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Wang F, Yuan Z, Qin S, Qin F, Zhang J, Mo C, Kang Y, Huang S, Qin F, Jiang J, Liu A, Liang H, Ye L. The effects of meteorological factors and air pollutants on the incidence of tuberculosis in people living with HIV/AIDS in subtropical Guangxi, China. BMC Public Health 2024; 24:1333. [PMID: 38760740 PMCID: PMC11100081 DOI: 10.1186/s12889-024-18475-0] [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: 12/03/2023] [Accepted: 03/28/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Previous studies have shown the association between tuberculosis (TB) and meteorological factors/air pollutants. However, little information is available for people living with HIV/AIDS (PLWHA), who are highly susceptible to TB. METHOD Data regarding TB cases in PLWHA from 2014 to2020 were collected from the HIV antiviral therapy cohort in Guangxi, China. Meteorological and air pollutants data for the same period were obtained from the China Meteorological Science Data Sharing Service Network and Department of Ecology and Environment of Guangxi. A distribution lag non-linear model (DLNM) was used to evaluate the effects of meteorological factors and air pollutant exposure on the risk of TB in PLWHA. RESULTS A total of 2087 new or re-active TB cases were collected, which had a significant seasonal and periodic distribution. Compared with the median values, the maximum cumulative relative risk (RR) for TB in PLWHA was 0.663 (95% confidence interval [CI]: 0.507-0.866, lag 4 weeks) for a 5-unit increase in temperature, and 1.478 (95% CI: 1.116-1.957, lag 4 weeks) for a 2-unit increase in precipitation. However, neither wind speed nor PM10 had a significant cumulative lag effect. Extreme analysis demonstrated that the hot effect (RR = 0.638, 95%CI: 0.425-0.958, lag 4 weeks), the rainy effect (RR = 0.285, 95%CI: 0.135-0.599, lag 4 weeks), and the rainless effect (RR = 0.552, 95%CI: 0.322-0.947, lag 4 weeks) reduced the risk of TB. Furthermore, in the CD4(+) T cells < 200 cells/µL subgroup, temperature, precipitation, and PM10 had a significant hysteretic effect on TB incidence, while temperature and precipitation had a significant cumulative lag effect. However, these effects were not observed in the CD4(+) T cells ≥ 200 cells/µL subgroup. CONCLUSION For PLWHA in subtropical Guangxi, temperature and precipitation had a significant cumulative effect on TB incidence among PLWHA, while air pollutants had little effect. Moreover, the influence of meteorological factors on the incidence of TB also depends on the immune status of PLWHA.
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Affiliation(s)
- Fengyi Wang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Zongxiang Yuan
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Shanfang Qin
- Chest Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Fengxiang Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Junhan Zhang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Chuye Mo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Yiwen Kang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Shihui Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Fang Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China.
| | - Aimei Liu
- Chest Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China.
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China.
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
- Joint Laboratory for Emerging Infectious Diseases in China (Guangxi)-ASEAN, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China.
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Song J, Nie Y, Wang B, Yang Y, Ma N, Tian J, Zhao Z, Zhang X, Cai J, Zhang X. A systematic review and meta-analysis of the association between air pollutants and the incidence of tuberculosis. Heliyon 2024; 10:e28801. [PMID: 38638993 PMCID: PMC11024561 DOI: 10.1016/j.heliyon.2024.e28801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024] Open
Abstract
Objective To investigate the association between air pollutants and the incidence of tuberculosis (TB) through a systematic review and meta-analysis, and to provide directions for future research and prevention of TB. Methods A search was conducted for all literature related to the incidence of TB and air pollution in the database. We screened the retrieved articles and proceeded statistical analyses using random effects models to investigate the relationships between five air pollutants (PM2.5, PM10, SO2, NO2 and O3) and the incidence of TB. Results The initial search identified 100 pieces of literature and 9 studies met the screening criteria after the screening. The single-day lagged risk ratio (RR) and 95% Confidence Intervals (CIs) for the combined effects estimates are as follows: PM2.5: 1.059 (0.966, 1.160); PM10: 1.000 (0.996, 1.004); SO2: 0.980 (0.954, 1.007); NO2: 1.011 (0.994, 1.027); O3: 0.994 (0.980,1.008). The cumulative lagged results for these five pollutants are listed like this: PM2.5: 1.095 (0.983, 1.219); PM10: 1.035 (1.006, 1.066); SO2: 0.964 (0.830, 1.121); NO2: 1.037 (1.010, 1.065); O3: 0.982 (0.954, 1.010). Conclusion The single-day lag effects of PM2.5, PM10, SO2, NO2, and O3 are not statistically significantly relevant for the occurrence of TB. However, the cumulative lag results show that both PM10 and NO2 contribute to the prevalence of TB, while the statistical relationship between the cumulative lag effects of PM2.5, SO2, and O3 and the onset of TB remains unknown.
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Affiliation(s)
- Jianshi Song
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Yaxiong Nie
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Binhao Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Yuechen Yang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Ning Ma
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Jiaming Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Zitong Zhao
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xinzhu Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Jianning Cai
- Department of Epidemic Control and Prevention, Center for Disease Prevention and Control of Shijiazhuang City, Shijiazhuang, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 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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Shrestha AB, Siam IS, Tasnim J, Dahal A, Roy P, Neupane S, Adhikari A, Khanal B, Ghimirie R, Shrestha D, Bhattarai S, Shrestha S, Mainali N, Sedai Y, Singh U. Prevalence of latent tuberculosis infection in Asian nations: A systematic review and meta-analysis. Immun Inflamm Dis 2024; 12:e1200. [PMID: 38411377 PMCID: PMC10898208 DOI: 10.1002/iid3.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 01/02/2024] [Accepted: 02/10/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) is a serious public health concern around the world including Asia. TB burden is high in Asian countries and significant population harbor latent tuberculosis infection(LTBI). AIM This systematic review and meta-analysis aims to evaluate the prevalence of LTBI in Asian countries. METHOD We performed a systematic literature search on PubMed, Embase, and ScienceDirect to identify relevant articles published between January 1, 2005, and January 1, 2023 investigating the overall prevalence of latent TB among people of Asia. Subgroup analysis was done for Asian subregions during the study period of 2011 to 2016 and 2017 to 2023, for tuberculin skin test (TST) and interferon gamma release assay (IGRA), respectively, as well as for QuantiFERON-TB (QFT) and TSPOT TB tests. Der Simonian and Laird's random-effects model was used to pool the prevalence of LTBI found using TST and IGRA. RESULT A total of 15 studies were included after a systematic search from standard electronic databases. The analysis showed that the prevalence of latent TB in Asia was 21% (95% confidence interval [CI]: 19%-23%) and 36% (95% CI: 12%-59%) according to IGRAs and TSTs (cut off 10 mm) results, respectively. Based on IGRA, the prevalence of latent TB was 20% (95% CI: 13%-25%) in 2011 to 2016 and 21% (95% CI: 18%-24%) in 2017 to 2023. Using QFT, the prevalence was 19% (95% CI: 17%-22%) and using TSPOT, the prevalence was 26% (95% CI: 21%-31%). According to the United Nations division of Asia, the prevalence was higher for the Southern region and least for the Western region using TST and higher in the South-Eastern region and least in the Western region using the IGRA test. CONCLUSION Almost a quarter of the Asian population has LTBI. Its diagnosis often poses a diagnostic challenge due to the unavailability of standard test in certain areas. Given this prevalence, a mass screening program is suggested with the available standard test and public awareness along with anti-TB regimen should be considered for individuals who test positive. However, for it to be implemented effectively, we need to take the affordability, availability, and cost-effectiveness of such interventions into account.
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Affiliation(s)
- Abhigan B. Shrestha
- Department of Internal MedicineM Abdur Rahim Medical CollegeDinajpurBangladesh
| | - Imran S. Siam
- Department of Internal MedicineChattagram Maa O Shishu Medical CollegeChattogramBangladesh
| | - Jarin Tasnim
- Department of Internal MedicineChattagram Maa O Shishu Medical CollegeChattogramBangladesh
| | - Abhinav Dahal
- Department of Internal MedicineNepalese Army Institute of Health SciencesKathmanduNepal
| | - Poulami Roy
- North Bengal Medical College and HospitalSiliguriWest BengalIndia
| | - Sushil Neupane
- Department of Internal MedicineManipal College of Medical SciencesPokharaNepal
| | - Ashok Adhikari
- Department of Internal MedicineUniversal College of Medical SciencesBhairawaNepal
| | - Barsha Khanal
- Department of Internal MedicineRangpur Medical CollegeRangpurBangladesh
| | - Rupesh Ghimirie
- Department of Internal MedicineKist Medical College and Teaching HospitalPatanNepal
| | - Dikshya Shrestha
- Department of Internal MedicineKist Medical College and Teaching HospitalPatanNepal
| | - Suju Bhattarai
- Department of Internal MedicineKathmandu Medical College and Teaching HospitalKathmanduNepal
| | - Sajina Shrestha
- Department of Internal MedicineKist Medical College and Teaching HospitalPatanNepal
| | - Nischal Mainali
- Kathmandu Medical College and Teaching HospitalKathmanduNepal
| | - Yubraj Sedai
- Division of Pulmonary Disease and Critical Care MedicineUniversity of Kentucky College of MedicineBowling GreenKentuckyUSA
| | - Uday Singh
- Department of Internal MedicineNobel Medical CollegeBiratnagarNepal
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Rodríguez-Fernández P, Romero-Andrada I, Molina-Moya B, Latorre I, Lacoma A, Prat-Aymerich C, Tabernero L, Domínguez J. Impact of diesel exhaust particles on infections with Mycobacterium bovis BCG in in vitro human macrophages and an in vivo Galleria mellonella model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 341:122597. [PMID: 37741543 PMCID: PMC10804993 DOI: 10.1016/j.envpol.2023.122597] [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: 06/10/2023] [Revised: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 09/25/2023]
Abstract
There are strong suggestions for a link between pulmonary tuberculosis (TB) and air quality. Diesel exhaust is one of the main contributors to pollution and it is reported to be able to modify susceptibility to lung infections. In this study we exposed THP-1 human macrophages and Mycobacterium bovis BCG to diesel exhaust particles (DEPs). High cytotoxicity and activation of apoptosis was found in THP-1 cells at 3 and 6 days, but no effect was found on the growth of M. bovis BCG. Infection of THP-1 cells exposed to a non-cytotoxic DEP concentration showed a limited capacity to engulf latex beads. However, M. bovis BCG infection of macrophages did not result in an increase in the bacterial burden, but it did result in an increase in the bacteria recovered from the extracellular media, suggesting a poor contention of M. bovis BCG. We also observed that DEP exposure limited the production of cytokines. Using the Galleria mellonella model of infection, we observed that larvae exposed to low levels of DEPs were less able to survive after infection with M. bovis BCG and had a higher internal bacterial load after 4 days of infection. Unraveling the links between air pollution and impairment of human antimycobacterial immunity is vital, because pollution is rapidly increasing in areas where TB incidence is extremely high.
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Affiliation(s)
- Pablo Rodríguez-Fernández
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain; Core Technology Facility, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK.
| | - Iris Romero-Andrada
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain
| | - Bárbara Molina-Moya
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain
| | - Irene Latorre
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain
| | - Alícia Lacoma
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain
| | - Cristina Prat-Aymerich
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain
| | - Lydia Tabernero
- Core Technology Facility, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK; Lydia Becker Institute for Immunology and Inflammation, University of Manchester, Manchester, UK
| | - José Domínguez
- Germans Trias i Pujol Research Institute (IGTP), CIBER Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Badalona, Spain.
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Ma Z, Fan H. Influential factors of tuberculosis in mainland China based on MGWR model. PLoS One 2023; 18:e0290978. [PMID: 37651412 PMCID: PMC10470953 DOI: 10.1371/journal.pone.0290978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023] Open
Abstract
Tuberculosis (TB), as a respiratory infectious disease, has damaged public health globally for decades, and mainland China has always been an area with high incidence of TB. Since the outbreak of COVID-19, it has seriously occupied medical resources and affected medical treatment of TB patients. Therefore, the authenticity and reliability of TB data during this period have also been questioned by many researchers. In response to this situation, this paper excludes the data from 2019 to the present, and collects the data of TB incidence in mainland China and the data of 11 influencing factors from 2014 to 2018. Using spatial autocorrelation methods and multiscale geographically weighted regression (MGWR) model to study the temporal and spatial distribution of TB incidence in mainland China and the influence of selected influencing factors on TB incidence. The experimental results show that the distribution of TB patients in mainland China shows spatial aggregation and spatial heterogeneity during this period. And the R2 and the adjusted R2 of MGWR model are 0.932 and 0.910, which are significantly better than OLS model (0.466, 0.429) and GWR model (0.836, 0.797). The fitting accuracy indicators MAE, MSE and MAPE of MGWR model reached 5.802075, 110.865107 and 0.088215 respectively, which also show that the overall fitting effect is significantly better than OLS model (19.987574, 869.181549, 0.314281) and GWR model (10.508819, 267.176741, 0.169292). Therefore, this model is based on real and reliable TB data, which provides decision-making references for the prevention and control of TB in mainland China and other countries.
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Affiliation(s)
- Zhipeng Ma
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
| | - Hong Fan
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, China
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Song X, Guo X, Hu X, Zhang Y, Wei D, Hu Y, Jiang L, Zhang Y. Human exposure risk assessment for infectious diseases due to temperature and air pollution: an overview of reviews. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:88272-88280. [PMID: 37440140 DOI: 10.1007/s11356-023-28453-5] [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: 02/28/2023] [Accepted: 06/22/2023] [Indexed: 07/14/2023]
Abstract
Air pollution and global temperature change are expected to affect infectious diseases. Air pollution usually causes inflammatory response and disrupts immune defense system, while temperature mainly exacerbates the effect of vectors on humans. Yet to date overview of systematic reviews assessing the exposure risk of air pollutants and temperature on infectious diseases is unavailable. This article aims to fill this research gap. PubMed, Embase, the Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature were searched. Systematic reviews and meta-analyses investigated the exposure risk of pollutants or temperature on infectious diseases were included. Two investigators screened literature, extracted data and performed the risk of bias assessments independently. A total of 23 articles met the inclusion criteria, which 3 (13%) were "low" quality and 20 (87%) were "critically low" quality. COVID-19 morbidity was associated with long-term exposure PM2.5 (RR = 1.056 per 1 [Formula: see text], 95% CI: 1.039-1.072) and NO2 (RR = 1.042 per 1 [Formula: see text], 95% CI: 1.017-1.068). In addition, for each 1 °C increase in temperature, the morbidity risk of dengue increased 13% (RR = 1.130 per 1 °C, 95% CI: 1.120-1.150), infectious diarrhea increased 8% (RR = 1.080 per 1 °C, 95% CI: 1.050-1.200), and hand, foot and mouth disease (HFMD) increased 5% (RR = 1.050 per 1 °C, 95% CI: 1.020-1.080). In conclusion, PM2.5 and NO2 increased the risk of COVID-19 and temperatures were associated with dengue, infectious diarrhoea and HFMD morbidity. Moreover, the exposure risk of temperature on COVID-19 was recommended to be further explored.
