give our sincere appreciation to the reviewers for their helpful comments on this article and research groups for the NHANES, which provided data for this collection.
Funding
This work was supported by the Scientific Research Project of Hunan Provincial Health Commission [Grant number 202204074707]; the Natural Science Foundation of Hunan Province [Grant number 2022JJ30516]; and the Scientific Research Project of Wuhan City Health Commission [Grant number WX18C29].
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Chen, J., Liao, Y., Luo, M. et al. Environmental polycyclic aromatic hydrocarbon exposure is associated with low back pain. Environ Geochem Health 45, 5093–5107 (2023). https://doi.org/10.1007/s10653-023-01567-y
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DOI: https://doi.org/10.1007/s10653-023-01567-y