PDS 67: Outdoor air pollution cardiometabolic effects, Exhibition Hall (PDS), Ground floor, August 27, 2019, 4:30 PM - 5:30 PM Background: Health effects of air pollution on anemia have been scarcely studied worldwide. We aimed to explore the associations of long-term exposure to ambient particulate matter (PM) and gaseous pollutants (NO2)with anemia prevalence and hemoglobin levels in China. Methodology: We used two-level linear regression models and modified Poisson regression with robust error variance to examine the associations of particulate matter (PM), and nitrogen dioxide (NO2) on haemoglobin levels and prevalence of anaemia, respectively, among 10611 older Chinese adults enrolled in WHO Study on global AGEing and adult health (SAGE) China Wave1 in 2007-2010 from 64 townships. The average community exposure to ambient air pollutants (PM with an aerodynamic diameter of 10 μm or less [PM10], 2·5 μm or less [PM2·5], 1 μm or less [PM1] and nitrogen dioxide [NO2]) for each participant was estimated using a satellite-based spatial statistical model. Haemoglobin levels were measured for participants from dried blood spots. Anaemia was defined using WHO haemoglobin-based criteria of b13 and b12 g/dL for men and women, respectively. Models were controlled for confounders. Mediation by C-reactive protein (CRP), a marker of systemic inflammation, was also investigated. Results: All the studied pollutants were significantly associated with increased anaemia prevalence (eg, the adjusted prevalence ratios associated with an increase in IQR in five year moving average for NO2, PM1, PM2·5, and PM10 were 1.42, 95% CI 1.35- 1.50; 1.15, 1.09- 1.23; 1.12, 1.06- 1.18; 1.05, 1.02- 1.08, respectively). These air pollutants were also associated with lower concentrations of haemoglobin (-1.76 95% CI -1.90- -1.62; -0.67, -0.78- -0.55; -0.98, -1.00- -0.68; -0.52, -0.65- -0.39, respectively). Stratified analyses indicated greater effects on the individuals who were smokers or alcohol drinkers. Conclusions: Air pollution exposures were significantly associated with increased prevalence of anaemia and decreased haemoglobin levels in a cohort of older Chinese adults.