Estimating the risk of anemia associated with PM2.5 exposure in Nepalese women of reproductive age

Shiva Raj Acharya; Jeevan Bhatta

doi:10.1038/s43856-026-01533-6

Estimating the risk of anemia associated with PM_2.5 exposure in Nepalese women of reproductive age

Shiva Raj Acharya^*, Jeevan Bhatta

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Although evidence links particulate matter exposure to anemia, research focused on women remains scarce. This study investigates the risk of anemia associated with PM_2.5 exposure among Nepalese women of reproductive age.

Methods: This study used nationally representative data from the 2022 Nepal Demographic and Health Survey, including a sample of 4133 women of reproductive age. Anemia was defined according to WHO guidelines (blood hemoglobin levels <12 g/dl for non-pregnant women and <11 g/dl for pregnant women), and mean PM_2.5 exposure data were obtained from the national air quality monitoring department.

Results: Here we show that higher PM_2.5 exposure is associated with an increased risk of anemia among Nepalese women. Weighted regression models revealed a consistent inverse relationship between PM_2.5 and blood hemoglobin levels (β, 95% CI: -0.161, -0.228 ~ -0.099). Each 10-µg/m³ increase in PM_2.5 resulted in a 29% greater risk of anemia (OR, 95% CI: 1.29, 1.14-1.42). The associated risk was more pronounced among women with lower educational attainment and those residing in mountainous regions.

Conclusions: This study provides substantial evidence linking air pollution to anemia in women of reproductive age, underscoring the urgent need for targeted health interventions and stricter air quality regulations in low-resource settings.

Original language	English
Article number	289
Pages (from-to)	1-8
Number of pages	8
Journal	Communications Medicine
Volume	6
Issue number	1
Early online date	25 Mar 2026
DOIs	https://doi.org/10.1038/s43856-026-01533-6
Publication status	Published - 19 May 2026
Externally published	Yes

Bibliographical note

Copyright the Author(s) 2026. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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title = "Estimating the risk of anemia associated with PM2.5 exposure in Nepalese women of reproductive age",

abstract = "Background: Although evidence links particulate matter exposure to anemia, research focused on women remains scarce. This study investigates the risk of anemia associated with PM2.5 exposure among Nepalese women of reproductive age. Methods: This study used nationally representative data from the 2022 Nepal Demographic and Health Survey, including a sample of 4133 women of reproductive age. Anemia was defined according to WHO guidelines (blood hemoglobin levels <12 g/dl for non-pregnant women and <11 g/dl for pregnant women), and mean PM2.5 exposure data were obtained from the national air quality monitoring department. Results: Here we show that higher PM2.5 exposure is associated with an increased risk of anemia among Nepalese women. Weighted regression models revealed a consistent inverse relationship between PM2.5 and blood hemoglobin levels (β, 95\% CI: -0.161, -0.228 \textasciitilde{} -0.099). Each 10-µg/m³ increase in PM2.5 resulted in a 29\% greater risk of anemia (OR, 95\% CI: 1.29, 1.14-1.42). The associated risk was more pronounced among women with lower educational attainment and those residing in mountainous regions. Conclusions: This study provides substantial evidence linking air pollution to anemia in women of reproductive age, underscoring the urgent need for targeted health interventions and stricter air quality regulations in low-resource settings.",

author = "Acharya, \{Shiva Raj\} and Jeevan Bhatta",

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N2 - Background: Although evidence links particulate matter exposure to anemia, research focused on women remains scarce. This study investigates the risk of anemia associated with PM2.5 exposure among Nepalese women of reproductive age. Methods: This study used nationally representative data from the 2022 Nepal Demographic and Health Survey, including a sample of 4133 women of reproductive age. Anemia was defined according to WHO guidelines (blood hemoglobin levels <12 g/dl for non-pregnant women and <11 g/dl for pregnant women), and mean PM2.5 exposure data were obtained from the national air quality monitoring department. Results: Here we show that higher PM2.5 exposure is associated with an increased risk of anemia among Nepalese women. Weighted regression models revealed a consistent inverse relationship between PM2.5 and blood hemoglobin levels (β, 95% CI: -0.161, -0.228 ~ -0.099). Each 10-µg/m³ increase in PM2.5 resulted in a 29% greater risk of anemia (OR, 95% CI: 1.29, 1.14-1.42). The associated risk was more pronounced among women with lower educational attainment and those residing in mountainous regions. Conclusions: This study provides substantial evidence linking air pollution to anemia in women of reproductive age, underscoring the urgent need for targeted health interventions and stricter air quality regulations in low-resource settings.

AB - Background: Although evidence links particulate matter exposure to anemia, research focused on women remains scarce. This study investigates the risk of anemia associated with PM2.5 exposure among Nepalese women of reproductive age. Methods: This study used nationally representative data from the 2022 Nepal Demographic and Health Survey, including a sample of 4133 women of reproductive age. Anemia was defined according to WHO guidelines (blood hemoglobin levels <12 g/dl for non-pregnant women and <11 g/dl for pregnant women), and mean PM2.5 exposure data were obtained from the national air quality monitoring department. Results: Here we show that higher PM2.5 exposure is associated with an increased risk of anemia among Nepalese women. Weighted regression models revealed a consistent inverse relationship between PM2.5 and blood hemoglobin levels (β, 95% CI: -0.161, -0.228 ~ -0.099). Each 10-µg/m³ increase in PM2.5 resulted in a 29% greater risk of anemia (OR, 95% CI: 1.29, 1.14-1.42). The associated risk was more pronounced among women with lower educational attainment and those residing in mountainous regions. Conclusions: This study provides substantial evidence linking air pollution to anemia in women of reproductive age, underscoring the urgent need for targeted health interventions and stricter air quality regulations in low-resource settings.

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Estimating the risk of anemia associated with PM_2.5 exposure in Nepalese women of reproductive age

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