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Li W, Wang J, Huang W, Yan Y, Liu Y, Zhao Q, Chen M, Yang L, Guo Y, Ma W. The association between humidex and tuberculosis: a two-stage modelling nationwide study in China. BMC Public Health 2024; 24:1289. [PMID: 38734652 PMCID: PMC11088084 DOI: 10.1186/s12889-024-18772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Under a changing climate, the joint effects of temperature and relative humidity on tuberculosis (TB) are poorly understood. To address this research gap, we conducted a time-series study to explore the joint effects of temperature and relative humidity on TB incidence in China, considering potential modifiers. METHODS Weekly data on TB cases and meteorological factors in 22 cities across mainland China between 2011 and 2020 were collected. The proxy indicator for the combined exposure levels of temperature and relative humidity, Humidex, was calculated. First, a quasi-Poisson regression with the distributed lag non-linear model (DLNM) was constructed to examine the city-specific associations between humidex and TB incidence. Second, a multivariate meta-regression model was used to pool the city-specific effect estimates, and to explore the potential effect modifiers. RESULTS A total of 849,676 TB cases occurred in the 22 cities between 2011 and 2020. Overall, a conspicuous J-shaped relationship between humidex and TB incidence was discerned. Specifically, a decrease in humidex was positively correlated with an increased risk of TB incidence, with a maximum relative risk (RR) of 1.40 (95% CI: 1.11-1.76). The elevated RR of TB incidence associated with low humidex (5th humidex) appeared on week 3 and could persist until week 13, with a peak at approximately week 5 (RR: 1.03, 95% CI: 1.01-1.05). The effects of low humidex on TB incidence vary by Natural Growth Rate (NGR) levels. CONCLUSION A J-shaped exposure-response association existed between humidex and TB incidence in China. Humidex may act as a better predictor to forecast TB incidence compared to temperature and relative humidity alone, especially in regions with higher NGRs.
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Affiliation(s)
- Wen Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Shandong University Climate Change and Health Center, Jinan, Shandong, China
| | - Jia Wang
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Shandong University Climate Change and Health Center, Jinan, Shandong, China
| | - Yanming Liu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Shandong University Climate Change and Health Center, Jinan, Shandong, China
| | - Mingting Chen
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Liping Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
- Shandong University Climate Change and Health Center, Jinan, Shandong, China.
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Nie Y, Yang Z, Lu Y, Bahani M, Zheng Y, Tian M, Zhang L. Interaction between air pollutants and meteorological factors on pulmonary tuberculosis in northwest China: A case study of eight districts in Urumqi. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:691-700. [PMID: 38182774 DOI: 10.1007/s00484-023-02615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
Meteorological factors and air pollutants are associated with the spread of pulmonary tuberculosis (PTB), but few studies have examined the effects of their interactions on PTB. Therefore, this study investigated the impact of meteorological factors and air pollutants and their interactions on the risk of PTB in Urumqi, a city with a high prevalence of PTB and a high level of air pollution. The number of new PTB cases in eight districts of Urumqi from 2014 to 2019 was collected, along with data on meteorological factors and air pollutants for the same period. A generalized additive model was applied to explore the effects of meteorological factors and air pollutants and their interactions on the risk of PTB incidence. Segmented linear regression was used to estimate the nonlinear characteristics of the impact of meteorological factors on PTB. During 2014-2019, a total of 14,402 new cases of PTB were reported in eight districts, with March to May being the months of high PTB incidence. The exposure-response curves for temperature (Temp), relative humidity (RH), wind speed (WS), air pressure (AP), and diurnal temperature difference (DTR) were generally inverted "U" shaped, with the corresponding threshold values of - 5.411 °C, 52.118%, 3.513 m/s, 1021.625 hPa, and 8.161 °C, respectively. The effects of air pollutants on PTB were linear and lagged. All air pollutants were positively associated with PTB, except for O3, which was not associated with PTB, and the ER values for the effects on PTB were as follows: 0.931 (0.255, 1.612) for PM2.5, 1.028 (0.301, 1.760) for PM10, 5.061 (0.387, 9.952) for SO2, 2.830 (0.512, 5.200) for NO2, and 5.789 (1.508, 10.251) for CO. Meteorological factors and air pollutants have an interactive effect on PTB. The risk of PTB incidence was higher when in high Temp-high air pollutant, high RH-high air pollutant, high WS-high air pollutant, lowAP-high air pollutant, and high DTR-high air pollutant. In conclusion, both meteorological and pollutant factors had an influence on PTB, and the influence on PTB may have an interaction.
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Affiliation(s)
- Yanwu Nie
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zhen Yang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Mailiman Bahani
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yanling Zheng
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China.