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Affiliation(s)
- Xuping Song
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
- McMaster Health Forum, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, L8S4L8, Canada
| | - Xinye Guo
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Xiaopeng Hu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yajie Zhang
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Dandan Wei
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | - Yue Hu
- School of Public Health, Lanzhou University, Lanzhou, 730000, China
| | | | - Yan Zhang
- Gansu Province Hospital Rehabilitation Center, Lanzhou, 730000, Gansu, China.
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Chen S, Wang X, Li D, Zhao J, Zhang J, Zhang Y, Zhang X, Kan X. Association Between Exposure to Ozone (O 3) and the Short-Term Effect on Tuberculosis Outpatient Visits: A Time-Series Study in 16 Cities of Anhui Province, China. J Multidiscip Healthc 2023; 16:2045-2055. [PMID: 37496636 PMCID: PMC10366443 DOI: 10.2147/jmdh.s412394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/19/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Evidence has shown that air pollutant exposure plays a vital role in the progression of tuberculosis (TB). The aim of this research was to assess the short-term effects of ozone (O3) exposure and TB outpatient visits in 16 prefecture-level cities of Anhui, China, 2015-2020. Methods Distributed lag nonlinear model (DLNM), Poisson generalized linear regression model and random effects model were applied in this study. The effects of different age and gender on TB were investigated by stratified analysis, and then we performed sensitivity analyses to verify the stability of the results. Results A total of 186,623 active TB cases were registered from January 1, 2015 to December 31,2020 in Anhui. The average concentration of ozone is 92.77 ± 42.95 μg/m3. The maximum lag-specific and cumulative relative risk (RR) of TB outpatient visits was 1.0240 (95% CI: 1.0170-1.0310, lag 28 days) for each 10 µg/m³ increase in O3 in the single-pollutant model. Estimation for 16 prefecture-level cities indicated that the strong association between O3 and the risk of TB outpatient visits was in tongling (RR = 1.0555, 95% CI: 1.0089-1.1042), Suzhou (RR = 1.0475, 95% CI: 1.0268-1.0687), wuhu (RR = 1.0358, 95% CI: 1.0023-1.0704). Stratified analysis showed that the health effects of ozone exposure remained significant in male and older adults, and there was no significant association between exposure to ozone in children and adolescents and the risk of tuberculosis. Discussion We found that ozone exposure increases the risk of TB infection in outpatient patients, with males and the elderly being more susceptible, and it is necessary for government departments to develop targeted publicity and prevention measures in response to the local air quality conditions.
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Affiliation(s)
- Shuangshuang Chen
- Department of Tuberculosis Prevent and Control, Center for Disease Control and Prevention of Hefei, Hefei, Anhui, 230051, People’s Republic of China
- Department of Scientific Research and Education, Anhui Chest Hospital, Hefei, Anhui, 230022, People’s Republic of China
- Department of Scientific Research and Education, Anhui Provincial Tuberculosis Institute, Hefei, Anhui, 230022, People’s Republic of China
| | - Xinqiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Danhui Li
- Department of Hospital Infection and Management, Anhui Chest Hospital, Hefei, Anhui, 230022, People’s Republic of China
| | - Jiawen Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Jingjing Zhang
- Department of Scientific Research and Education, Anhui Provincial Tuberculosis Institute, Hefei, Anhui, 230022, People’s Republic of China
| | - Yongzhong Zhang
- Department of Tuberculosis Prevent and Control, Anhui Provincial Tuberculosis Institute, Hefei, Anhui, 230022, People’s Republic of China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Xiaohong Kan
- Department of Scientific Research and Education, Anhui Chest Hospital, Hefei, Anhui, 230022, People’s Republic of China
- Department of Scientific Research and Education, Anhui Provincial Tuberculosis Institute, Hefei, Anhui, 230022, People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of 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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10
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Lu JW, Mao JJ, Zhang RR, Li CH, Sun Y, Xu WQ, Zhuang X, Zhang B, Qin G. Association between long-term exposure to ambient air pollutants and the risk of tuberculosis: A time-series study in Nantong, China. Heliyon 2023; 9:e17347. [PMID: 37441410 PMCID: PMC10333459 DOI: 10.1016/j.heliyon.2023.e17347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Background Increasing evidence has shown that the risk of tuberculosis (TB) might be related to the exposure to air pollutants; however, the findings are inconsistent and studies on long-term air pollutant exposure and TB risk are scarce. This study aime to assess the relationship between monthly exposure to air pollution and TB risk in Nantong, China. Methods We collected the time series data on the number of TB cases, as well as environmental and socioeconomic covariates from January 2005 to December 2020. The impact of air pollutant exposure on TB risk was evaluated using the distributed lag nonlinear model (DLNM). Stratified analyses were conducted to examine the effect modifications of sex and age on the association between air pollutants and TB risk. Sensitivity analyses were applied to test the stability of the model. Results There were a total of 54,096 cases of TB in Nantong during the study period. In the single-pollutant model, for each 10 μg/m3 increase in concentration, the pooled relative risks (RRs) of TB reached the maximum to 1.10 (95% confidence interval (CI): 1.04-1.16, lag 10 months) for particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5), 1.05 (95% CI: 1.01-1.10, lag 9 months) for particulate matter with aerodynamic diameter less than 10 μm (PM10), and 1.11 (95%CI: 1.04-1.19, lag 10 months) for nitrogen dioxide (NO2). Ozone (O3) did not show significant effect on TB risk. Effect modifications of sex and age on the association between air pollutants and TB risk were not observed. The multi-pollutant model results showed no significant variation compared with the single-pollutant model. Conclusions Our study suggests that air pollutants pose a substantial threat to the TB risk. Reducing air pollution might be crucial for TB prevention and control.
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Affiliation(s)
- Jia-Wang Lu
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong University Medical School, Nantong, China
| | - Jun-Jie Mao
- Department of Epidemiology and Biostatistics, Nantong University School of Public Health, Nantong, China
| | - Rong-Rong Zhang
- Nantong Centre for Disease Control and Prevention, Nantong, China
| | - Chun-Hu Li
- Department of Epidemiology and Biostatistics, Nantong University School of Public Health, Nantong, China
| | - Yu Sun
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong University Medical School, Nantong, China
| | - Wan-Qing Xu
- Department of Internal Medicine, Nantong University Medical School, Nantong, China
| | - Xun Zhuang
- Department of Epidemiology and Biostatistics, Nantong University School of Public Health, Nantong, China
| | - Bin Zhang
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong University Medical School, Nantong, China
| | - Gang Qin
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, Nantong University Medical School, Nantong, China
- National Key Clinical Construction Specialty - Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Nantong University, Nantong, China
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11
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Monoson A, Schott E, Ard K, Kilburg-Basnyat B, Tighe RM, Pannu S, Gowdy KM. Air pollution and respiratory infections: the past, present, and future. Toxicol Sci 2023; 192:3-14. [PMID: 36622042 PMCID: PMC10025881 DOI: 10.1093/toxsci/kfad003] [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: 01/10/2023] Open
Abstract
Air pollution levels across the globe continue to rise despite government regulations. The increase in global air pollution levels drives detrimental human health effects, including 7 million premature deaths every year. Many of these deaths are attributable to increased incidence of respiratory infections. Considering the COVID-19 pandemic, an unprecedented public health crisis that has claimed the lives of over 6.5 million people globally, respiratory infections as a driver of human mortality is a pressing concern. Therefore, it is more important than ever to understand the relationship between air pollution and respiratory infections so that public health measures can be implemented to ameliorate further morbidity and mortality. This article aims to review the current epidemiologic and basic science research on interactions between air pollution exposure and respiratory infections. The first section will present epidemiologic studies organized by pathogen, followed by a review of basic science research investigating the mechanisms of infection, and then conclude with a discussion of areas that require future investigation.
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Affiliation(s)
- Alexys Monoson
- Department of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Evangeline Schott
- Department of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Kerry Ard
- School of Environment and Natural Resources, The Ohio State University, Columbus, Ohio 43210, USA
| | - Brita Kilburg-Basnyat
- Department of Pharmacology and Toxicology, East Carolina University, Greenville, North Carolina 27834, USA
| | - Robert M Tighe
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA
| | - Sonal Pannu
- Department of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Kymberly M Gowdy
- Department of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
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12
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Popovic I, Soares Magalhães RJ, Yang Y, Yang S, Yang B, Dong G, Wei X, Fox GJ, Hammer MS, Martin RV, van Donkelaar A, Ge E, Marks GB, Knibbs LD. Effects of long-term ambient air pollution exposure on township-level pulmonary tuberculosis notification rates during 2005-2017 in Ningxia, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 317:120718. [PMID: 36435281 DOI: 10.1016/j.envpol.2022.120718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/17/2022] [Accepted: 11/20/2022] [Indexed: 06/16/2023]
Abstract
Studies examining long-term effects of ambient air pollution exposure, measured as annual averages, on pulmonary tuberculosis (TB) incidence are scarce, particularly in endemic, rural settings. We performed a small-area study in Ningxia Hui Autonomous Region (NHAR), a high TB-burden area in rural China, using township-level (n = 358 non-overlapping townships) annual TB notification data (2005-2017). We aimed to determine if annual average concentrations of ambient air pollution (particulate matter <2·5 μm [PM2·5], nitrogen dioxide [NO2] ozone [O3]) were associated with TB notification rates (as a proxy for incidence). Air pollution effects on TB notification rates at township-level were estimated as incidence rate ratios (IRR), fitted using a generalised estimating equation (GEE) adjusted for covariates (age, sex, occupation, education, ethnicity, remoteness [urban or rural], household crowding and solid fuel use). A total of 38,942 TB notifications were reported in NHAR between 2005 and 2017. The mean annual TB notification rate was 67 (standard deviation [SD]; 7) per 100,000 people. Median concentrations of PM2·5, NO2, and O3 were 42 μg/m3 (interquartile range [IQR]; 38-48 μg/m3), 15 ppb (IQR; 12-16 ppb), and 56 ppb (IQR; 56-57 ppb), respectively. In single pollutant models, adjusted for covariates, an interquartile range (IQR) increase (10 μg/m3) in PM2·5 was significantly associated with higher TB notification rates (IRR: 1∙35; 95% CI: 1·25-1·48). Comparable effects on notifications of TB were observed for increases in NO2 exposure (IRR: 1·20 per IQR (4 ppb) increase; 95% CI: 1·08-1·31). Ground-level ozone was not associated with TB notification rate in any models. The observed effects were consistent over time, in multi-pollutant models, and appeared robust to additional adjustment for indicators of household crowding, solid fuel use and remoteness. More rigorous study designs are needed to understand if improving air quality has population-level benefits on TB disease incidence in endemic settings.
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Affiliation(s)
- Igor Popovic
- Faculty of Medicine, School of Public Health, University of Queensland, Herston, 4006, Australia; UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, 4343, Australia.
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, 4343, Australia; Children's Health and Environment Program, UQ Children's Health Research Center, The University of Queensland, South Brisbane, 4101, Australia
| | - Yurong Yang
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan, 750004, China
| | - Shukun Yang
- Department of Radiology, The Second Affiliated Hospital of Ningxia Medical University, The First People's Hospital in Yinchuan, Yinchuan, 750004, China
| | - Boyi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510085, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510085, China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Greg J Fox
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, NSW, 2006, Australia
| | - Melanie S Hammer
- Department of Energy, Environmental, and Chemical Engineering, Washington University, St Louis, 63130, United States
| | - Randall V Martin
- Department of Energy, Environmental, and Chemical Engineering, Washington University, St Louis, 63130, United States; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, B3H 3J5, Canada
| | - Aaron van Donkelaar
- Department of Energy, Environmental, and Chemical Engineering, Washington University, St Louis, 63130, United States; Department of Physics and Atmospheric Science, Dalhousie University, Halifax, B3H 3J5, Canada
| | - Erjia Ge
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Liverpool, 2170, Australia; Woolcock Institute of Medical Research, Glebe, 2037, Australia
| | - Luke D Knibbs
- Public Health Unit, Sydney Local Health District, Camperdown, 2050, Australia; Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, 2006, Australia
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13
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Sun S, Chang Q, He J, Wei X, Sun H, Xu Y, Soares Magalhaes RJ, Guo Y, Cui Z, Zhang W. The association between air pollutants, meteorological factors and tuberculosis cases in Beijing, China: A seven-year time series study. ENVIRONMENTAL RESEARCH 2023; 216:114581. [PMID: 36244443 DOI: 10.1016/j.envres.2022.114581] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/22/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Tuberculosis (TB) is a severe public health problem globally. Previous studies have revealed insufficient and inconsistent associations between air pollutants, meteorological factors and TB cases. Yet few studies have examined the associations between air pollutants, meteorological factors and TB cases in Beijing. OBJECTIVE The purpose of this study was to explore the impact of air pollutants and meteorological factors on TB in Beijing, and to provide novel insights into public health managers to formulate control strategies of TB. METHODS Data on the daily case of TB in Beijing during 2014-2020 were obtained from Chinese tuberculosis information management system. Concurrent data on the daily PM10, PM2.5, SO2, NO2, CO and O3, were obtained from the online publication platform of the Chinese National Environmental Monitoring Center. Daily average temperature, average wind speed, relative humidity, sunshine duration and total precipitation were collected from the China Meteorological Science Data Sharing Service System. A distributed lag non-linear model was fitted to identify the non-linear exposure-response relationship and the lag effects between air pollutions, meteorological factors and TB cases in Beijing. RESULTS In the single-factor model, the excess risk (ER) of TB was significantly positively associated with every 10 μg/m3 increase in NO2 in lag 1 week (ER: 1.3%; 95% confidence interval [CI]: 0.4%, 2.3%) and every 0.1 m/s increase in average wind speed in lag 5 weeks (ER: 0.3%; 95% CI: 0.1%, 0.5%), and was negatively associated with every 10 μg/m3 increase in O3 in lag 1 week (ER: -1.2%; 95% CI: -1.8%, -0.5%), every 5 °C increase in average temperature (ER: -1.7%; 95% CI: -2.9%, -0.4%) and every 10% increase in average relative humidity (ER: -0.4%; 95% CI: -0.8%, -0.1%) in lag 10 weeks, respectively. In the multi-factor model, the lag effects between TB cases and air pollutants, meteorological factors were similar. The subgroup analysis suggests that the effects of NO2, O3, average wind speed and relative humidity on TB were greater in male or labor age subgroup, while the effect of CO was greater in the elderly. In addition, no significant associations were found between PM2.5, SO2, sunshine duration and TB cases. CONCLUSION Our findings provide a better understanding of air pollutants and meteorological factors driving tuberculosis occurrence in Beijing, which enhances the capacity of public health manager to target early warning and disease control policy-making.
