ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1620411
Air Pollution Increases Gastroesophageal Reflux Disease Risk: Evidence from a Prospective Cohort Study
Provisionally accepted
- 1Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
- 2Xi'an Jiaotong University Health Science Center, Xi'an, China
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Background Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal disorders with uncertain etiology and high prevalence. Ambient air pollution has been linked with gastrointestinal diseases, but the impact of long-term air pollution exposure on GERD incidence is still unclear. Methods We performed a cohort study using the UK Biobank database. Annual mean concentrations of air pollutants, including PM10, PM2.5-10, PM2.5, NOX, and NO2, were obtained from the ESCAPE study using the land use regression model. The Cox proportional hazard regression model was employed to estimate the percentage change of GERD incidence risk related to long-term air pollutant exposures. We further explored the exposure-response relationship curves and identified the vulnerable populations. Results During a follow-up period of 14.1 ± 2.4 years, a total of 32,413 (11.2%) individuals were diagnosed with GERD among 289,387 participants. We estimated that each interquartile range increase in PM10, PM2.5-10, PM2.5, NOX, NO2, and NO was associated with 1.69%, 1.29%, 3.57%, 2.08%, 1.93%, and 2.28% higher incidence risks of GERD, respectively. Almost linear exposure-response curves were observed, particularly for GERD without esophagitis. The females, middle-aged, overweight, White ethnicity, and higher socioeconomic status individuals were more vulnerable to GERD when exposed to air pollutants. Conclusions This study provided robust evidence supporting the association between long-term exposure to air pollutants and increased risk of GERD incidence. Our research revealed that exposure to both particulate matter and gaseous pollutants was associated with a higher risk of GERD, especially for GERD without esophagitis.
Keywords: Gastroesophageal reflux disease, Air Pollution, Particulate Matter, Gaseous pollutants, prospective cohort study
Received: 29 Apr 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Ran, Lei, Wang, Li, Ye, Mei, Sun, Chen and Dai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fei Dai, Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, China
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