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Wang Q, Li YL, Yin YL, Hu B, Yu CC, Wang ZD, Li YH, Xu CJ, Wang YB. Association of air pollutants and meteorological factors with tuberculosis: a national multicenter ecological study in China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1629-1641. [PMID: 37535117 DOI: 10.1007/s00484-023-02524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/17/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
The impact of weather variability and air pollutants on tuberculosis (TB) has been a research hotspot. Previous studies have mostly been limited to a certain area or with a small sample size of cases, and multi-scale systematic studies are lacking. In this study, 14,816,329 TB cases were collected from 31 provinces in China between 2004 and 2018 to estimate the association between TB risk and meteorological factors and air pollutants using a two-stage time-series analysis. The impact and lagged time of meteorological factors and air pollutants on TB risk varied greatly in different provinces and regions. Overall cumulative exposure-response summary associations across 31 provinces suggested that high monthly mean relative humidity (RH) (66.8-82.4%, percentile56-100 (P56-100)), rainfall (316.5-331.1 mm, P96-100), PM2.5 exposure concentration (93.3-145.0 μg/m3, P58-100), and low monthly mean wind speed (1.6-2.1 m/s, P0-38) increased the risk of TB incidence, with a relative risk (RR) of 1.10 (95% CI: 1.04-1.16), 1.10 (95% CI: 1.03-1.16), 2.08 (95% CI: 1.18-3.65), and 2.06 (95% CI: 1.27-3.33), and attributable risk percent (AR%) of 9%, 9%, 52%, and 51%, respectively. Conversely, high monthly average wind speed (2.3-2.9 m/s, P54-100) and mean temperature (20.2-25.3 °C, P79-96), and low monthly average rainfall (2.4-25.2 mm, P0-7) and concentration of SO2 (8.1-21.2 μg/m3, P0-16) exposure decreased the risk of TB incidence, with an overall cumulative RR of 0.92 (95% CI: 0.87-0.98), 0.74 (95% CI: 0.59-0.94), 0.87 (95% CI: 0.79-0.95), and 0.72 (95% CI: 0.56-0.93), respectively. Our study provided insights into future planning of public health interventions for TB.
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Affiliation(s)
- Qian Wang
- School of Public Health, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China
| | - Yan-Lin Li
- School of Public Health, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China
| | - Ya-Ling Yin
- Sino-UK Joint Laboratory of Brain Function and Injury of Henan Province, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China
| | - Bin Hu
- School of Public Health, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China
| | - Chong-Chong Yu
- School of Public Health, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China
| | - Zhen-de Wang
- School of Public Health, Weifang Medical University, Shandong Province, Weifang, 261053, China
- National Center for Tuberculosis Control and Prevention, China Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yu-Hong Li
- National Center for Tuberculosis Control and Prevention, China Center for Disease Control and Prevention, Beijing, 102206, China
| | - Chun-Jie Xu
- Institute of Medical Biotechnology, Chinese Academy of Medical Sciences & Peking Union Medical Sciences, Beijing, 100730, China.
| | - Yong-Bin Wang
- School of Public Health, Xinxiang Medical University, Henan Province, Xinxiang, 453003, China.
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Tao B, Li Z, Wang Y, Wu J, Shi X, Shi J, Liu Q, Wang J. Environment pollutants exposure affects the endogenous activation of within-host Mycobacterium tuberculosis. ENVIRONMENTAL RESEARCH 2023; 227:115695. [PMID: 36958381 DOI: 10.1016/j.envres.2023.115695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Epidemiological studies have linked ambient pollutants with tuberculosis (TB) risk, but the association has not been fully understood. Here, for the first time, we applied whole-genome sequencing (WGS) to assess the reproductive state of Mycobacterium tuberculosis (MTB) by profiling the mutation rate of MTB (MTBMR) during within-host endogenous reactivated progression, intending to dissect the actual effects of ambient pollutants on the endogenous reactivation. METHODS We conducted a retrospective cohort study on bacteriologically confirmed TB patients and followed them for relapse in Jiangsu and Sichuan Province, China. Endogenous and exogenous activation were distinguished by WGS of the pathogen. The average concentration of air pollution was estimated by considering a lag of 0-1 to 0-12 months. We applied a generalized additive model with a Poisson function to evaluate the relationships between ambient pollutants exposure and MTBMR. RESULTS In the single-pollutant adjusted models, the maximum effect for PM10 (MTBMR increase: 81.87%, 95% CI: 38.38, 139.03) and PM2.5 (MTBMR increase: 73.91%, 95% CI: 22.17, 147.55) was observed at a lag of 0-12 months for every 10 μg/m³ increase. For SO2, the maximum effect was observed at lag 0-8 months, with MTBMR increasing by 128.06% (95% CI: 45.92, 256.44); and for NO2, the maximum effect was observed at lag 0-9 months, with MTBMR increasing by 124.02% (95% CI: 34.5, 273.14). In contrast, the O3 concentration was inversely associated with MTBMR, and the maximum reduction of MTBMR was 6.18% (95% CI: -9.24, -3.02) at a lag of 0-9 months. Similar results were observed for multi-pollutant models. CONCLUSIONS Increased exposure to ambient pollutants (PM10, PM2.5, SO2, and NO2) contributed to a faster MTBMR, indicating that MTB exhibits increased reproductive activity, thus accelerating within-host endogenous reactivation. O3 exposure could decrease the MTBMR, suggesting that MTB exerts low reproductive activity by inhibiting within-host endogenous activation.
