The associations of ambient fine particles with tuberculosis incidence and the modification effects of ambient temperature: A nationwide time-series study in China

Jia Wang; Wen Li; Wenzhong Huang; Yuan Gao; Yanming Liu; Qian Hui Teng; Qi Zhao; Mingting Chen; Yuming Guo; Wei Ma

doi:10.1016/j.jhazmat.2023.132448

The associations of ambient fine particles with tuberculosis incidence and the modification effects of ambient temperature: A nationwide time-series study in China

J Hazard Mater. 2023 Oct 15:460:132448. doi: 10.1016/j.jhazmat.2023.132448. Epub 2023 Sep 1.

Authors

Jia Wang¹, Wen Li², Wenzhong Huang³, Yuan Gao³, Yanming Liu³, Qian Hui Teng³, Qi Zhao⁴, Mingting Chen⁵, Yuming Guo⁶, Wei Ma⁷

Affiliations

¹ National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
² Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China; Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁴ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China.
⁵ National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: chenmt@chinacdc.cn.
⁶ Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: yuming.guo@monash.edu.
⁷ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Shandong University Climate Change and Health Center, Jinan, Shandong, China. Electronic address: weima@sdu.edu.cn.

PMID: 37683354
DOI: 10.1016/j.jhazmat.2023.132448

Abstract

Ambient fine particulate matter (PM_2.5) is a major air pollutant that poses significant risks to human health. However, little is known about the association of PM_2.5 with tuberculosis (TB) incidence, and whether temperature modifies the association.This study aimed to explore the association between ambient PM_2.5 exposure and TB incidence in China and the modification effects of temperature. Weekly meteorological data, PM_2.5 concentrations, and TB incidence numbers were collected for 22 cities across Mainland China, from 2011 to 2020. A quasi-Poisson regression with the distributed lag non-linear model was used to assess city-specific PM_2.5-TB associations. A multivariate meta-regression model was then used to pool the city-specific effect estimates, at the national and regional levels. A J-shaped PM_2.5-TB relationship was observed at the national level for China. Compared to those with minimum PM_2.5-TB risk, people who were exposed to the highest PM_2.5 concentrations had a 26 % (RR:1.26, 95 % confidence interval [CI]: 1.05, 1.52) higher risk for TB incidence. J-shaped PM_2.5-TB associations were also observed for most sub-groups, however, no significant modifying effects were found. While a trend was observed between low temperatures and increased exposure-response associations, these results were not significant. Overall, approximately 20 % of TB cases in the 22 study cities, over the period 2011-2020, could be attributed to PM_2.5 exposure. Strengthening the monitoring and emission control of PM_2.5 could aid the prevention and control of TB incidence.

Keywords: Ambient Particulate Matter; China; Risk assessment; Tuberculosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants*
China / epidemiology
Humans
Incidence
Temperature
Tuberculosis* / epidemiology

Substances

Air Pollutants