Socioeconomic disparities in PFAS exposure and susceptibility to diabetes in Chinese adults: A nationwide cross-sectional study
By Saisai Ji, Jinghua Wang, Yingli Qu, Zheng Li, Yitao Pan, Yawei Li, Haocan Song, Linna Xie, Wenli Zhang, Jiayi Cai, Feng Zhao, Ying Zhu, Zhaojin Cao, Shilu Tong, Yuebin Lv, Jiayin Dai, Guang Jia, and Xiaoming Shi
Environ. Health
June 10, 2026
DOI: 10.1021/envhealth.6c00036
Emerging evidence indicates that socioeconomic status (SES) shapes not only patterns of environmental exposure but also the susceptibility to environmental hazards. Per- and polyfluoroalkyl substances (PFAS) represent a distinctive case in which socioeconomically disadvantaged populations often exhibit lower exposure levels, raising critical questions about how such exposure patterns translate into health inequalities, particularly for diabetes. Using cross-sectional data from 10 302 adults participating in the China National Human Biomonitoring (CNHBM) program, we examined socioeconomic disparities in serum PFAS concentrations and assessed whether lower SES is associated with stronger PFAS-diabetes associations among Chinese adults. We found that individuals with higher SES exhibited 4–10% higher serum concentrations of PFOA, PFUnDA, PFHxS, PFHpS, PFOS, and 6:2 Cl-PFESA (all p values <0.05). In contrast, associations between PFAS exposure and diabetes were generally stronger among low-SES participants. Across multiple PFAS, odds ratios for diabetes in the low-SES group were 0–17% greater relative to the high-SES group, with statistically significant effect modification observed for PFUnDA, PFOS, and 6:2 Cl-PFESA. These findings indicate that socioeconomic disadvantage may be associated with greater susceptibility, even at lower exposure levels, underscoring the importance of considering differential susceptibility when assessing environmental health risks and advancing health equity.
Location:
Topics: