Association between living environmental quality and lung function among middle-aged and older adults in China

This study is intended to examine the connection between residential environmental quality and lung function as well as its deterioration. To this end, we used data from 2011 to 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,129 subjects aged ≥45 years participated in the cross-sectional study, with 5,009 subjects completing four-year follow-up. Linear and logistic regression were applied to explore associations of living environmental quality with PEF, PEF% pred, and severe airflow limitation. Additionally, linear regression was also employed to investigate the relationship between living environmental quality and the annual decline in PEF and PEF% pred, complemented by subgroup analyses. Additionally, sensitivity analyses were conducted. The results showed that, compared to high-risk living environments, both middle- and low-risk living environments showed positive associations with PEF and PEF% pred, and effectively relieve severe airflow limitation. Furthermore, the longitudinal analysis indicated that the low-risk living environment is significantly associated with a slow decline in PEF (β = -3.07, 95%CI: -5.13 ~ -1.01, P = 0.003) and PEF% pred (β = -0.009, 95%CI: -0.015 ~ -0.004, P = 0.001), particularly among urban residents. In summary, a higher quality of life environment score is associated with preserved lung function and a slower decline.