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Affiliation(s)
- Bilin Tao
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; Department of Epidemiology, The Third People's Hospital of Changzhou, Changzhou, China; Department of Epidemiology, Gusu School, Nanjing Medical University, Nanjing, China
| | - Zhongqi Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yuting Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jizhou Wu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinling Shi
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jinyan Shi
- Department of Clinical Laboratory, The Fourth People's Hospital of Lianyungang, Lianyungang, China
| | - Qiao Liu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, China.
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; Department of Epidemiology, The Third People's Hospital of Changzhou, Changzhou, China; Department of Epidemiology, Gusu School, Nanjing Medical University, Nanjing, China.
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Zavala MJ, Becker GL, Blount RJ. Interrelationships between tuberculosis and chronic obstructive pulmonary disease. Curr Opin Pulm Med 2023; 29:104-111. [PMID: 36647566 PMCID: PMC9877200 DOI: 10.1097/mcp.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Our objective was to review the current literature regarding socioeconomic, environmental, clinical, and immunologic factors common to chronic obstructive pulmonary disease (COPD) and tuberculosis (TB). RECENT FINDINGS Recent studies suggest that TB patients might be at increased risk for developing COPD. Conversely, additional prospective cohort studies have determined that COPD patients are at increased risk for active TB: a risk that appears to be partially mediated through inhaled corticosteroid use. Tobacco smoking, poverty, air pollution, and malnutrition are associated with COPD and TB. Vitamin D has been shown to prevent COPD exacerbations, but its use for preventing TB infection remains unclear. Surfactant deficiency, elevated matrix metalloproteinases, and toll-like receptor 4 polymorphisms play key roles in the pathogenesis of both diseases. SUMMARY Recent studies have elucidated interrelationships between COPD and TB. Future research is needed to optimize clinical and public health approaches that could mitigate risk factors contributing to both diseases.
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Affiliation(s)
- Michael J Zavala
- Division of Pulmonary and Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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Zheng H, Liu D, Zhao X, Zhao X, Liu Y, Li D, Shi T, Ren X. Influence and prediction of meteorological factors on brucellosis in a northwest region of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:9962-9973. [PMID: 36064850 DOI: 10.1007/s11356-022-22831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
This paper aims to study the cumulative lag effect of meteorological factors on brucellosis incidence and the prediction performance based on Random Forest model. The monthly number of brucellosis cases and meteorological data from 2015 to 2019 in Yongchang of Gansu Province, northwest China, were used to build distributed lag nonlinear model (DLNM). The number of brucellosis cases of lag 1 month and meteorological data from 2015 to 2018 were used to build RF model to predict the brucellosis incidence in 2019. Meanwhile, SARIMA model was established to compare the prediction performance with RF model according to R2 and RMSE. The results indicated that the population had a high incidence risk at temperature between 5 and 13 °C and lag between 0 and 18 days, sunshine duration between 225 and 260 h and lag between 0 and 1 month, and atmosphere pressure between 789 and 793.5 hPa and lag between 0 and 18 days. The R2 and RMSE of train set and test set in RF model were 0.903, 1.609, 0.824, and 2.657, respectively, and the R2 and RMSE in SARIMA model were 0.530 and 7.008. This study found significant nonlinear and lag associations between meteorological factors and brucellosis incidence. The prediction performance of RF model was more accurate and practical compared with SARIMA model.
