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ORIGINAL RESEARCH article

Front. Public Health
Sec. Environmental Health and Exposome
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1511215
This article is part of the Research Topic New Environmental Pollutants, Aging, and Age-Related Diseases View all articles

Association between ethylene oxide exposure and osteoarthritis risk

Provisionally accepted
Zhongshan Li Zhongshan Li 1Qi Qu Qi Qu 2Rui Jiang Rui Jiang 1Shuanglin Mou Shuanglin Mou 3Zhiyu Wang Zhiyu Wang 2Wensheng Zhu Wensheng Zhu 3*
  • 1 College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
  • 2 Medical School, Hubei Minzu University, Enshi, China
  • 3 Huanggang Hospital of Traditional Chinese Medicine, Department of Osteology, Hubei University of Chinese Medicine, Wuhan, China

The final, formatted version of the article will be published soon.

    Background: Ethylene oxide (EO) is widely used as a disinfectant and is also a common environmental pollutant. Exposure to EO has been associated with various systemic diseases, posing crucial health risks. However, EO is frequently employed as a sterilizing agent in orthopedics, while its association with the risk of skeletal system diseases remains insufficiently evaluated. This study aims to investigate the association between EO exposure and the risk of Osteoarthritis (OA), a prevalent orthopedic condition.: A total of 3,386 participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and 2017-2018 cycles, including 952 individuals with OA. Box plots assessed EO concentration differences between OA and non-OA groups.Weighted logistic regression models and restricted cubic spline (RCS) models were used to evaluate the relationship between EO exposure and OA risk. Subgroup analysis and interaction test explored variations in the association across different characteristics.Results: No significant difference in EO concentrations was found between OA and non-OA groups. In multivariate logistic regression, high EO level exposure was significantly associated with increased OA risk. Additionally, a nonlinear U-shaped and J-shaped association was observed in the unadjusted and adjusted RCS models, respectively. Subgroup analysis revealed that the association between EO exposure and OA risk was more pronounced in the 20-40 and 40-65 age groups, never smokers(Not at all), and those with low calcium levels (<8.5 mg/dL) or low vitamin D levels (<75 nmol/L).Conclusions: EO exposure is associated with OA risk, exhibiting a J-shaped relationship, with this association being particularly pronounced in individuals under 65 years old or those with low calcium or vitamin D levels. Further prospective studies are needed to examine the association between EO exposure and OA risk.

    Keywords: Osteoarthritis, Ethylene Oxide, Epidemiology, NHANES, Cross-sectional study

    Received: 14 Oct 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Li, Qu, Jiang, Mou, Wang and Zhu. 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: Wensheng Zhu, Huanggang Hospital of Traditional Chinese Medicine, Department of Osteology, Hubei University of Chinese Medicine, Wuhan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.