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Affiliation(s)
- Shanhua Sun
- Beijing Institute of Tuberculosis Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Qinxue Chang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Junyu He
- Ocean College, Zhejiang University, Zhoushan, China; Ocean Academy, Zhejiang University, Zhoushan, China
| | - Xianyu Wei
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hailong Sun
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yuanyong Xu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Ricardo J Soares Magalhaes
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Brisbane, Australia; Child Health Research Center, The University of Queensland, Brisbane, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China.
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14
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Min KD, Kim SY, Cho SI. Ambient PM 2.5 exposures could increase risk of tuberculosis recurrence. Environ Health Prev Med 2023; 28:48. [PMID: 37648454 PMCID: PMC10480611 DOI: 10.1265/ehpm.23-00131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The effect of ambient PM2.5 on the incidence of tuberculosis (TB) has been investigated in epidemiological studies. However, they did not separately study new and relapsed TB infection and focused on relatively short-term effects of PM2.5. In this regard, we examined the associations of long-term PM2.5 exposures with both new and relapsed TB incidences in South Korea, where the disease burden of TB is greatest among high-income countries. METHODS An area-level ecological study of 250 districts was conducted from 2015 to 2019. Age- and sex-standardized TB incidence ratios for each district and year were used as outcome variables, and their associations with PM2.5 concentrations for one to five-year average were examined. Negative binomial regression models incorporating spatiotemporal autocorrelation were employed using integrated nested Laplace approximations. Stratified analyses were conducted by type of TB (total, new, and relapsed cases). RESULTS Districts with higher PM2.5 concentrations tended to have significantly higher TB recurrence rate. The relative risks per 10 µg/m3 PM2.5 increase were 1.218 (95% credible interval 1.051-1.411), 1.260 (1.039-1.527) and 1.473 (1.015-2.137) using the two, three and five-year average PM2.5 exposures, respectively. CONCLUSIONS The results imply that interventions for reducing air pollution might help prevent TB recurrence.
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Affiliation(s)
- Kyung-Duk Min
- College of Veterinary Medicine, Chungbuk National University
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center
| | - Sung-il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University
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15
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Wu DW, Cheng YC, Wang CW, Hung CH, Chen PS, Chu-Sung Hu S, Richard Lin CH, Chen SC, Kuo CH. Impact of the synergistic effect of pneumonia and air pollutants on newly diagnosed pulmonary tuberculosis in southern Taiwan. ENVIRONMENTAL RESEARCH 2022; 212:113215. [PMID: 35367429 DOI: 10.1016/j.envres.2022.113215] [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: 09/26/2021] [Revised: 03/10/2022] [Accepted: 03/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND An increased incidence of pulmonary tuberculosis (PTB) among patients with pulmonary diseases exposed to air pollution has been reported. OBJECTIVE To comprehensively investigate the association between pneumonia (PN) and air pollution with PTB through a large-scale follow-up study. METHODS We conducted a retrospective study using data from the Kaohsiung Medical University Hospital Research Database and the Taiwan Air Quality Monitoring Database. We included adult patients with PN, PTB and other comorbidities according to ICD-9 codes. Control subjects without PN were matched by age, sex and ten comorbidities to each PN patient at a ratio of 4:1. RESULTS A total of 82,590 subjects were included. The PTB incidence rate was significantly higher in the PN group (2,391/100,000) than in the control group (1,388/100,000). The crude hazard ratio (HR) of PN-associated PTB incidence decreased with time, and the overall 7 years the HR (95% confidence interval; CI) was 1.74 (1.55-1.96). The overall adjusted HR and 95% CI of PN-related PTB in the multivariate Cox regression analysis was 3.38 (2.98-3.84). In addition, there was a cumulative lag effect of all air pollutants within 30 days of exposure. The peak adjusted HRs for PTB were noted on the 3rd, 8th, 12th and 12th days of PM2.5, O3, SO2 and NO exposure, respectively. The overall peak HRs (95% CI) of PM2.5, O3, SO2 and NO were 1.145 (1.139-1.152), 1.153 (1.145-1.161), 1.909 (1.839-1.982) and 1.312 (1.259-1.367), respectively, and there was a synergistic effect with pneumonia on the risk of PTB. CONCLUSIONS A strong association was found between past episodes of PN and the future risk of PTB. In addition, air pollutants including PM2.5, SO2, O3 and NO, together with previous episodes of PN, had both long-term and short-term impact on the incidence of PTB.
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Affiliation(s)
- Da-Wei Wu
- Doctoral Degree Program, Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Yu-Cheng Cheng
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, 80424, Taiwan
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Chih-Hsing Hung
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Pei-Shih Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung, 804, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Stephen Chu-Sung Hu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan; Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Department of Dermatology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, 807, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, 80424, Taiwan.
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan; Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
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Chong KC, Yeoh EK, Leung CC, Lau SYF, Lam HCY, Goggins WB, Zhao S, Ran J, Mohammad KN, Chan RWY, Lai CKC, Chan PKS, Leung CSY, Chen VXY, Wang Y, Wei Y. Independent effect of weather, air pollutants, and seasonal influenza on risk of tuberculosis hospitalization: An analysis of 22-year hospital admission data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 837:155711. [PMID: 35523336 DOI: 10.1016/j.scitotenv.2022.155711] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/19/2022] [Accepted: 05/01/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND While influenza infections and environmental factors have been documented as potential drivers of tuberculosis, no investigations have simultaneously examined their impact on tuberculosis at a population level. This study thereby made use of Hong Kong's surveillance data over 22 years to elucidate the temporal association between environmental influences, influenza infections, and tuberculosis activity. METHODS Weekly total numbers of hospital admissions due to tuberculosis, meteorological data, and outdoor air pollutant concentrations in Hong Kong during 1998-2019 were obtained. All-type influenza-like illness positive (ILI+) rate and type-specific ILI+ rates were used as proxies for influenza activity. Quasi-Poisson generalized additive models together with distributed lag non-linear models were used to assess the association of interest. RESULTS A total of 164,116 hospital admissions due to tuberculosis were notified in public settings over a period of 22 years. The cumulative adjusted relative risk (ARR) of hospital admission due to tuberculosis was 1.07 (95% CI, 1.00-1.14) when the mean ambient temperature increased from 15.1 °C (the 5th percentile) to 24.5 °C (median). Short-term exposure to air pollutants was not found to be statistically significantly related to tuberculosis hospitalization. Accounting for the environmental covariates in the analysis, the cumulative ARR of tuberculosis admission was elevated to 1.05 (95% CI, 1.01-1.08) when the rate of ILI+ total increased from zero to 19.9 per 1000 consultations, the 95th percentile. CONCLUSION Our findings demonstrated that increased influenza activity and higher temperature were related to a higher risk of tuberculosis admissions. Stepping up the promotion of influenza vaccination, especially before the summer season, may lower the risk of tuberculosis infection/reactivation for vulnerable groups (e.g. elderly born before the launch of Bacillus Calmette-Guérin vaccination programme).
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Affiliation(s)
- Ka Chun Chong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Chiu Leung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Steven Yuk Fai Lau
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly Ching Yu Lam
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shi Zhao
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kirran N Mohammad
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Renee Wan Yi Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Christopher Koon Chi Lai
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Paul Kay Sheung Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Cecilia Shih Ya Leung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Victor Xin Yuan Chen
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yawen Wang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuchen Wei
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong, China.
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17
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Dimala CA, Kadia BM. A systematic review and meta-analysis on the association between ambient air pollution and pulmonary tuberculosis. Sci Rep 2022; 12:11282. [PMID: 35788679 PMCID: PMC9253106 DOI: 10.1038/s41598-022-15443-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/23/2022] [Indexed: 11/25/2022] Open
Abstract
There is inconclusive evidence on the association between ambient air pollution and pulmonary tuberculosis (PTB) incidence, tuberculosis-related hospital admission and mortality. This review aimed to assess the extent to which selected air pollutants are associated to PTB incidence, hospital admissions and mortality. This was a systematic review of studies published in English from January 1st, 1946, through May 31st, 2022, that quantitatively assessed the association between PM2.5, PM10, NO2, SO2, CO, O3 and the incidence of, hospital admission or death from PTB. Medline, Embase, Scopus and The Cochrane Library were searched. Extracted data from eligible studies were analysed using STATA software. Random-effect meta-analysis was used to derive pooled adjusted risk and odds ratios. A total of 24 studies (10 time-series, 5 ecologic, 5 cohort, 2 case–control, 1 case cross-over, 1 cross-sectional) mainly from Asian countries were eligible and involved a total of 437,255 tuberculosis cases. For every 10 μg/m3 increment in air pollutant concentration, there was a significant association between exposure to PM2.5 (pooled aRR = 1.12, 95% CI: 1.06–1.19, p < 0.001, N = 6); PM10 (pooled aRR = 1.06, 95% CI: 1.01–1.12, p = 0.022, N = 8); SO2 (pooled aRR = 1.08, 95% CI: 1.04–1.12, p < 0.001, N = 9); and the incidence of PTB. There was no association between exposure to CO (pooled aRR = 1.04, 95% CI: 0.98–1.11, p = 0.211, N = 4); NO2 (pooled aRR = 1.08, 95% CI: 0.99–1.17, p = 0.057, N = 7); O3 (pooled aRR = 1.00, 95% CI: 0.99–1.02, p = 0.910, N = 6) and the incidence of PTB. There was no association between the investigated air pollutants and mortality or hospital admissions due to PTB. Overall quality of evidence was graded as low (GRADE approach). Exposure to PM2.5, PM10 and SO2 air pollutants was found to be associated with an increased incidence of PTB, while exposure to CO, NO2 and O3 was not. There was no observed association between exposure to these air pollutants and hospital admission or mortality due to PTB. The quality of the evidence generated, however, remains low. Addressing the tuberculosis epidemic by 2030 as per the 4th Sustainable Development Goal may require a more rigorous exploration of this association.
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Affiliation(s)
- Christian Akem Dimala
- Health and Human Development (2HD) Research Network, Douala, Cameroon.,Department of Medicine, Reading Hospital, Tower Health System, West Reading, PA, USA
| | - Benjamin Momo Kadia
- Health Education and Research Organisation (HERO) Cameroon, Buea, Cameroon. .,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
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18
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Association of Daily Exposure to Air Pollutants with the Risk of Tuberculosis in Xuhui District of Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106085. [PMID: 35627622 PMCID: PMC9141396 DOI: 10.3390/ijerph19106085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 12/17/2022]
Abstract
Previous studies have suggested that air pollutant exposure is related to tuberculosis (TB) risk, but results have not been consistent. This study evaluated the relation between daily air pollutant exposure and TB incidence in Shanghai from 2014 to 2019. Overall, there were four pollutants that were positively related to the risk of new TB cases. After a 5 μg/m3 increase, the maximum lag-specific and cumulative relative risk (RR) of SO2 were 1.081, (95% CI: 1.035–1.129, lag: 3 days) and 1.616 (95% CI: 1.119–2.333, lag: 0–13 days), while for NO2, they were 1.061 (95% CI: 1.015–1.11, lag: 4 days) and 1.8 (95% CI: 1.113–2.91, lag: 0–15 days). As for PM2.5, with a 50 μg/m3 increase, the lag-specific and cumulative RR were 1.064 (95% CI: 1–1.132, lag: 6 days) and 3.101 (95% CI: 1.096–8.777, lag: 0–21 days), while for CO, the lag-specific RR was 1.03 (95% CI: 1.005–1.057, lag: 8 days) and the cumulative RR was 1.436 (95% CI: 1.004–2.053, lag: 0–16 days) with a 100 μg/m3 increase. The associations tended to be stronger in male and elderly patients and differed with seasons. Air pollutant exposure may be a risk factor for TB incidence.
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19
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Feng Y, Wei J, Hu M, Xu C, Li T, Wang J, Chen W. Lagged Effects of Exposure to Air Pollutants on the Risk of Pulmonary Tuberculosis in a Highly Polluted Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5752. [PMID: 35565147 PMCID: PMC9106023 DOI: 10.3390/ijerph19095752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/24/2022] [Accepted: 05/07/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Although significant correlations have been observed between air pollutants and the development of pulmonary tuberculosis (PTB) in many developed countries, data are scarce for developing and highly polluted regions. METHOD A combined Poisson generalized linear regression-distributed lag nonlinear model was used to determine the associations between long-term exposure (2005-2017) to air pollutants and the risk of PTB in the Beijing-Tianjin-Hebei region. RESULTS The monthly PTB cases exhibited a fluctuating downward trend. For each 10 μg/m3 increase in concentration, the maximum lag-specific risk and cumulative relative risk (RR) were 1.011 (95% confidence interval (CI): 1.0091.012, lag: 3 months) and 1.042 (1.036-1.048, 5 months) for PM2.5, and 1.023 (1.015-1.031, 0 months) and 1.041 (1.026-1.055, 2 months) for NO2. The risk of PTB was negatively correlated with O3 exposure, and the minimum lag-specific risk and cumulative RR were 0.991 (95% CI: 0.987-0.994, lag: 0 months) and 0.974 (0.968-0.981, 4 months), respectively. No age-dependent effects were observed. CONCLUSIONS Our results revealed potential associations between outdoor exposure to PM2.5, NO2, and O3 and the risk of PTB. Further research should explore the corresponding interactions and potential mechanisms.
