Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
Department of Clinical Laboratory, Yixing People's Hospital, Wuxi, 214200, People's Republic of China.
Int J Infect Dis. 2019 Oct;87:177-184. doi: 10.1016/j.ijid.2019.07.027. Epub 2019 Jul 30.
To explore the long-term effect of exposure to ambient air pollution on the risk of active tuberculosis (TB).
We constructed a distributed-lag nonlinear model (DLNM) to evaluate the relatively long-term influence of outdoor PM, PM, SO and NO exposure on active TB risk in the city of Lianyungang in Jiangsu Province, China.
There were 7,282 TB cases reported in the study area during 2014-2017, with annual median (interquartile range) concentrations of PM, PM, SO and NO at 45.86 (34.57-64.14) μg/m, 85.43 (62.86-116.14) μg/m, 22.00 (15.71-30.86) μg/m and 30.00 (23.29-38.57) μg/m, respectively. The single-pollutant model showed that for each 10 μg/m increase in concentration, the cumulative relative risk of TB was 1.12 (lag 0-24 weeks, 95% CI: 1.03-1.22) for PM with reference to 35 μg/m; 1.11 (lag 0-21 weeks, 95% CI: 1.06-1.17) for PM with reference to 70 μg/m; 1.37 (lag 0-20 weeks, 95% CI: 1.16-1.62) for SO with reference to 60 μg/m; and 1.29 (lag 0-22 weeks, 95% CI: 1.11-1.49) for NO with reference to 40 μg/m. In the multipollutant model considering both PM and NO, the association remained significant.
Our results revealed a potential association between outdoor exposure to PM, PM, SO, and NO 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.
探讨暴露于环境空气污染对活动性肺结核（TB）风险的长期影响。
我们构建了一个分布式滞后非线性模型（DLNM），以评估中国江苏省连云港市户外 PM、PM、SO 和 NO 暴露对活动性 TB 风险的相对长期影响。
在 2014-2017 年期间，研究区域报告了 7282 例 TB 病例，PM、PM、SO 和 NO 的年中位数（四分位距）浓度分别为 45.86（34.57-64.14）μg/m、85.43（62.86-116.14）μg/m、22.00（15.71-30.86）μg/m 和 30.00（23.29-38.57）μg/m。单污染物模型显示，与 35μg/m 相比，浓度每增加 10μg/m，TB 的累积相对风险为 1.12（滞后 0-24 周，95%CI：1.03-1.22）；与 70μg/m 相比，PM 为 1.11（滞后 0-21 周，95%CI：1.06-1.17）；与 60μg/m 相比，SO 为 1.37（滞后 0-20 周，95%CI：1.16-1.62）；与 40μg/m 相比，NO 为 1.29（滞后 0-22 周，95%CI：1.11-1.49）。在同时考虑 PM 和 NO 的多污染物模型中，关联仍然显著。
我们的结果表明，户外暴露于 PM、PM、SO 和 NO 与活动性 TB 之间存在潜在关联。考虑到发展中国家的人们继续暴露于严重的户外空气污染和高比例的潜伏性 TB 感染，空气污染恶化与活动性 TB 之间的关联值得进一步关注。
