# Association between ethylene oxide exposure and osteoarthritis risk among middle-aged and young adults: a cross-sectional study

## TL;DR

This study found that higher ethylene oxide exposure is linked to a greater risk of osteoarthritis in young and middle-aged adults.

## Contribution

The study identifies a novel association between ethylene oxide exposure and increased osteoarthritis risk in this age group.

## Key findings

- Individuals in the highest tertile of EO exposure had a 224% higher OA risk compared to the lowest tertile.
- The prediction model showed good discriminatory power and potential clinical benefits for OA risk evaluation.
- No nonlinear associations or significant interactions were observed in subgroups.

## Abstract

The relationship between exposure to ethylene oxide (EO) and the risk of developing osteoarthritis (OA) remains unclear. We aimed to explore the association between EO exposure and OA risk among young and middle-aged adults.

We utilized data from the 2013–2018 National Health and Nutrition Examination Survey, involving 2,380 individuals aged 20–60 years. Weighted multivariable regression models, smooth curve fitting (SCF), subgroup analysis and interaction tests were employed to examine the association between EO exposure and OA risk. Furthermore, we performed variable selection via least absolute shrinkage and selection operator regression and multivariable regression analyses to construct a prediction model.

Increased EO exposure was associated with increased OA risk. After full adjustment, individuals in the highest tertile of EO exposure had a significantly greater OA risk (224% increase) than did those in the lowest tertile of EO exposure (OR = 3.24; 95% CI: 1.61–6.52; p for trend = 0.002). SCF did not indicate any nonlinear associations. There was no statistically significant interaction observed in any of the subgroups (all p > 0.05). We built a prediction model visualized with a nomogram. This prediction model demonstrated good discriminatory power, excellent precision, and potential clinical benefits.

The findings of our research demonstrated that among middle-aged and young adults, EO exposure was positively associated with OA risk. A prediction model was developed by integrating EO exposure with other factors readily acquired from users to assist in the evaluation and management of high-risk OA groups.