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Affiliation(s)
- Yuqing Feng
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA;
| | - Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing 210023, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
| | - Tao Li
- Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China; (Y.F.); (C.X.); (J.W.)
| | - Wei Chen
- Chinese Center for Disease Control and Prevention, Beijing 102206, China;
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20
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Wang XQ, Li YQ, Hu CY, Huang K, Ding K, Yang XJ, Cheng X, Zhang KD, Yu WJ, Wang J, Zhang YZ, Ding ZT, Zhang XJ, Kan XH. Short-term effect of ambient air pollutant change on the risk of tuberculosis outpatient visits: a time-series study in Fuyang, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:30656-30672. [PMID: 34993790 DOI: 10.1007/s11356-021-17323-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/29/2021] [Indexed: 06/14/2023]
Abstract
There is growing evidence that air pollution plays a role in TB, and most studies have been conducted in the core countries with inconsistent results. Few studies have comprehensively included the six common air pollutants, so they cannot consider whether various pollutants interact with each other. Our objectives were to investigate the association between short-term exposure to six common air pollutants and the risk of tuberculosis outpatient visits in Fuyang, China, 2015-2020. We combined the two models to explore the effects of exposure to six air pollutants on the risk of tuberculosis outpatient visits, including the Poisson generalized linear regression model and distributed lag non-linear model (DLNM). We performed stratified analyses for the season, type of cases, gender, and age. We used the lag-specific relative risks and cumulative relative risk obtained by increasing pollutant concentration by per 10 units to evaluate the connection between six air pollutants and TB; PM2.5 (RR = 1.0018, 95% CI: 1.0004-1.0032, delay of 12 days) and SO2 (RR = 1.0169, 95% CI: 1.0007-1.0333, lag 0-16 days) were 0.9549 (95% CI: 0.9389-0.9712, lag 0 day) and 0.8212 (95% CI: 0.7351-0.9173, 0-20-day lag). Stratified analyses showed that seasonal differences had a greater impact on TB, males were more likely to develop TB than females, older people were more likely to develop TB than younger people, and air pollution had a great impact on new cases. Exposure to O3, CO, PM10, PM2.5, and NO2 increases the risk of TB outpatient visits, except SO2 which reduces the risk. The incidence of TB has seasonal fluctuations. It is necessary for the government to establish a sound environmental monitoring and early warning system to strengthen the monitoring and emission management of pollutants in the atmosphere. Management, prevention, and treatment measures should be developed for high-risk groups (males and older people), reducing the risk of TB by reducing their specific behaviors and changing their lifestyle. We need to pay more attention to the impact of seasonal effects on TB to protect TB patients and avoid a shortage of medical resources, and it is necessary for the government to develop some seasonal preventive measures in the future.
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Affiliation(s)
- Xin-Qiang Wang
- 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
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- 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
| | - Kang-Di Zhang
- 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
| | - Jie Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yong-Zhong Zhang
- Anhui Institute of Tuberculosis Prevention and Control, 397 Jixi Road, Hefei, 230022, China
| | - Zhen-Tao Ding
- Fuyang Provincial Center for Disease Control and Prevention, 19 Zhongnan Avenue, Fuyang, 236030, China
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Xiao-Hong Kan
- Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei, 230022, China.
- Anhui Chest Hospital, 397 Jixi Road, Hefei, 230022, China.
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21
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Bai KJ, Tung NT, Hsiao TC, Chen TL, Chung KF, Ho SC, Tsai CY, Chen JK, Lee CN, Lee KY, Chang CC, Chen TT, Feng PH, Chen KY, Su CL, Thao HNX, Dung HB, Thuy TPC, Lee YL, Chuang HC. Associations between lung-deposited dose of particulate matter and culture-positive pulmonary tuberculosis pleurisy. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:6140-6150. [PMID: 34448140 DOI: 10.1007/s11356-021-16008-5] [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: 05/11/2021] [Accepted: 08/13/2021] [Indexed: 06/13/2023]
Abstract
Epidemiological studies identified the relationship between air pollution and pulmonary tuberculosis. Effects of lung-deposited dose of particulate matter (PM) on culture-positive pulmonary tuberculosis remain unclear. This study investigates the association between lung-deposited dose of PM and pulmonary tuberculosis pleurisy. A case-control study of subjects undergoing pleural effusion drainage of pulmonary tuberculosis (case) and chronic heart failure (control) was conducted. Metals and biomarkers were quantified in the pleural effusion. The air pollution exposure was measured and PM deposition in the head, tracheobronchial, alveolar region, and total lung region was estimated by Multiple-path Particle Dosimetry (MPPD) Model. We performed multiple logistic regression to examine the associations of these factors with the risk of tuberculosis. We observed that 1-μg/m3 increase in PM10 was associated with 1.226-fold increased crude odds ratio (OR) of tuberculosis (95% confidence interval (CI): 1.023-1.469, p<0.05), 1-μg/m3 increase in PM2.5-10 was associated with 1.482-fold increased crude OR of tuberculosis (95% CI: 1.048-2.097, p < 0.05), 1-ppb increase in NO2 was associated with 1.218-fold increased crude OR of tuberculosis (95% CI: 1.025-1.447, p < 0.05), and 1-ppb increase in O3 was associated with 0.735-fold decreased crude OR of tuberculosis (95% CI: 0.542 0.995). We observed 1-μg/m3 increase in PM deposition in head and nasal region was associated with 1.699-fold increased crude OR of tuberculosis (95% CI: 1.065-2.711, p < 0.05), 1-μg/m3 increase in PM deposition in tracheobronchial region was associated with 1.592-fold increased crude OR of tuberculosis (95% CI: 1.095-2.313, p < 0.05), 1-μg/m3 increase in PM deposition in alveolar region was associated with 3.981-fold increased crude OR of tuberculosis (95% CI: 1.280-12.386, p < 0.05), and 1-μg/m3 increase in PM deposition in total lung was associated with 1.511-fold increased crude OR of tuberculosis (95% CI: 1.050-2.173, p < 0.05). The results indicate that particle deposition in alveolar region could cause higher risk of pulmonary tuberculosis pleurisy than deposition in other lung regions.
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Affiliation(s)
- Kuan-Jen Bai
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Nguyen Thanh Tung
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Ta-Chih Hsiao
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Tsai-Ling Chen
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Kian Fan Chung
- Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Jen-Kun Chen
- Institute of Biomedical Engineering & Nanomedicine, National Health Research Institutes, Miaoli, Taiwan
- Graduate Institute of Life Sciences and School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Nin Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Cheng Chang
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Yuan Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chien-Ling Su
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | | | - Hoang Ba Dung
- Otorhinolaryngology Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Tran Phan Chung Thuy
- Otorhinolaryngology Department, Faculty of Medicine, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan.
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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22
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Ge E, Gao J, Wei X, Ren Z, Wei J, Liu X, Wang X, Zhong J, Lu J, Tian X, Fei F, Chen B, Wang X, Peng Y, Luo M, Lei J. Effect modification of greenness on PM 2.5 associated all-cause mortality in a multidrug-resistant tuberculosis cohort. Thorax 2021; 77:1202-1209. [PMID: 34876501 DOI: 10.1136/thoraxjnl-2020-216819] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 11/06/2021] [Indexed: 11/04/2022]
Abstract
RATIONALE Evidence for the association between fine particulate matter (PM2.5) and mortality among patients with tuberculosis (TB) is limited. Whether greenness protects air pollution-related mortality among patients with multidrug-resistant tuberculosis (MDR-TB) is completely unknown. METHODS 2305 patients reported in Zhejiang and Ningxia were followed up from MDR-TB diagnosis until death, loss to follow-up or end of the study (31 December 2019), with an average follow-up of 1724 days per patient. 16-day averages of contemporaneous Normalised Difference Vegetation Index (NDVI) in the 500 m buffer of patient's residence, annual average PM2.5 and estimated oxidant capacity Ox were assigned to patients regarding their geocoded home addresses. Cox proportional hazards regression models were used to estimate HRs per 10 μg/m3 exposure to PM2.5 and all-cause mortality among the cohort and individuals across the three tertiles, adjusting for potential covariates. RESULTS HRs of 1.702 (95% CI 1.680 to 1.725) and 1.169 (1.162 to 1.175) were observed for PM2.5 associated with mortality for the full cohort and individuals with the greatest tertile of NDVI. Exposures to PM2.5 were stronger in association with mortality for younger patients (HR 2.434 (2.432 to 2.435)), female (2.209 (1.874 to 2.845)), patients in rural (1.780 (1.731 to 1.829)) and from Ningxia (1.221 (1.078 to 1.385)). Cumulative exposures increased the HRs of PM2.5-related mortality, while greater greenness flattened the risk with HRs reduced in 0.188-0.194 on average. CONCLUSIONS Individuals with MDR-TB could benefit from greenness by having attenuated associations between PM2.5 and mortality. Improving greener space and air quality may contribute to lower the risk of mortality from TB/MDR-TB and other diseases.
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Affiliation(s)
- Erjia Ge
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jianhui Gao
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Jing Wei
- Iowa Technology Institute, Department of Chemical and Biochemical Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Xin Liu
- School of Geoscience and Technology, Southwest Petroleum University, Chengdu, Sichuan, China
| | - Xiaomeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Jingru Lu
- Institute of Ningxia Tuberculosis Control, The Fourth People's Hospital of Ningxia, Yinchuan, Ningxia, China
| | - Xiaomei Tian
- Institute of Ningxia Tuberculosis Control, The Fourth People's Hospital of Ningxia, Yinchuan, Ningxia, China
| | - Fangrong Fei
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Bin Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xiaolin Wang
- Institute of Ningxia Tuberculosis Control, The Fourth People's Hospital of Ningxia, Yinchuan, Ningxia, China
| | - Ying Peng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ming Luo
- School of Geography and Planning, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Juan Lei
- Institute of Ningxia Tuberculosis Control, The Fourth People's Hospital of Ningxia, Yinchuan, Ningxia, China
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Niu Z, Qi Y, Zhao P, Li Y, Tao Y, Peng L, Qiao M. Short-term effects of ambient air pollution and meteorological factors on tuberculosis in semi-arid area, northwest China: a case study in Lanzhou. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:69190-69199. [PMID: 34291414 DOI: 10.1007/s11356-021-15445-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/10/2021] [Indexed: 05/21/2023]
Abstract
To investigate the short-term effects of ambient air pollution and meteorological factors on daily tuberculosis (TB), semi-parametric generalized additive model was used to assess the impacts of ambient air pollutants and meteorological factors on daily TB case from 2005 to 2010 in Chengguan District, Lanzhou, China. Then a non-stratification parametric model and a stratification parametric model were applied to study the interactive effect of air pollutants and meteorological factors on daily TB. The results show that sulfur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with aerodynamic diameter less than 10μm (PM10) were positively correlated with daily TB case; the excess risk (ER) and 95% confidence interval (CI) were 1.79% (0.40%, 3.20%), 3.86% (1.81%, 5.96%), and 0.32% (0.02%, 0.62%), respectively. Daily TB case was positively correlated with maximum temperature, minimum temperature, average temperature, vapor pressure, and relative humidity, but negatively correlated with atmospheric pressure, wind speed, and sunshine duration. The association with average temperature was the strongest, whose ER and 95% CI were 4.43% (3.15%, 5.72%). In addition, there were significant interaction effects between air pollutants and meteorological factors on daily TB case.
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Affiliation(s)
- Zhaocheng Niu
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yuejun Qi
- Lanzhou Municipal Health Service Center, Lanzhou, 730030, China
| | - Puqiu Zhao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yidu Li
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Yan Tao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China.
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China.
| | - Lu Peng
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
| | - Mingli Qiao
- Gansu Key Laboratory for Environmental Pollution Prediction and Control, College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
- Key Laboratory of Western China's Environmental Systems (Ministry of Education), College of Earth and Environmental Sciences, Lanzhou University, 222 South Tianshui Road, Chengguan District, Lanzhou, 730000, Gansu Province, People's Republic of China
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Im C, Kim Y. Spatial pattern of tuberculosis (TB) and related socio-environmental factors in South Korea, 2008-2016. PLoS One 2021; 16:e0255727. [PMID: 34352032 PMCID: PMC8341643 DOI: 10.1371/journal.pone.0255727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/23/2021] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) incidence and corresponding mortality rates in S. Korea are unusual and unique compared to other economically developed countries. Korea has the highest TB incidence rate in Organization for Economic Co-operation and Development (OECD) countries. TB is known as a disease reflecting socio-economic and environmental conditions of a society. Besides, TB is an infectious disease spread through the air, naturally forming spatial dependence of its incidence. This study investigates TB incidences in Korea in socio-economic and environmental perspectives. Eigenvector spatial filtering applied accounts for spatial autocorrelation in the TB incidence, and Getis-Ord Gi* statistic tracks the changes of TB clusters at given time. The results show that population composition ratio, population growth rate, health insurance payment, and public health variables are significant throughout the study period. Environmental variables make minor effects on TB incidence. This study argues that unique demographic features of Korea are a potential threat to TB control in the future.
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Affiliation(s)
- Changmin Im
- Department of Geography, Graduate School, Korea University, Seoul, South Korea
| | - Youngho Kim
- Department of Geography & Geography Education, Korea University, Seoul, South Korea
- * E-mail:
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Xiang K, Xu Z, Hu YQ, He YS, Dan YL, Wu Q, Fang XH, Pan HF. Association between ambient air pollution and tuberculosis risk: A systematic review and meta-analysis. CHEMOSPHERE 2021; 277:130342. [PMID: 33794431 DOI: 10.1016/j.chemosphere.2021.130342] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
There is a growing body of evidence suggesting an association between air pollution exposure and tuberculosis (TB) incidence, but no meta-analysis has assembled all evidence so far. This review and meta-analysis aimed to derive a more reliable estimation on the association between air pollution and TB incidence. PubMed, Embase and Web of Science electronic databases were systemically searched for eligible literature. The PECO framework was used to form the eligibility criteria. Effect estimates and 95% confidence intervals (CIs) published in the included studies were pooled quantitatively. Seventeen articles met the inclusion criteria. The pooled estimates showed that long-term exposure to particulate matter with an aerodynamic diameter ≤10 μm (PM10) was associated with increased incidence of TB (per 10 μg/m3 increase in concentrations of PM10: risk ratios (RR) = 1.058, 95% CI: 1.021-1.095). Besides, long-term exposure to sulfur dioxide (SO2) and nitrogen dioxide (NO2) were significantly associated with TB incidence (per 1 ppb increase, SO2: RR = 1.016, 95% CI: 1.001-1.031; NO2: 1.010, 95% CI: 1.002-1.017). We did not find a significant association of PM2.5, ozone (O3) or carbon monoxide (CO) with TB risk, regardless of long-term or short-term exposure. However, in view of the 2016 ASA Statement and the biological plausibility of PM2.5 damaging host immunity, the association between PM2.5 and TB risk remains to be further established. This meta-analysis shows that long-term exposure to PM10, SO2 or NO2 is associated with increased odds of TB, and the specific biological mechanisms warrant further research.