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Affiliation(s)
- Hongmiao Zheng
- School of Public Health, Lanzhou University, Gansu, China
| | - Dongpeng Liu
- Gansu Provincial Center for Disease Control and Prevention, Gansu, China
| | - Xin Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiangkai Zhao
- School of Public Health, Lanzhou University, Gansu, China
| | - Yanchen Liu
- School of Public Health, Lanzhou University, Gansu, China
| | - Donghua Li
- School of Public Health, Lanzhou University, Gansu, China
| | - Tianshan Shi
- School of Public Health, Lanzhou University, Gansu, China
| | - Xiaowei Ren
- School of Public Health, Lanzhou University, Gansu, China.
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Pignon B, Borel C, Lajnef M, Richard JR, Szöke A, Hemery F, Leboyer M, Foret G, Schürhoff F. PM 2.5 and PM 10 air pollution peaks are associated with emergency department visits for psychotic and mood disorders. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:88577-88586. [PMID: 35834080 PMCID: PMC9281271 DOI: 10.1007/s11356-022-21964-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/07/2022] [Indexed: 05/05/2023]
Abstract
Particulate matters with a diameter of less than 10 µm (PM10) or less than 2.5 µm (PM2.5) are major air pollutants. Their relationship to psychiatric disorders has not yet been extensively studied. We aimed to explore the relationship between PM10 and PM2.5 air pollution peaks and the daily number of emergency visits for psychotic and mood disorders. Clinical data were collected from the Emergency Department of a Paris suburb (Créteil, France) from 2008 to 2018. Air pollution data were measured by the Paris region air quality network (Airparif) and collected from public databases. Pollution peak periods were defined as days for which the daily mean level of PM was above nationally predefined warning thresholds (20 µg/m3 for PM2.5, and 50 µg/m3 for PM10), and the 6 following days. Multivariable analyses compared the number of daily visits for psychotic and mood (unipolar and bipolar) disorders according to pollution peak, using negative binomial regression. After adjustment on meteorological variables (temperature, humidity, amount of sunshine in minutes), the daily number of emergency visits for psychotic disorders was significantly higher during PM2.5 and PM10 air pollution peak periods; while the number of visits for unipolar depressive disorders was higher only during PM10 peak periods (β = 0.059, p-value = 0.034). There were no significant differences between peak and non-peak periods for bipolar disorders. Differences in the effects of PM air pollution on psychotic and mood disorders should be analyzed in further studies.
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Affiliation(s)
- Baptiste Pignon
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France.
| | - Cynthia Borel
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Mohamed Lajnef
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Jean-Romain Richard
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Andrei Szöke
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - François Hemery
- Service d'information Médical, Hôpitaux Universitaire Henri-Mondor, 94000, Créteil, France
| | - Marion Leboyer
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
| | - Gilles Foret
- Univ Paris Est Créteil and Université de Paris, CNRS, LISA, 94010, Créteil, France
| | - Franck Schürhoff
- Univ Paris Est Créteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fondation FondaMental, 94010, Créteil, France
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Liu Y, Zhou L, Zhang W, Yang Y, Yang Y, Pan L, Ba Y, Wang R, Huo Y, Ren X, Bai Y, Cheng N. Time series analysis on association between ambient air pollutants and orofacial clefts during pregnancy in Lanzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:72898-72907. [PMID: 35618997 DOI: 10.1007/s11356-022-19855-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
Current studies on air pollutant exposure during pregnancy and orofacial clefts (OFCs) have inconsistent results, and few studies have investigated refined susceptible windows for OFCs. We aim to estimate association between air pollution and OFCs during the first trimester of pregnancy and identify specific susceptible windows. Birth data was obtained from Birth Defects Surveillance Network in Lanzhou from 2014 to 2019. Air pollution data and temperature data were obtained from ambient air monitoring stations and China Meteorological Data Network, respectively. A distribution lag nonlinear model (DLNM) was applied to estimate weekly-exposure-lag-response association between air pollutant levels and OFCs. The study included 320,787 perinatal infants from 2014 to 2019, of which 685 (2.14‰) were OFCs. The results demonstrated that exposure of pregnant women to aerodynamic diameter ≤ 10 μm (PM10) at lag 4-5 weeks was significantly associated with the risk of OFCs, with the greatest impact at the lag 4 week (RR = 1.029, 95% CI = 1.001-1.057). Exposure to sulfur dioxide (SO2) at lag 2-4 weeks was significantly associated with the risk of OFCs, with the greatest impact at the lag 3 week (RR = 1.096, 95% CI = 1.041-1.177). This study provides further evidence that exposure to air pollution increases the risk of OFCs in the first trimester of pregnancy.
