School of Health Sciences, Wuhan University, 115 Donghu Road, 430071, Wuhan, China.
Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, 1960 East West Rd, Biomed Bldg, D105, Honolulu, USA.
Environ Res. 2021 Jan;192:110327. doi: 10.1016/j.envres.2020.110327. Epub 2020 Oct 17.
Evidence suggests that air pollution is associated with many adverse health outcomes such as cardiovascular diseases (CVD), respiratory diseases, cancer, and birth defects. Yet few studies dig into the relationship between air pollution and airborne infectious diseases.
Daily data on influenza incidence were obtained from Hubei Provincial Center for Disease Control and Prevention (Hubei CDC). Data on air pollutants including nitrogen dioxide (NO), sulfur dioxide (SO), ground-level ozone (O), particulate matter (PM) with aerodynamic diameter ≤ 2.5 μm (PM), and PM with aerodynamic diameter ≤ 10 μm (PM) were retrieved from ten national air sampling stations located at Wuhan. We applied generalized additive model (GAM) to estimate the associations between air pollution and the risk of influenza in Wuhan, China during 2015-2017.
In the single-day lag model, the largest effect estimates were observed at lag 0. An increased relative risk (RR) of influenza was significantly associated with a 10 μg/m increase in SO (RR: 1.099; 95% confidence interval [CI]: 1.011-1.195), NO (RR: 1.039; 95% CI: 1.013-1.065), and O (RR: 1.005; 95% CI: 0.994-1.016), respectively. In the multi-day lag model, concentrations of SO, NO, and O were statistically significantly associated with the risk of influenza at lag 0-1. The seasonal analysis suggests that the influence of air pollution on influenza is greater in the cold season as compared in the warm season in the early lag days. The multi-pollutant model indicates that NO may be a potential confounder for co-pollutants.
Our study shows that air pollution may be associated with the risk of influenza in a broad sense. Therefore, when formulating policies to deal with influenza outbreaks in the future, factors regarding air pollution should be taken into consideration.
有证据表明，空气污染与许多不良健康后果有关，如心血管疾病（CVD）、呼吸道疾病、癌症和出生缺陷。然而，很少有研究深入探讨空气污染与空气传播传染病之间的关系。
从湖北省疾病预防控制中心（Hubei CDC）获得每日流感发病率数据。从位于武汉的十个国家空气采样站获取了包括二氧化氮（NO）、二氧化硫（SO）、地面臭氧（O）、空气动力学直径≤2.5μm 的颗粒物（PM）和空气动力学直径≤10μm 的颗粒物（PM）在内的空气污染物数据。我们应用广义相加模型（GAM）估计 2015-2017 年期间中国武汉空气污染与流感风险之间的关系。
在单日滞后模型中，滞后 0 时观察到最大的效应估计值。流感的相对风险（RR）与 SO（RR：1.099；95%置信区间[CI]：1.011-1.195）、NO（RR：1.039；95% CI：1.013-1.065）和 O（RR：1.005；95% CI：0.994-1.016）浓度每增加 10μg/m 呈显著正相关。在多日滞后模型中，SO、NO 和 O 的浓度在滞后 0-1 时与流感的风险呈统计学显著相关。季节性分析表明，与温暖季节相比，寒冷季节空气污染对流感的影响更大。多污染物模型表明，NO 可能是共污染物的潜在混杂因素。
我们的研究表明，空气污染可能与流感风险广义相关。因此，在未来制定应对流感爆发的政策时，应考虑与空气污染有关的因素。