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Affiliation(s)
- Kun Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Yu-Qian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Yi-Lin Dan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Qian Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Xue-Hui Fang
- Anhui Provincial TB (Tuberculosis) Institute, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
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Liu Y, Zhao S, Li Y, Song W, Yu C, Gao L, Ran J, He D, Li H. Effect of ambient air pollution on tuberculosis risks and mortality in Shandong, China: a multi-city modeling study of the short- and long-term effects of pollutants. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:27757-27768. [PMID: 33515408 DOI: 10.1007/s11356-021-12621-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
Few studies conducted in China have assessed the effects of ambient air pollution exposure on tuberculosis (TB) risk and mortality, especially with a multicity setting. We evaluated the effect of short- and long-term ambient sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and particulate matter≤2.5 μm in aerodynamic diameter (PM2.5) exposures on development and mortality of active TB in 7 Chinese cities in Shandong province from January 1, 2013, to December 31, 2017. We estimated the pollution-associated risk to new infection TB, recurrent TB, and mortality in relation to 1-μg/m3 increases in air pollutants using the penalized multivariate Poisson regression models. A total of 83,555 new infective TB and 3060 recurrent TB including 997 deaths were recorded. Short- and long-term exposures to outdoor air pollutants (SO2, NO2, CO, O3, and PM2.5) were significantly associated with new infection TB, recurrent TB risk, and mortality. The dominant positive effects of SO2, NO2, CO, and PM2.5 for new infection and recurrent TB risk were observed at long-term (>30 days) exposure, whereas the dominant effects of SO2, CO, and PM2.5 for mortality were observed at short-term (≤30 days) exposures. Of the 5 air pollutants we assessed, SO2 and PM2.5 exhibited more consistent and strong associations with TB-related outcomes. We estimated an increase of 1.33% (95% CI 1.29%, 1.37%) and 3.04% (95% CI 2.98%, 3.11%) in new infection TB count for each 1-μg/m3 increase of SO2 at lag 0-180 days and PM2.5 at lag 0-365 days, respectively. This epidemiologic study in China shows that air pollution exposure is associated with increased risk of active TB development and mortality. The control of ambient air pollution may benefit the control and decrease the mortality of TB disease.
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Affiliation(s)
- Yao Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China
| | - Shi Zhao
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China
| | - Yifan Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China
| | - Wanmei Song
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China
| | - Cuixiang Yu
- Respiration Medicine, Qianfoshan Hospital Affiliated to Shandong First Medical University, Shandong Province, Jinan, China
| | - Lei Gao
- NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Jinjun Ran
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong, SAR, China
| | - Daihai He
- Department of Applied Mathematics, Hong Kong Polytechnic University, Hung Hom, Hong Kong, SAR, China.
| | - Huaichen Li
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, China.
- Shandong University of Chinese Traditional Medicine, Jinan, Shandong, China.
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Patel V, Foster A, Salem A, Kumar A, Kumar V, Biswas B, Mirsaeidi M, Kumar N. Long-term exposure to indoor air pollution and risk of tuberculosis. INDOOR AIR 2021; 31:628-638. [PMID: 33016379 PMCID: PMC9580027 DOI: 10.1111/ina.12756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/13/2020] [Accepted: 09/25/2020] [Indexed: 05/09/2023]
Abstract
Indoor air pollution (IAP) is a recognized risk factor for various diseases. This paper examines the role of indoor solid fuel exposure in the risk of mycobacterium tuberculosis (TB) in Delhi Metropolitan, India. Using a cross-sectional design, subjects were screened for a history of active TB and lifelong exposure to IAP sources, such as solid fuel burning and kerosene. The TB prevalence rate in the study area was 1117 per 100 000 population. Every year, increase in solid fuel exposure was associated with a three percent higher likelihood of a history of active TB. Subjects exposed to solid fuel and kerosene use for both heating home and cooking showed significant associations with TB. Age, household expenditure (a proxy of income), lung function, and smoking also showed significant associations with TB. Smokers and solid fuel-exposed subjects were four times more likely to have a history of active TB than non-smoker and unexposed subjects. These finding calls strategies to mitigate solid fuel exposure, such as use of clean cookstove and ventilation, to mitigate the risk of TB which aligns with the United Nations' goal of "End TB by 2030."
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Affiliation(s)
- Vidhiben Patel
- Department of Public Health Sciences, Environmental Health Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew Foster
- Department of Economics, Brown University, Providence, RI, USA
| | - Alison Salem
- Department of Public Health Sciences, Environmental Health Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Amit Kumar
- Society for Environmental Health, New Delhi, India
| | - Vineet Kumar
- Society for Environmental Health, New Delhi, India
| | - Biplab Biswas
- Department of Geography, Burdwan University, Burdwan, West Bengal 713104, India
| | - Mehdi Mirsaeidi
- Department of Public Health Sciences, Environmental Health Division, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, Miller School of Medicine, Miami VA Healthcare System, University of Miami, Miami, FL, USA
| | - Naresh Kumar
- Department of Public Health Sciences, Environmental Health Division, University of Miami Miller School of Medicine, Miami, FL, USA
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Saif NT, Janecki JM, Wanner A, Colin AA, Kumar N. Pediatric Asthma Attack and Home Paint Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4118. [PMID: 33924688 PMCID: PMC8069823 DOI: 10.3390/ijerph18084118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
Although asthma mortality has been declining for the past several decades, asthma morbidity is on the rise, largely due to deteriorating indoor air quality and comorbidities, such as allergies. Consumer products and building materials including paints emit volatile organic compounds (VOCs), such as propylene glycol (PG), which is shown to dehydrate respiratory tracts and can contributor to airway remodeling. We hypothesize that paint exposure increases the risk of asthma attacks among children because high levels of VOCs persist indoors for many weeks after painting. Children 1-15 years old visiting two of the University of Miami general pediatric clinics were screened for their history of asthma and paint exposure by interviewing their parents and/or guardians accompanying them to the clinic. They were also asked questions about asthma diagnosis, severity of asthma and allergies and their sociodemographics. The risk of asthma attack among asthmatic children was modeled with respect to paint exposure adjusting for potential confounders using multivariate logistic regressions. Of 163 children, 36 (22%) reported physician-diagnosed asthma and of these, 13 (33%) had an asthma attack during the last one year. Paint exposure was marginally significant in the univariate analysis (OR = 4.04; 95% CI = 0.90-18.87; p < 0.1). However, exposed asthmatic children were 10 times more likely to experience an asthma attack than unexposed asthmatic children (OR = 10.49; CI = 1.16-94.85, p < 0.05) when adjusted for other risk factors. Given paint is one of the sources of indoor VOCs, multiple strategies are warranted to manage the health effects of VOC exposure from paint, including the use of zero-VOC water-based paint, exposure avoidance and clinical interventions.
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Affiliation(s)
- Nadia T. Saif
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.T.S.); (J.M.J.)
| | - Julia M. Janecki
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.T.S.); (J.M.J.)
| | - Adam Wanner
- Division of Pulmonary and Sleep Medicine, University of Miami Health System, Miami, FL 33136, USA;
| | - Andrew A. Colin
- Division of Pediatric Pulmonology, Miller School of Medicine, University of Miami Health System, Miami, FL 33136, USA;
| | - Naresh Kumar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.T.S.); (J.M.J.)
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Wang W, Guo W, Cai J, Guo W, Liu R, Liu X, Ma N, Zhang X, Zhang S. Epidemiological characteristics of tuberculosis and effects of meteorological factors and air pollutants on tuberculosis in Shijiazhuang, China: A distribution lag non-linear analysis. ENVIRONMENTAL RESEARCH 2021; 195:110310. [PMID: 33098820 DOI: 10.1016/j.envres.2020.110310] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/28/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Tuberculosis (TB) is a serious public health problem in China. There is evidence to prove that meteorological factors and exposure to air pollutants have a certain impact on TB. But the evidence of this relationship is insufficient, and the conclusions are inconsistent. METHODS Descriptive epidemiological methods were used to describe the distribution characteristics of TB in Shijiazhuang in the past five years. Through the generalized linear regression model (GLM) and the generalized additive model (GAM), the risk factors that affect the incidence of TB are screened. A combination of GLM and distribution lag nonlinear model (DLNM) was used to evaluate the lag effect of environmental factors on the TB. Results were tested for robustness by sensitivity analysis. RESULTS The incidence of TB in Shijiazhuang showed a downward trend year by year, with seasonality and periodicity. Every 10 μg/m3 of PM10 changes, the RR distribution is bimodal. The first peak of RR occurs on the second day of lag (RR = 1.00166, 95% CI: 1.00023, 1.00390); the second risk period starts from 13th day of lag and peaks on15th day (RR = 1.00209, 95% CI: 1.00076, 1.00341), both of which are statistically significant. The cumulative effect of increasing 10 μg/m3 showed a similar bimodal distribution. Time zones where the RR makes sense are days 4-6 and 13-20. RR peaked on the 18th day (RR = 1.02239, 95% CI: 1.00623, 1.03882). The RR has a linear relationship with the concentration. Under the same concentration, the RR peaks within 15-20 days. CONCLUSION TB in Shijiazhuang City showed a downward trend year by year, with obvious seasonal fluctuations. The air pollutant PM10 increases the risk of TB. The development of TB has a short-term lag and cumulative lag effects. We should focus on protecting susceptible people from TB in spring and autumn, and strengthen the monitoring and emission management of PM10 in the atmosphere.
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Affiliation(s)
- Wenjuan Wang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Weiheng Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Jianning Cai
- Department of Epidemic Control and Prevention, Center for Disease Prevention and Control of Shijiazhuang City, Shijiazhuang, China
| | - Wei Guo
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Ran Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xuehui Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Ning Ma
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China
| | - Xiaolin Zhang
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, China.
| | - Shiyong Zhang
- Department of Epidemic Control and Prevention, Center for Disease Prevention and Control of Shijiazhuang City, Shijiazhuang, China.
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Du J, Yang J, Wang L, Wu X, Cao W, Sun S. A comparative study of the disease burden attributable to PM 2.5 in China, Japan and South Korea from 1990 to 2017. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 209:111856. [PMID: 33412383 DOI: 10.1016/j.ecoenv.2020.111856] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Exposure to fine particulate matter (PM2.5) is one of the leading contributors to disease burden. However, little is known about the spatial and temporal trends of the disease burden attributable to PM2.5 in the three major economies in East Asia. We aimed to estimate the patterns and temporal variations of the disease burden attributable to PM2.5 in China, Japan, and South Korea from 1990 to 2017. METHODS We obtained data on disease burden attributable to PM2.5 from the Global Burden of Disease Study (GBD) 2017. We retrieved the numbers and age-standardized mortality rate (ASMR) and disability-adjusted life years (DALYs) rate (ASDR) of disease attributable to PM2.5 by age, sex, socio-demographic index (SDI), and country. We used percentage change and estimated annual percentage change (EAPC) to assess the trends of ASMR and ASDR attributable to PM2.5 between 1990 and 2017. We further calculated the contribution of population growth, population aging, and changes in mortality or DALYs rate to the net changes in total deaths and DALYs associated with PM2.5. RESULTS We found considerable differences in the disease burden attributable to PM2.5 in China, Japan, and South Korea. In 2017, the ASMR and ASDR of disease attributable to PM2.5 in China were 49.37 (95% UI: 41.18, 57.5) per 100,000 population and 1065.9 (95% UI: 891.28, 1237.38) per 100,000 population, respectively, which was about four times higher than that of Japan and twice higher than that of South Korea. Regardless of country, the ASMR and ASDR were more pronounced among elders and males. From 1990 to 2017, the declines in ASMR and ASDR were more pronounced in Japan and South Korea than in China. The changes in PM2.5 associated total deaths and DALYs between 1990 and 2017 were the combined effects of population aging, population growth, and changes in mortality or DALY rate, resulting in a net increase in total deaths and DALYs in China but little changes in Japan and South Korea. CONCLUSIONS PM2.5 still contributed to significant disease burdens in 2017, although age-standardized disease burden has declined from 1990 to 2017. There has been an increasing trend in total deaths and DALYs in China, which was primarily driven by population aging.
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Affiliation(s)
- Jianqiang Du
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Jianjun Yang
- School of Biological and Environmental Engineering, Xi'an University, Xi'an, Shaanxi 710065, China
| | - Lina Wang
- Department of Neurology, Xi'an Ninth Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710052, China
| | - Xiaoming Wu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI 02912, USA
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
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Liu F, Zhang Z, Chen H, Nie S. Associations of ambient air pollutants with regional pulmonary tuberculosis incidence in the central Chinese province of Hubei: a Bayesian spatial-temporal analysis. Environ Health 2020; 19:51. [PMID: 32410699 PMCID: PMC7226955 DOI: 10.1186/s12940-020-00604-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Air pollution and pulmonary tuberculosis (PTB) are still serious worldwide problems, especially in areas of developing countries. Whether there is an association between high ambient air pollutant concentrations and PTB has not been fully explored. METHODS Bayesian spatial-temporal models were constructed to analyse the association between ambient air pollutants (particulate matter with aerodynamic diameters of ≤10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2)) and PTB incidence, adjusting for socioeconomic covariates. We collected data on pulmonary TB, ambient air pollution (PM10, SO2 and NO2) concentrations and socioeconomic covariates from 17 prefectures in the central Chinese province of Hubei between Jan 1, 2006, and Dec 31, 2015. RESULTS For every annual 10 μg/m3 increase in SO2, the relative risk (RR) of PTB incidence was 1.046 (95% credible interval [CI], 1.038-1.054) in the study area. Moreover, we found positive associations with each annual 10 μg/m3 increase in ambient air pollutants (PM10, SO2 and NO2) in females but only with SO2 in males. A significant association for each 10 μg/m3 increase in SO2 was observed in all the age groups, with a significant association for PM10 only in children under 14 years of age. A significant response relationship was also observed at a 0-1 month moving average lag for each 10 μg/m3 increase in SO2. CONCLUSIONS High ambient air pollution concentrations in areas of developing countries might increase the risk of regional PTB incidence, especially for women and young people. Precautions and protective measures and efforts to reduce ambient air pollutant concentrations should be strengthened in developing countries.
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Affiliation(s)
- Fuqiang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, People's Republic of China
| | - Zhixia Zhang
- Wuchang University of Technology, Wuhan, 430000, Hubei, People's Republic of China
| | - Hongying Chen
- Hubei Centre for Disease Prevention and Control, Wuhan, 430000, Hubei, People's Republic of China.
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, People's Republic of China.