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Affiliation(s)
- Yanyan Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Zhou
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Wenling Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yanjun Yang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yan Yang
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Pan
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yupei Ba
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ruijuan Wang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yanbei Huo
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaoyu Ren
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ning Cheng
- Center for Reproductive Health and Birth Defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
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Huang K, Hu CY, Yang XY, Zhang Y, Wang XQ, Zhang KD, Li YQ, Wang J, Yu WJ, Cheng X, Cao JY, Zhang T, Kan XH, Zhang XJ. Contributions of ambient temperature and relative humidity to the risk of tuberculosis admissions: A multicity study in Central China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156272. [PMID: 35644395 DOI: 10.1016/j.scitotenv.2022.156272] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND As a communicable disease and major public health issue, many studies have quantified the associations between tuberculosis (TB) and meteorological factors with inconsistent results. The purpose of this multicenter study was to characterize the associations between ambient temperature, humidity and the risk of TB hospitalizations and to investigate potential heterogeneity. METHOD Data on daily hospitalizations for TB, meteorological factors and ambient air pollutants for 16 cities in Anhui Province were collected from 2015 to 2020. A distributed lag nonlinear model (DLNM) was performed to obtain the estimates of meteorological-TB relationships by cities. Then, we used the multivariate meta-regression model to pool the city-specific estimates with air pollution, demographic indicators, medical resource and latitude as potential modifiers to explore the sources of heterogeneity. Finally, we divided the whole province into three regions to validate the meteorological-TB relationships by regions. RESULTS The overall pooled temperature-TB association presented an approximate S-shaped curve, with relative risk (RR) peaking at 5 °C (RR = 1.536, 95% CI: 1.303-1.811) compared to the reference temperature (27 °C). Lag-response curve suggested that low temperature exposure increased the risk of TB hospitalizations at lag 0 and 1 day (lag0 day: RR = 1.136, 95% CI: 1.048-1.231, lag1 day: RR = 1.052, 95% CI: 1.023-1.082). However, the overall exposure-response curve between relative humidity and TB showed almost horizontal line with reference relative humidity to 78%. The residual heterogeneity ranged from 27.1% to 36.9%, with air pollution, latitude and medical resource explained the largest proportion. CONCLUSION We found that low temperature exposure is associated with an acute increased risk of TB hospitalizations in Anhui Province. The association between temperature and TB admission varies depending on air pollution, latitude, and medical resources. Since the effect of short-term exposure to humidity is not significant, further studies are supposed to focus on the long-term effect of humidity.
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Affiliation(s)
- Kai Huang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xi-Yao Yang
- Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Xin-Qiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Kang-Di Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ying-Qing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Wen-Jie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Xin Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Ji-Yu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China
| | - Tao Zhang
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China
| | - Xiao-Hong Kan
- Anhui Chest Hospital, 397 Jixi Road, Hefei 230022, China; Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei 230022, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China.
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Study on the Associations between Meteorological Factors and the Incidence of Pulmonary Tuberculosis in Xinjiang, China. ATMOSPHERE 2022. [DOI: 10.3390/atmos13040533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pulmonary tuberculosis (PTB) has been a major threat to global public health. The association between meteorological factors and the incidence of PTB has been widely investigated by the generalized additive model, auto-regressive integrated moving average model and the distributed lag model, etc. However, these models could not address a non-linear or lag correlation between them. In this paper, a penalized distributed lag non-linear model, as a generalized and improved one, was applied to explore the influence of meteorological factors (such as air temperature, relative humidity and wind speed) on the PTB incidence in Xinjiang from 2004 to 2019. Moreover, we firstly use a comprehensive index (apparent temperature, AT) to access the impact of multiple meteorological factors on the incidence of PTB. It was found that the relationships between air temperature, relative humidity, wind speed, AT and PTB incidence were nonlinear (showed “wave-type “, “invested U-type”, “U-type” and “wave-type”, respectively). When air temperature at the lowest value (−16.1 °C) could increase the risk of PTB incidence with the highest relative risk (RR = 1.63, 95% CI: 1.21–2.20). An assessment of relative humidity demonstrated an increased risk of PTB incidence between 44.5% and 71.8% with the largest relative risk (RR = 1.49, 95% CI: 1.32–1.67) occurring at 59.2%. Both high and low wind speeds increased the risk of PTB incidence, especially at the lowest wind speed 1.4 m/s (RR = 2.20, 95% CI: 1.95–2.51). In particular, the lag effects of low and high AT on PTB incidence were nonlinear. The lag effects of extreme cold AT (−18.5 °C, 1st percentile) on PTB incidence reached a relative risk peak (RR = 2.18, 95% CI: 2.06–2.31) at lag 1 month. Overall, it was indicated that the environment with low air temperature, suitable relative humidity and wind speed is more conducive to the transmission of PTB, and low AT is associated significantly with increased risk of PTB in Xinjiang.
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