Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, People's Republic of China.
Emerg Microbes Infect. 2024 Dec;13(1):2399275. doi: 10.1080/22221751.2024.2399275. Epub 2024 Sep 5.
Published studies on outdoor air pollution and tuberculosis risk have shown heterogeneous results. Discrepancies in prior studies may be partially explained by the limited geographic scope, diverse exposure times, and heterogeneous statistical methods. Thus, we conducted a multi-province, multi-city time-series study to comprehensively investigate this issue. We selected 67 districts or counties from all geographic regions of China as study sites. We extracted data on newly diagnosed pulmonary tuberculosis (PTB) cases, outdoor air pollutant concentrations, and meteorological factors in 67 sites from January 1, 2014 to December 31, 2019. We utilized a generalized additive model to evaluate the relationship between ambient air pollutants and PTB risk. Between 2014 and 2019, there were 172,160 newly diagnosed PTB cases reported in 67 sites. With every 10-μg/m increase in SO, NO, PM, PM, and 1-mg/m in CO, the PTB risk increased by 1.97% [lag 0 week, 95% confidence interval (CI): 1.26, 2.68], 1.30% (lag 0 week, 95% CI: 0.43, 2.19), 0.55% (lag 8 weeks, 95% CI: 0.24, 0.85), 0.59% (lag 10 weeks, 95% CI: 0.16, 1.03), and 5.80% (lag 15 weeks, 95% CI: 2.96, 8.72), respectively. Our results indicated that ambient air pollutants were positively correlated with PTB risk, suggesting that decreasing outdoor air pollutant concentrations may help to reduce the burden of tuberculosis in countries with a high burden of tuberculosis and air pollution.
已发表的关于室外空气污染和结核病风险的研究结果存在差异。先前研究中的差异部分可以用有限的地理范围、不同的暴露时间和不同的统计方法来解释。因此，我们进行了一项多省份、多城市的时间序列研究，以全面研究这个问题。我们选择了中国所有地理区域的 67 个区或县作为研究地点。我们从 2014 年 1 月 1 日至 2019 年 12 月 31 日从 67 个地点提取了新诊断的肺结核（PTB）病例、室外空气污染物浓度和气象因素的数据。我们利用广义加性模型评估了环境空气污染物与 PTB 风险之间的关系。2014 年至 2019 年期间，67 个地点报告了 172160 例新诊断的 PTB 病例。SO、NO、PM、PM 每增加 10μg/m 和 CO 每增加 1mg/m，PTB 风险分别增加 1.97%（滞后 0 周，95%置信区间：1.26，2.68）、1.30%（滞后 0 周，95%置信区间：0.43，2.19）、0.55%（滞后 8 周，95%置信区间：0.24，0.85）、0.59%（滞后 10 周，95%置信区间：0.16，1.03）和 5.80%（滞后 15 周，95%置信区间：2.96，8.72）。我们的结果表明，环境空气污染物与 PTB 风险呈正相关，这表明降低室外空气污染物浓度可能有助于减轻结核病负担和空气污染负担较重的国家的结核病负担。