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Huang K, Ding K, Yang XJ, Hu CY, Jiang W, Hua XG, Liu J, Cao JY, Zhang T, Kan XH, Zhang XJ. Association between short-term exposure to ambient air pollutants and the risk of tuberculosis outpatient visits: A time-series study in Hefei, China. ENVIRONMENTAL RESEARCH 2020; 184:109343. [PMID: 32192989 DOI: 10.1016/j.envres.2020.109343] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/03/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The current evidence has presented mixed results between air pollutants exposure and the progression of tuberculosis (TB). The purpose of this study was to explore the association between short-term exposure to air pollutants and the risk of TB outpatient visits in Hefei, China. METHODS Time-series analysis was used to assess the effect of short-term exposure to ambient air pollutants on the risk of TB outpatient visits. A Poisson generalized linear regression model combined with a distributed lag non-linear model (DLNM) was applied to explore the association. The effects of different gender (male, female), age (≤65 years old, >65 years old) and season (cold season, warm season) on the risk of TB were investigated by stratified analysis. Sensitivity analyses were conducted to test the robustness of our findings. RESULTS A total of 22,749 active TB cases were identified from November 1, 2013 to December 31, 2018 in Hefei. The overall exposure-response curve showed that the concentration of particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) and nitrogen dioxide (NO2) exposure were positively correlated with the risk of TB outpatient visits, while ozone (O3) and sulfur dioxide (SO2) exposure were negatively correlated with the risk of TB outpatient visits. The maximum lag-specific and cumulative relative risk (RR) of TB outpatient visits were 1.057 [95%CI: 1.002-1.115, lag 3 day] and 1.559 (95%CI: 1.057-2.300, lag 13 days) for each 10 μg/m³ increase in PM2.5; 1.026 (95% CI: 1.008-1.044, lag 0 day) and 1.559 (95%CI: 1.057-2.300, lag 07 days) for each 10 μg/m³ increase in NO2; 0.866 (95% CI: 0.801-0.935, lag 5 day) and 0.852 (95%CI: 1.01-1.11, lag 0-14 days) for each 10 μg/m³ increase in SO2 in the single-pollutant model. There was only a negative association between O3 exposure and the cumulative risk of TB outpatient visits (RR = 0.960, 95%CI: 0.936-0.984, lag 07 days). Stratified analyses showed that the effects of SO2 and O3 exposure were different between warm and cold seasons. The effect of NO2 exposure remained statistically significant in male, younger, and cold season subgroups. Besides, elderly people are more susceptible to PM2.5 exposure. CONCLUSION This study suggests that exposure to PM2.5, NO2, SO2, and O3 are associated with the risk of TB outpatient visits. Seasonal variation may have a greater impact on the risk of TB outpatient visits compared with gender and age.
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Affiliation(s)
- Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- 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
| | - Wen Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Guo Hua
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, 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 Medical University Clinical College of Chest, 397 Jixi Road, Hefei, 230022, China; Anhui Chest Hospital, 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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Yang J, Zhang M, Chen Y, Ma L, Yadikaer R, Lu Y, Lou P, Pu Y, Xiang R, Rui B. A study on the relationship between air pollution and pulmonary tuberculosis based on the general additive model in Wulumuqi, China. Int J Infect Dis 2020; 96:42-47. [PMID: 32200108 DOI: 10.1016/j.ijid.2020.03.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/08/2020] [Accepted: 03/13/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE This study aimed to explore the impact of atmospheric pollutants on the incidence of tuberculosis (TB), and provide new ideas for the prevention and control of TB in the future. METHODS It explored the relationship between air pollutants and meteorological factors, as well as between air pollutants and heating through Spearman correlation analysis and rank sum test. Additionally, it analyzed the relationship between air pollutants and TB incidence using the general additive model. Statistical analysis results at the p<0.05 level were considered significant. RESULTS Three months after exposure to air pollutants (PM2.5, SO2, NO2, and CO) TB incidence increased. However, TB incidence increased 9 months after exposure to PM10. The single pollutant model showed when concentrations of PM2.5, PM10, SO2, NO2, CO, and O3 increased by 1μg/m3 (or 1mg/m3), the number of TB cases increased by 0.09%, 0.08%, 0.58%, 0.42%, 6.9%, and 0.57%, respectively. The optimal multi-pollutant model was a two-factor model (PM10+NO2). CONCLUSION Air pollutants including PM2.5, PM10, SO2, NO2, CO, and O3 increased the risk of TB. Few studies have been conducted in this area of research, especially regarding the mechanism. The results of this study should contribute to the understanding of TB incidence and prompt additional research.
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Affiliation(s)
- Jiandong Yang
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China.
| | - Mengxi Zhang
- Center for Studies of Displaced Populations, Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health & Tropical Medicine, China
| | - Yanggui Chen
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
| | - Li Ma
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
| | - Rayibai Yadikaer
- Health Inspection of Health and Family Planning Commission of Xinjiang Uygur Autonomous Region, China
| | - Yaoqin Lu
- Department of Occupational and Environmental Health, Xinjiang Medical University School of Public Health, China; Science and Education Department, Wulumuqi Center for Disease Control and Prevention, China
| | - Pengwei Lou
- Medical Records Statistics Room, The Fourth Affiliated Hospital of Xinjiang Medical University, China
| | - Yujiao Pu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, China
| | - Ran Xiang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, China
| | - Baolin Rui
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
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Kim H, Yu S, Choi H. Effects of particulate air pollution on tuberculosis development in seven major cities of Korea from 2010 to 2016: methodological considerations involving long-term exposure and time lag. Epidemiol Health 2020; 42:e2020012. [PMID: 32164052 PMCID: PMC7285441 DOI: 10.4178/epih.e2020012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Epidemiological evidence of associations between ambient particulate matter (PM) and tuberculosis (TB) risk is accumulating. Two previous studies in Korea found associations between air pollution—especially sulfur dioxide (SO2)—and TB. In this study, we conducted an annual time-series cross-sectional study to assess the effect of PM with an aerodynamic diameter less than 10 μm (PM10) on TB risk in seven major cities of Korea from 2010 to 2016, taking into account time lag and long-term cumulative exposure. METHODS Age-standardized TB notification rates were derived using the Korea National TB Surveillance System. Annual average PM10 concentrations were obtained from annual Korean air quality reports. We applied a generalized linear mixed model with unconstrained distributed lags of exposure to PM10. We adjusted for potential confounders such as age, health behaviors, and area-level characteristics. RESULTS Both average annual PM10 concentrations and age-standardized TB notification rates decreased over time. The association between cumulative exposure to PM10 and TB incidence became stronger as a longer exposure duration was considered. An increase of one standard deviation (5.63 μg/m3) in PM10 exposure for six years was associated with a 1.20 (95% confidence interval, 1.17 to 1.22) times higher TB notification rate. The marginal association of exposure duration with the TB notification rate was highest at four and five years prior to TB notification. This association remained consistent even after adjusting it for exposure to SO2. CONCLUSIONS The findings of this study suggest that cumulative exposure to PM10 may affect TB risk, with a potential lag effect.
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Affiliation(s)
- Honghyok Kim
- BK21Plus Program in Embodiment: Health-Society Interaction, Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea.,School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Sarah Yu
- BK21Plus Program in Embodiment: Health-Society Interaction, Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea.,Research Center, the Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Seoul, Korea.,School of Health Policy and Management, Korea University College of Health Science, Seoul, Korea
| | - Hongjo Choi
- Research Center, the Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Seoul, Korea.,Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
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Gulhan PY, Elverisli MF, Ercelik M, Aytekin F, Balbay O, Arbak P. Relationship between Diagnosis Period and Internal and External Air Quality in Patients with Tuberculosis. Eurasian J Med 2020; 52:77-80. [PMID: 32158320 DOI: 10.5152/eurasianjmed.2020.19226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective The aim of this study was to investigate the relationship between bacteriological case definitions and indoor and outdoor air quality parameters in tuberculosis (TB). Materials and Methods A total of 200 patients with TB diagnosed and treated in our hospital during 2012-2018 were included to this study. The air monitoring measurement parameters of the National Air Quality Network [particulate matter 10 (PM10), sulfur dioxide (SO2), air temperature, air pressure, and relative humidity] for the same time period were obtained from the web page http://laboratory.cevre.gov.tr/Default.ltr.aspx. Results Of the 200 patients, 62.5% (125) were males and 37.5% (75) were females. The rate of diagnosis based on culture and smear positivity was 48.4% (31), which was significantly higher than that in the clinic [10.9% (7)] among patients who used stove for warming. The rate of diagnosis based on culture and smear positivity [52.1% (25)] was significantly higher than that in the clinic [8.3% (4)] among patients who were exposed to biomass. The univariate analysis revealed no significant independent effect of warming and biomass use on case definition. According to the case definitions, the mean values of PM10, SO2, and temperature in the diagnosed month showed no statistically significant difference. The humidity level in the month was significantly higher, during which cases diagnosed using smear and culture positivity were compared with cases diagnosed using only culture positivity (p=0.023). Conclusion This study indicates that biomass used as a cooking fuel is a risk factor for pulmonary TB, implying that TB occurrence can be reduced significantly by lowering or preventing the exposure to cooking smoke emitted from biomass fuel.
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Affiliation(s)
- Pinar Yildiz Gulhan
- Department of Chest Disease, Duzce University School of Medicine, Duzce, Turkey
| | | | - Merve Ercelik
- Department of Chest Disease, Duzce University School of Medicine, Duzce, Turkey
| | - Fuat Aytekin
- Department of Chest Disease, Duzce University School of Medicine, Duzce, Turkey
| | - Oner Balbay
- Department of Chest Disease, Duzce University School of Medicine, Duzce, Turkey
| | - Peri Arbak
- Department of Chest Disease, Duzce University School of Medicine, Duzce, Turkey
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Lin YJ, Lin HC, Yang YF, Chen CY, Ling MP, Chen SC, Chen WY, You SH, Lu TH, Liao CM. Association Between Ambient Air Pollution and Elevated Risk of Tuberculosis Development. Infect Drug Resist 2019; 12:3835-3847. [PMID: 31827330 PMCID: PMC6902850 DOI: 10.2147/idr.s227823] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/24/2019] [Indexed: 11/23/2022] Open
Abstract
Background Broad-scale evidence has shown the significant association between ambient air pollutants and the development of tuberculosis (TB). However, the impact of air quality on the risk of TB in Taiwan is still poorly understood. Objective To develop a probabilistic integrated population-level risk assessment approach for evaluating the contribution of ambient air pollution exposure to the risk of TB development among different regions of Taiwan. Materials and methods A Bayesian-based probabilistic risk assessment model was implemented to link exposure concentrations of various air pollutants quantified in a probabilistic manner with the population-based exposure-response models developed by using an epidemiological investigation. Results The increment of the risk of TB occurred in a region with a higher level of air pollution, indicating a strong relationship between ambient air pollution exposures and TB incidences. Carbon monoxide (CO) exposure showed the highest population attributable fraction (PAF), followed by nitrogen oxides (NOX) and nitrogen dioxide (NO2) exposures. In a region with higher ambient air pollution, it is most likely (80% risk probability) that the contributions of CO exposure to development of TB were 1.6–12.2% (range of median PAFs), whereas NOX and NO2 exposures contributed 1.2–9.8% to developing TB. Conclusion Our findings provide strong empirical support for the hypothesis and observations from the literature that poor air quality is highly likely to link aetiologically to the risk of TB. Therefore, substantial reductions in CO, NOX, and NO2 exposures are predicted to have health benefits to susceptible and latently infected individuals that provide complementary mitigation efforts in reducing the burden of TB. Considering that people continue to be exposed to both TB bacilli and ambient air pollutants, our approach can be applied for different countries/regions to identify which air pollutants contribute to a higher risk of TB in order to develop potential mitigation programs.
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Affiliation(s)
- Yi-Jun Lin
- Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei, Taiwan
| | - Hsing-Chieh Lin
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Ying-Fei Yang
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Chi-Yun Chen
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Min-Pei Ling
- Department of Food Science, National Taiwan Ocean University, Keelung City, Taiwan
| | - Szu-Chieh Chen
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wei-Yu Chen
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Han You
- Institute of Food Safety and Risk Management, National Taiwan Ocean University, Keelung City, Taiwan
| | - Tien-Hsuan Lu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Chung-Min Liao
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
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Sohn M, Kim H, Sung H, Lee Y, Choi H, Chung H. Association of social deprivation and outdoor air pollution with pulmonary tuberculosis in spatiotemporal analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:657-667. [PMID: 30698032 DOI: 10.1080/09603123.2019.1566522] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/03/2019] [Indexed: 06/09/2023]
Abstract
The objective of this study was to identify the association between social deprivation, outdoor air pollution, and tuberculosis (TB) incidence rate or mortality rate. The study sample comprised 25 districts in Seoul, Korea. We used two public data derived from the Community Health Survey and Seoul Statistics. The geographic information system analysis and random effects Poisson regression were applied to explore the association of social deprivation and air pollution with TB incidence and mortality. An 1 ppb increase in sulfur dioxide (SO2) concentration was significantly associated with the risk of TB incidence (risk ratio [RR] = 1.046, 95% confidence interval [CI]: 1.028, 1.065). An 1 unit increase in the deprivation index was significantly related to a6% increase in the mortality of TB (RR = 1.063, 95% CI: 1.031, 1.097). : Our results imply that social deprivation and air pollution may affect the different TB outcomes. Effective policy-making for TB control should reflect the differing outcomes between TB incidence and mortality.
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Affiliation(s)
- Minsung Sohn
- Department of Public Health Sciences, Graduate School of Korea University, BK21Plus Program in Public Health Sciences , Seoul , Republic of Korea
- Department of Health and Care Administration, The Cyber University of Korea , Seoul , Republic of Korea
| | - Honghyok Kim
- Department of Public Health Sciences, Graduate School of Korea University, BK21Plus Program in Public Health Sciences , Seoul , Republic of Korea
| | - Hyoju Sung
- Department of Public Health Sciences, Graduate School of Korea University, BK21Plus Program in Public Health Sciences , Seoul , Republic of Korea
| | - Younsue Lee
- Policy Development and Research, The Korea National Enterprise for Clinical Trials , Seoul , Republic of Korea
| | - Hongjo Choi
- Department of Research and Development, The Korean Institute of Tuberculosis , Osong , Republic of Korea
| | - Haejoo Chung
- Department of Public Health Sciences, Graduate School of Korea University, BK21Plus Program in Public Health Sciences , Seoul , Republic of Korea
- School of Health Policy and Management, College of Public Health Science, Korea University , Seoul , Republic of Korea
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Hao J, Yang Z, Huang S, Yang W, Zhu Z, Tian L, Lu Y, Xiang H, Liu S. The association between short-term exposure to ambient air pollution and the incidence of mumps in Wuhan, China: A time-series study. ENVIRONMENTAL RESEARCH 2019; 177:108660. [PMID: 31445438 DOI: 10.1016/j.envres.2019.108660] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Previous studies have estimated the association between meteorological factors and mumps outbreaks without assessing the influence of air pollution. In this research, we explored the effects of short-term exposure to air pollution on the incidence of mumps. METHODS Our time-series analysis was conducted using data collected in Wuhan, China from 2015 to 2017. Daily number of mumps cases was obtained from Disease Reporting System in Hubei Provincial Center for Disease Control and Prevention. Data on air pollution was obtained from 10 national air quality monitoring stations, including nitrogen dioxide (NO2), sulfur dioxide (SO2), ground-level ozone (O3), particulate matter less than or equal to 10 μm in aerodynamic diameter (PM10), and particulate matter less than or equal to 2.5 μm in aerodynamic diameter (PM2.5). Daily meteorological data including temperature and relative humidity were obtained from Hubei Meteorological Bureau. We performed a Poisson regression in generalized additive models (GAM) to explore the association between the incidence of mumps and exposure to air pollution. RESULTS We observed that the effects of air pollutants were statistically significant mainly in two periods, lag 0 to lag 5 and lag 20 to lag 25, with the strongest effects appearing at lag 2 and lag 23. The cumulative effects were stronger than single-day lag effects. The stratified analysis showed the effect of pollutants during the hot season was stronger than that during the cold season, especially for NO2 and SO2. CONCLUSIONS We found that exposure to NO2 and SO2 was significantly associated with higher risk of developing mumps. Our findings could help deepen the understanding of how air pollution exposure affects the incidence of mumps.
