Weaver Amanda K, Keeney Nicole, Head Jennifer R, Heaney Alexandra K, Camponuri Simon K, Collender Philip, Bhattachan Abinash, Okin Gregory S, Eisen Ellen A, Sondermeyer-Cooksey Gail, Yu Alexander, Vugia Duc J, Jain Seema, Balmes John, Taylor John, Remais Justin V, Strickland Matthew J
Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California, USA.
Department of Geosciences, Texas Tech University, Lubbock, Texas, USA.
Environ Health Perspect. 2025 Jan;133(1):17003. doi: 10.1289/EHP13875. Epub 2025 Jan 13.
Coccidioidomycosis, caused by inhalation of spp. spores, is an emerging infectious disease that is increasing in incidence throughout the southwestern US. The pathogen is soil-dwelling, and spore dispersal and human exposure are thought to co-occur with airborne mineral dust exposures, yet fundamental exposure-response relationships have not been conclusively estimated.
We estimated associations between fine mineral dust concentration and coccidioidomycosis incidence in California from 2000 to 2017 at the census tract level, spatiotemporal heterogeneity in exposure-response, and effect modification by antecedent climate conditions.
We acquired monthly census tract-level coccidioidomycosis incidence data and modeled fine mineral dust concentrations from 2000 to 2017. We fitted zero-inflated distributed-lag nonlinear models to estimate overall exposure-lag-response relationships and identified factors contributing to heterogeneity in exposure-responses. Using a random-effects meta-analysis approach, we estimated county-specific and pooled exposure-responses for cumulative exposures.
We found a positive exposure-response relationship between cumulative fine mineral dust exposure in the 1-3 months before estimated disease onset and coccidioidomycosis incidence across the study region [incidence rate ratio (IRR) for an increase from 0.1 to ; 95% CI: 1.46, 1.74]. Positive, supralinear associations were observed between incidence and modeled fine mineral dust exposures 1 [ (95% CI: 1.10, 1.17)], 2 [ (95% CI: 1.09, 1.20)] and 3 [ (95% CI: 1.04, 1.12)] months before estimated disease onset, with the highest exposures being particularly associated. The cumulative exposure-response relationship varied significantly by county [lowest IRR, western Tulare: 1.05 (95% CI: 0.54, 2.07); highest IRR, San Luis Obispo: 3.01 (95% CI: 2.05, 4.42)]. Season of exposure and prior wet winter were modest effect modifiers.
Lagged exposures to fine mineral dust were strongly associated with coccidioidomycosis incidence in the endemic regions of California from 2000 to 2017. https://doi.org/10.1289/EHP13875.
球孢子菌病由吸入球孢子菌属孢子引起，是一种新发传染病，在美国西南部发病率呈上升趋势。该病原体存在于土壤中，孢子传播和人类接触被认为与空气中的矿物粉尘接触同时发生，但基本的暴露-反应关系尚未得到最终确定。
我们估计了2000年至2017年加利福尼亚州普查区层面细矿物粉尘浓度与球孢子菌病发病率之间的关联、暴露-反应的时空异质性以及前期气候条件的效应修正。
我们获取了普查区层面每月的球孢子菌病发病率数据，并对2000年至2017年的细矿物粉尘浓度进行建模。我们拟合了零膨胀分布滞后非线性模型，以估计总体暴露-滞后-反应关系，并确定导致暴露-反应异质性的因素。使用随机效应荟萃分析方法，我们估计了县特异性和累积暴露的合并暴露-反应。
我们发现，在估计疾病发作前1-3个月的累积细矿物粉尘暴露与整个研究区域的球孢子菌病发病率之间存在正暴露-反应关系[发病率比值比（IRR），从0.1增加到；95%置信区间：1.46，1.74]。在估计疾病发作前1 [（95%置信区间：1.10，1.17）]、2 [（95%置信区间：1.09，1.20）]和3 [（95%置信区间：1.04，1.12）]个月，发病率与建模的细矿物粉尘暴露之间观察到正的、超线性关联，最高暴露尤其相关。累积暴露-反应关系因县而异[最低IRR，图莱里西部：1.05（95%置信区间：0.54，2.07）；最高IRR，圣路易斯奥比斯波：3.01（95%置信区间：2.05，4.42）]。暴露季节和前期湿润冬季是适度的效应修正因素。
2000年至2017年，加利福尼亚州地方病流行区滞后暴露于细矿物粉尘与球孢子菌病发病率密切相关。https://doi.org/10.1289/EHP13875 。