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Affiliation(s)
- Jiayuan Hao
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Zhiyi Yang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Shuqiong Huang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
| | - Wenwen Yang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
| | - Zhongmin Zhu
- College of Information Science and Engineering, Wuchang Shouyi University, Wuhan, 430064, China; State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, 430079, China.
| | - Liqiao Tian
- State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, 430079, China.
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University of Hawaii at Manoa, 1960 East-West Rd, Biomed Bldg, D105, Honolulu, HI, 96822, USA.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
| | - Suyang Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, 430071, China; Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, 430071, China.
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Li Z, Mao X, Liu Q, Song H, Ji Y, Xu D, Qiu B, Tian D, Wang J. Long-term effect of exposure to ambient air pollution on the risk of active tuberculosis. Int J Infect Dis 2019; 87:177-184. [PMID: 31374344 DOI: 10.1016/j.ijid.2019.07.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To explore the long-term effect of exposure to ambient air pollution on the risk of active tuberculosis (TB). METHODS We constructed a distributed-lag nonlinear model (DLNM) to evaluate the relatively long-term influence of outdoor PM2.5, PM10, SO2 and NO2 exposure on active TB risk in the city of Lianyungang in Jiangsu Province, China. RESULTS There were 7,282 TB cases reported in the study area during 2014-2017, with annual median (interquartile range) concentrations of PM2.5, PM10, SO2 and NO2 at 45.86 (34.57-64.14) μg/m3, 85.43 (62.86-116.14) μg/m3, 22.00 (15.71-30.86) μg/m3 and 30.00 (23.29-38.57) μg/m3, respectively. The single-pollutant model showed that for each 10 μg/m3 increase in concentration, the cumulative relative risk of TB was 1.12 (lag 0-24 weeks, 95% CI: 1.03-1.22) for PM2.5 with reference to 35 μg/m3; 1.11 (lag 0-21 weeks, 95% CI: 1.06-1.17) for PM10 with reference to 70 μg/m3; 1.37 (lag 0-20 weeks, 95% CI: 1.16-1.62) for SO2 with reference to 60 μg/m3; and 1.29 (lag 0-22 weeks, 95% CI: 1.11-1.49) for NO2 with reference to 40 μg/m3. In the multipollutant model considering both PM10 and NO2, the association remained significant. CONCLUSIONS Our results revealed a potential association between outdoor exposure to PM2.5, PM10, SO2, and NO2 and active TB. Considering that people from developing countries continue to be exposed to both severe outdoor air pollution and high rates of latent TB infection, the association between worsening air pollution and active TB deserves further attention.
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Affiliation(s)
- Zhongqi Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Xuhua Mao
- Department of Clinical Laboratory, Yixing People's Hospital, Wuxi, 214200, People's Republic of China
| | - Qiao Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Huan Song
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Ye Ji
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Dian Xu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Beibei Qiu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Dan Tian
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China; Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
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Xu M, Liao J, Yin P, Hou J, Zhou Y, Huang J, Liu B, Chen R, Ke L, Chen H, Hu P. Association of air pollution with the risk of initial outpatient visits for tuberculosis in Wuhan, China. Occup Environ Med 2019; 76:560-566. [DOI: 10.1136/oemed-2018-105532] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/14/2019] [Accepted: 06/12/2019] [Indexed: 12/18/2022]
Abstract
ObjectivesPrevious studies suggested the association of air pollution with initial Mycobacterium tuberculosis infection and the disease development. However, few studies have been conducted on air pollution and initial tuberculosis (TB) consults using short-interval data. We investigated the weekly association between air pollution and initial TB outpatient visits.MethodsWe used a Poisson regression model combined with a distributed lag non-linear model to conduct a time-series study with weekly air pollution data and TB cases during 2014–2017 in Wuhan, China.ResultsA 10 µg/m3 increase in NO2 (nitrogen dioxide) was associated with 11.74% (95% CI: 0.70 to 23.98, lag 0–1 weeks), 21.45% (95% CI: 1.44 to 45.41, lag 0–2 weeks) and 12.8% (95% CI: 0.97 to 26.02, lag 0–1 weeks) increase in initial TB consults among all patients with TB, old patients (≥60 years old) and male ones, respectively. A 10 µg/m3 increase in SO2 (sulfur dioxide) was associated with −22.23% (95% CI: −39.23 to −0.49, lag 0–16 weeks), −28.65% (95% CI: −44.3 to −8.58, lag 0–16 weeks), −23.85 (95% CI: −41.79 to −0.37, lag 0–8 weeks) and −23.82% (95% CI: −41.31 to −1.11, lag 0–16 weeks) increase in initial TB consults among the total, young (aged 15–59 years old), old and male patients, respectively. In old patients, a 0.1 mg/m3 increase in CO (carbon monoxide) and a 10 µg/m3 increase in PM2.5 (particulate matter) were separately associated with 42.32% (95% CI: 1.16 to 100.22, lag 0–16 weeks) and 17.38% (95% CI: 0.28 to 37.38, lag 0–16 weeks) increases in TB consults.ConclusionOur study first highlighted the importance of weekly association between air pollution and the risk of initial TB consults, which is helpful for the arrangements of TB screening and medical assistance.
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Wang H, Tian C, Wang W, Luo X. Temporal Cross-Correlations between Ambient Air Pollutants and Seasonality of Tuberculosis: A Time-Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091585. [PMID: 31064146 PMCID: PMC6540206 DOI: 10.3390/ijerph16091585] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 11/18/2022]
Abstract
The associations between ambient air pollutants and tuberculosis seasonality are unclear. We assessed the temporal cross-correlations between ambient air pollutants and tuberculosis seasonality. Monthly tuberculosis incidence data and ambient air pollutants (PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2)) and air quality index (AQI) from 2013 to 2017 in Shanghai were included. A cross-correlogram and generalized additive model were used. A 4-month delayed effect of PM2.5 (0.55), PM10 (0.52), SO2 (0.47), NO2 (0.40), CO (0.39), and AQI (0.45), and a 6-month delayed effect of O3 (−0.38) on the incidence of tuberculosis were found. The number of tuberculosis cases increased by 8%, 4%, 18%, and 14% for a 10 μg/m3 increment in PM2.5, PM10, SO2, and NO2; 4% for a 10 unit increment in AQI; 8% for a 0.1 mg/m3 increment in CO; and decreased by 4% for a 10 μg/m3 increment in O3. PM2.5 concentrations above 50 μg/m3, 70 μg/m3 for PM10, 16 μg/m3 for SO2, 47 μg/m3 for NO2, 0.85 mg/m3 for CO, and 85 for AQI, and O3 concentrations lower than 95 μg/m3 were positively associated with the incidence of tuberculosis. Ambient air pollutants were correlated with tuberculosis seasonality. However, this sort of study cannot prove causality.
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Affiliation(s)
- Hua Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Changwei Tian
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Wenming Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Xiaoming Luo
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
- Department of Public Health, Soochow University, Kunshan 215300, China.
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Azimi M, Feng F, Zhou C. Air pollution inequality and health inequality in China: An empirical study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:11962-11974. [PMID: 30825123 DOI: 10.1007/s11356-019-04599-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 02/18/2019] [Indexed: 05/17/2023]
Abstract
China's residents experience unequal exposure to air pollution in different regions, and the corresponding health consequences have increased remarkably. To ensure sustainable development, China should monitor health inequality and its potential determinants. This study empirically examines the health inequalities (represented by perinatal and tuberculosis mortalities) caused by air pollution inequalities (represented by SO2 and NOx emissions) from 31 Chinese provinces in the period 2006 to 2015, using the generalized method of moments (GMM) and quantile regression (QR). The GMM results reveal a strong positive relationship between SO2/NOx emission inequality and tuberculosis mortality inequality. In contrast, the QR results show that perinatal mortality inequality is closely related to emission inequality across all percentiles for SO2 emission and at the 75th percentile for NOx emission. Our findings help policymakers to identify health disparities and be mindful of air pollution inequality as a factor in the elimination of health inequality.
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Affiliation(s)
- Mohaddeseh Azimi
- School of Management, University of Science and Technology of China, Hefei, 230026, China.
| | - Feng Feng
- School of Management, University of Science and Technology of China, Hefei, 230026, China.
| | - Chongyang Zhou
- School of Management, University of Science and Technology of China, Hefei, 230026, China
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Wei Q, Wu J, Zhang Y, Cheng Q, Bai L, Duan J, Gao J, Xu Z, Yi W, Pan R, Su H. Short-term exposure to sulfur dioxide and the risk of childhood hand, foot, and mouth disease during different seasons in Hefei, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 658:116-121. [PMID: 30577010 DOI: 10.1016/j.scitotenv.2018.11.481] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/05/2018] [Accepted: 11/30/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Sulfur dioxide (SO2) is an important component of air pollution, adversely impacting human health worldwide. This study aimed to examine the association between short-term exposure to SO2 and childhood hand, foot, and mouth disease (HFMD) in Hefei, China. METHODS A Poisson generalized additive model (GAM) combining the time-series regression analyses was used to fit the SO2-HFMD association. The effect of SO2 was estimated using the single-day lag models (lag0, lag1, lag2) and the moving average lag models (lag01, lag02) We also conducted stratified analyses by season, ages (0-4 years old, 5-14 years old), gender (male, female), childcare patterns (scattered children, kindergarten children) and residence areas (urban, rural). Two-pollutant models were adopted to test the robustness of the results. RESULTS There was a statistically significant association between SO2 and the risk of childhood HFMD. For total cases, the relative risk (RR) at lag0 was 1.038 (95% confidence interval (CI): 1.018-1.057) in whole-period and 1.088 (95% CI: 1.059-1.118) in cold season. During cold season, we observed significant associations between SO2 and HFMD among all subgroups except for children aged 5-14 years old and the adverse effects occurred on lag0, lag1, lag01, lag02. However, in hot season, SO2 were significant only for females (lag01 with RR = 1.054; 95%CI = 1.007-1.101) and scattered children (lag01 with RR = 1.054; 95%CI = 1.007-1.101). In general, females and scattered children appeared to be more vulnerable to SO2. CONCLUSIONS This study suggests a significant association between SO2 and HFMD. especially during cold season. Compared with males and kindergarten children, females and scattered children are at higher risk of developing HFMD.
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Affiliation(s)
- Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jinju Wu
- Hefei Centre for Disease Control and Prevention, Hefei, Anhui 230032, China
| | - Yanwu Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Qiang Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Lijun Bai
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jun Duan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Jiaojiao Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Zihan Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui 230032, China.
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Zhu X, Qiu H, Wang L, Duan Z, Yu H, Deng R, Zhang Y, Zhou L. Risks of hospital admissions from a spectrum of causes associated with particulate matter pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:90-100. [PMID: 30502738 DOI: 10.1016/j.scitotenv.2018.11.240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 05/04/2023]
Abstract
Ambient particulate matter (PM) pollution has been linked to elevated hospital admissions (HAs), especially from respiratory and cardiovascular diseases. However, few studies have estimated the associations between PM pollution and HAs for a wider range of broad disease categories. This study aimed to evaluate the effects of PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) and ≤10 μm (PM10) on a range of broad and specific causes of HAs in Chengdu, China during 2015-2016, using a generalized additive model (GAM). Age-, gender- and season-specific analyses were also performed on the broad categories. We further calculated the corresponding morbidity burden due to PM exposure. During the study period, the daily mean level for PM2.5 and PM10 was 57.3 μg/m3 and 94.7 μg/m3, respectively. For broad disease categories, each 10 μg/m3 increase in PM10 at lag06 was associated with increments of 0.65% (95% CI: 0.32%-0.99%) in HAs from respiratory, 0.49% (95% CI: 0.04%-0.95%) from circulatory and 0.91% (95% CI: 0.15%-1.69%) from skin and subcutaneous tissue diseases. By contrast, only respiratory HAs showed a significant positive association with elevated PM2.5 at lag06 (1.03% increase per 10 μg/m3, 95% CI: 0.50%-1.56%, p < 0.001). Increased HAs risks for several more refined specific causes within respiratory, circulatory, skin and subcutaneous tissue, nervous and genitourinary diseases were also observed. Subgroup analyses indicated that effect estimates were modified by age, gender and season. Overall, the largest morbidity burden was observed in myocardial infarction, about 11.27% (95% CI: 3.45%-18.07%) and 11.11% (95% CI: 4.07%-17.27%) of HAs for myocardial infarction could be attributable to PM2.5 and PM10 levels exceeding the WHO's air quality guidelines (24-h mean: 25 μg/m3 for PM2.5 and 50 μg/m3 for PM10). Our study suggests that both PM2.5 and PM10 increase risks of morbidity from broad range of causes of HAs in Chengdu, and result in substantial morbidity burden.
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Affiliation(s)
- Xiaojuan Zhu
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China; Center for Artificial Intelligence and Smart Health, School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Hang Qiu
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China; Center for Artificial Intelligence and Smart Health, School of Computer Science and Engineering, University of Electronic Science and Technology of China, Chengdu, China.
| | - Liya Wang
- Big Data Research Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhanqi Duan
- Health and Family Planning Information Center of Sichuan Province, Chengdu, China
| | - Haiyan Yu
- School of Economics and Management, Chongqing University of Posts and Telecommunications, Chongqing, China; Department of Statistics, The Pennsylvania State University, University Park, PA, USA
| | - Ren Deng
- Health and Family Planning Information Center of Sichuan Province, Chengdu, China
| | - Yanlong Zhang
- Chengdu Shulianyikang Technology Co., Ltd, Chengdu, China
| | - Li Zhou
- Health and Family Planning Information Center of Sichuan Province, Chengdu, China.
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Popovic I, Soares Magalhaes RJ, Ge E, Marks GB, Dong GH, Wei X, Knibbs LD. A systematic literature review and critical appraisal of epidemiological studies on outdoor air pollution and tuberculosis outcomes. ENVIRONMENTAL RESEARCH 2019; 170:33-45. [PMID: 30557690 DOI: 10.1016/j.envres.2018.12.011] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/21/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Abstract
Ambient air pollution is the leading environmental risk factor for disease globally. Air pollutants can increase the risk of some respiratory infections, but their effects on tuberculosis (TB) are unclear. In this systematic literature review, we aimed to assess epidemiological studies on the association between outdoor air pollutants and TB incidence, hospital admissions and death (collectively referred to here as 'TB outcomes'). We sought to consolidate available evidence on this topic and propose recommendations for future studies. Following PRISMA guidelines, we searched PubMed, Web of Science, Google Scholar, and Scopus with no restrictions imposed on year of publication. A total of 11 epidemiological studies, performed in Asia, Europe and North America, met our inclusion criteria (combined sample size: 215,337 people). We extracted key study characteristics from each eligible publication, including design, exposure assessment, analytical approaches and effect estimates. The studies were assessed for overall quality and risk of bias using standard criteria. The pollutant most frequently associated with statistically significant effects on TB outcomes was fine particulate matter ( < 2.5 µm; PM2.5); 6/11 studies assessed PM2.5, of which 4/6 demonstrated a significant association). There was some evidence of significant associations between PM10 ( < 10 µm), nitrogen dioxide (NO2) and sulfur dioxide (SO2) and TB outcomes, but these associations were inconsistent. The existing epidemiological evidence is limited and shows mixed results. However, it is plausible that exposure to air pollutants, particularly PM2.5, may suppress important immune defence mechanisms, increasing an individual's susceptibility to development of active TB and TB-related mortality. Considering the small number of studies relative to the demonstrably large global health burdens of air pollution and TB, further research is required to corroborate the findings in the current literature. Based on a critical assessment of existing evidence, we conclude with methodological suggestions for future studies.
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Affiliation(s)
- Igor Popovic
- School of Public Health, Faculty of Medicine, University of Queensland, Herston, Australia.
| | - Ricardo J Soares Magalhaes
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia; Children's Health and Environment Program, Child Health Research Centre, University of Queensland, Brisbane, Australia
| | - Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Guy B Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, Australia; Woolcock Institute of Medical Research, Sydney, Australia; Centre for Air Pollution, Energy and Health Research, Glebe, NSW, Australia
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaolin Wei
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Luke D Knibbs
- School of Public Health, Faculty of Medicine, University of Queensland, Herston, Australia; Centre for Air Pollution, Energy and Health Research, Glebe, NSW, Australia
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Bae S, Kwon HJ. Current State of Research on the Risk of Morbidity and Mortality Associated with Air Pollution in Korea. Yonsei Med J 2019; 60:243-256. [PMID: 30799587 PMCID: PMC6391524 DOI: 10.3349/ymj.2019.60.3.243] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The effects of air pollution on health can vary regionally. Our goal was to comprehensively review previous epidemiological studies on air pollution and health conducted in Korea to identify future areas of potential study. MATERIALS AND METHODS We systematically searched all published epidemiologic studies examining the association between air pollution and occurrence of death, diseases, or symptoms in Korea. After classifying health outcomes into mortality, morbidity, and health impact, we summarized the relationship between individual air pollutants and health outcomes. RESULTS We analyzed a total of 27 studies that provided 104 estimates of the quantitative association between risk of mortality and exposure to air pollutants, including particulate matter with aerodynamic diameter less than 10 μm, particulate matter with aerodynamic diameter less than 2.5 μm, sulfur dioxide, nitrogen dioxide, ozone, and carbon monoxide in Korea between January 1999 and July 2018. Regarding the association with morbidity, there were 38 studies, with 98 estimates, conducted during the same period. Most studies examined the short-term effects of air pollution using a time series or case-crossover study design; only three cohort studies that examined long-term effects were found. There were four health impact studies that calculated the attributable number of deaths or disability-adjusted life years due to air pollution. CONCLUSION There have been many epidemiologic studies in Korea regarding air pollution and health. However, the present review shows that additional studies, especially cohort and experimental studies, are needed to provide more robust and accurate evidence that can be used to promote evidence-based policymaking.
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Affiliation(s)
- Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.
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Yao L, LiangLiang C, JinYue L, WanMei S, Lili S, YiFan L, HuaiChen L. Ambient air pollution exposures and risk of drug-resistant tuberculosis. ENVIRONMENT INTERNATIONAL 2019; 124:161-169. [PMID: 30641260 DOI: 10.1016/j.envint.2019.01.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 01/03/2019] [Accepted: 01/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Few epidemiological studies have explored the effects of air pollution on the risk of drug-resistant tuberculosis (DR-TB). OBJECTIVE To investigate the short and long term residential concentrations of ambient air pollutants (particulate matter <10 μm in diameter (PM10) and particulate matter≤2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)) in relation to the risk of DR-TB in a typical air pollution city, Jinan city, China. METHODS A total of 752 new culture-confirmed TB cases reported in TB prevention and control institutions of Jinan from January 1, 2014 to December 31, 2015 were included. Average individual-level concentrations of air pollution for 5 different exposure windows, vary from 90 days to 720 days to diagnosis were estimated using measurements from monitor closest to the patient home addresses. Logistic regression model adjusted for potential confounders was employed to evaluate correlation between air pollution and DR-TB risk at different five exposure windows individually. RESULTS There were substantially increased mono-drug resistance and poly-drug resistance risks for ambient PM2.5, PM10, O3, and CO exposures. High exposure to PM2.5, PM10, and CO was also significantly associated with increased incidence of multi-drug resistance (MDR) both in the single- and multi-pollutants regression models. The dominant positive associations for PM2.5was observed at 540 days exposure, for O3 was observed at 180 days exposure, and for PM10 and CO was observed from 90 days to 540 days exposures. CONCLUSIONS Our finding suggest that exposure to ambient air pollution (PM2.5, PM10, O3, and CO) are associated with increased risk of DR-TB. We provided epidemiological evidence of association between pollution exposure and mono-, poly- and multi-drug resistance.
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Affiliation(s)
- Liu Yao
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Cui LiangLiang
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Liu JinYue
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Song WanMei
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Su Lili
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Li YiFan
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
| | - Li HuaiChen
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
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Tian L, Yang C, Zhou Z, Wu Z, Pan X, Clements ACA. Spatial patterns and effects of air pollution and meteorological factors on hospitalization for chronic lung diseases in Beijing, China. SCIENCE CHINA-LIFE SCIENCES 2019; 62:1381-1388. [PMID: 30671885 DOI: 10.1007/s11427-018-9413-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/19/2018] [Indexed: 11/30/2022]
Abstract
Chronic obstructive pulmonary disease (COPD), lung cancer (LC) and tuberculosis (TB) are common chronic lung diseases that generate a large disease burden and significant health care resource use in China. The aim of this study was to quantify spatial patterns and effects of air pollution and meteorological factors on hospitalization of COPD, LC and TB in Beijing. Daily counts of hospitalization for 2010 were obtained from the Beijing Urban Employees Basic Medical Insurance (UEBMI) system. Bayesian hierarchical Poisson regression models were applied to identify spatial patterns of hospitalization for COPD, LC and TB at the district level and explore associations with inhalable particulate matter (aerodynamic diameter <10 μm, PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), mean temperature and relative humidity. There were 18,882, 14,295 and 2,940 counts of hospitalizations for COPD, LC and TB respectively, in Beijing in 2010. Clusters of high relative risk were in different locations for the three diseases. The effect of relative humidity on COPD hospitalization was most significant with a relative risk (RR) of 1.070 (95%CI: 1.054, 1.086) per one percent increase. For lung cancer hospitalization, exposure to ambient SO2 was associated with a RR of 1.034 (95%CI: 1.011, 1.058) per μg m-3 increase. For tuberculosis, the effect of mean temperature was significant with a RR of 1.107 (95%CI: 1.038, 1.180) per °C increase. Risk factors and spatial patterns were different for hospitalization of non-infectious and infectious chronic lung disease in Beijing. Even over a short time period (one year), associations were apparent with air pollution and meteorological factors.
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Affiliation(s)
- Lin Tian
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100191, China
- Institute for Packaging Materials and Pharmaceutical Excipients Control, National Institutes for Food and Drug Control, Beijing, 100150, China
| | - Chuan Yang
- Peking University Third Hospital, Beijing, 100083, China
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
| | - Zijun Zhou
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191, China
| | - Ziting Wu
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Archie C A Clements
- Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Qld, 4006, Australia
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Liu Y, Cui L, Hou L, Yu C, Tao N, Liu J, Li Y, Zhou C, Yang G, Li H. Ambient Air Pollution Exposures and Newly Diagnosed Pulmonary Tuberculosis in Jinan, China: A Time Series Study. Sci Rep 2018; 8:17411. [PMID: 30479352 PMCID: PMC6258663 DOI: 10.1038/s41598-018-35411-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 11/05/2018] [Indexed: 12/23/2022] Open
Abstract
Few epidemiological studies have evaluated the effects of air pollution on the risk of pulmonary tuberculosis (TB). We investigated the associations of ambient air pollutants (particulate matter with aerodynamic diameter <2.5 μm (PM2.5), sulfur dioxide (SO2),nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO)) in relation to the risk of pulmonary TB in a cohort of Chinese TB patient in Jinan city from 2011 to 2015. A total of 9344 newly diagnosed pulmonary TB cases were included. Poisson regression model was employed to estimate the risk of air pollution and daily diagnosed pulmonary TB. Four different air pollution exposure windows (3, 6, 9, and 12 months) before TB diagnoses were calculated from the daily concentration of air pollution. In overall analysis, we did not find strong evidence for an association between continuous exposures to most ambient air pollutants and risk for pulmonary TB. However, in categorical analysis, we observed statistically significant overall associations between pulmonary TB risk and PM2.5 (3 month exposure window: RR = 1.228, 95%CI: 1.091-1.381) as well as CO (3 month exposure window: RR = 1.169, 95%CI: 1.028-1.329; 9 month exposure window: RR = 1.442, 95%CI: 1.028-2.024) exposures. Moreover, subgroup analyses suggested that most of the air pollutants (PM2.5, SO2, O3, and CO) were significantly associated with increased risk of TB among the males, the females, the <60 years, and the smear negative cases. The dominant statistically significant associations were detected at 3-month exposure window of air pollution before the diagnosis of TB. Our results detected positive associations between ambient PM2.5, CO exposures and the risk of newly diagnosed pulmonary TB in China. The suggestive evidence that the 3 month air pollution exposure window was associated with increased TB risk warrants further investigation.
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Affiliation(s)
- Yao Liu
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - LiangLiang Cui
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, China; Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, China
| | - LuJian Hou
- Jinan Research Academy of Environmental Sciences, Jinan, Shandong, China
| | - ChunBao Yu
- Shandong Chest Hospital, Jinan, Shandong, China
| | - NingNing Tao
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - JinYue Liu
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - YiFan Li
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - ChengChao Zhou
- School of Public Health, Key Lab of Health Economics and Policy Research, Shandong University, Jinan, Shandong, China
| | - GuoRu Yang
- Department of Respiratory Medicine, Weifang No.2 People's Hospital, Weifang, Shandong, China
| | - HuaiChen Li
- Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
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50
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Elf JL, Kinikar A, Khadse S, Mave V, Suryavanshi N, Gupte N, Kulkarni V, Patekar S, Raichur P, Paradkar M, Kulkarni V, Pradhan N, Breysse PN, Gupta A, Golub JE. The association of household fine particulate matter and kerosene with tuberculosis in women and children in Pune, India. Occup Environ Med 2018; 76:40-47. [PMID: 30194271 DOI: 10.1136/oemed-2018-105122] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 07/11/2018] [Accepted: 08/14/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Household air pollution (HAP) is a risk factor for respiratory disease, however has yet to be definitively associated with tuberculosis (TB). We aimed to assess the association between HAP and TB. METHODS A matched case-control study was conducted among adult women and children patients with TB and healthy controls matched on geography, age and sex. HAP was assessed using questionnaires for pollution sources and 24-hour household concentrations of particulate matter <2.5 μm in diameter (PM2.5). RESULTS In total, 192 individuals in 96 matched pairs were included. The median 24-hour time-weighted average PM2.5 was nearly seven times higher than the WHO's recommendation of 25 µg/m3, and did not vary between controls (179 µg/m3; IQR: 113-292) and cases (median 157 µg/m3; 95% CI 93 to 279; p=0.57). Reported use of wood fuel was not associated with TB (OR 2.32; 95% CI 0.65 to 24.20) and kerosene was significantly associated with TB (OR 5.49, 95% CI 1.24 to 24.20) in adjusted analysis. Household PM2.5 was not associated with TB in univariate or adjusted analysis. Controlling for PM2.5 concentration, kerosene was not significantly associated with TB, but effect sizes ranged from OR 4.30 (95% CI 0.78 to 30.86; p=0.09) to OR 5.49 (0.82 to 36.75; p=0.08). CONCLUSIONS Use of kerosene cooking fuel is positively associated with TB in analysis using reported sources of exposure. Ubiquitously high levels of particulates limited detection of a difference in household PM2.5 between cases and controls.
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Affiliation(s)
- Jessica L Elf
- Department of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Department of Medicine, Division of Infectious Diseases, Center for TB Research, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.,Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Aarti Kinikar
- Pediatrics Department, Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
| | - Sandhya Khadse
- Pediatrics Department, Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India
| | - Vidya Mave
- Department of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Nishi Suryavanshi
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Nikhil Gupte
- Department of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Vaishali Kulkarni
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | - Sunita Patekar
- Byramjee Jeejeebhoy Government Medical College and Sassoon Government Hospitals, Pune, India
| | - Priyanka Raichur
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Mandar Paradkar
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Vandana Kulkarni
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Neeta Pradhan
- Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India
| | - Patrick N Breysse
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Currently employed by the Centers for Disease Control and Prevention. Patrick Breysse is serving in his personal capacity
| | - Amita Gupta
- Department of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jonathan E Golub
- Department of Medicine, Division of Infectious Diseases, Center for TB Research, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.,Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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