Zhang Xiaolong, Li Zhongqi, Tao Bilin, Fu Ying, Cui Caiyan, Wang Feixian, Li Yun, Wang Yu, Jiang Jun, Wang Jianming
Department of Tuberculosis Control and Prevention, Suzhou Center for Disease Control and Prevention, Suzhou, China.
Department of Epidemiology, Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
BMJ Open. 2025 Mar 26;15(3):e089290. doi: 10.1136/bmjopen-2024-089290.
The detrimental effects of particulate matter (PM) on human health have been widely corroborated. We aimed to examine the association between outdoor PM and the drug resistance risk among workers and farmers with pulmonary tuberculosis (PTB).
We performed a population-based time-series study using routinely collected meteorological and TB surveillance data.
We selected Suzhou City, China, as the study area. Data on patients with PTB and meteorological factors were extracted from the National Tuberculosis Online Registration System and the China Meteorological Data Sharing Center.
This study included 7868 patients with PTB diagnosed from January 2017 to December 2021 in Suzhou.
The generalised additive model was used to estimate the effects of outdoor PM on the drug resistance risk of TB among workers and farmers who typically work outdoors. Moreover, subgroup analyses were carried out to evaluate the associations in different populations and seasons.
Although there was no significant association between PM with an aerodynamic diameter≤10 µm (PM) and drug-resistant risk in the overall analysis, subgroup analysis revealed a significant positive association in the winter season. Similarly, PM with an aerodynamic diameter≤2.5 µm (PM) was significantly associated with drug resistance risk among males with a lag of 0-3 days, people ≤60 years with a lag of 0-7 days and in the winter season with a lag of 0-7 days, 0-15 days, 0-90 days or 0-180 days.
Outdoor PM and PM were positively related to the drug resistance risk of workers and farmers with PTB. Reducing ambient PM pollution might reduce the burden of TB. Further research is required to verify the association through in vitro experiments and extensive cohort studies.
颗粒物（PM）对人类健康的有害影响已得到广泛证实。我们旨在研究室外PM与肺结核（PTB）患者（工人和农民）耐药风险之间的关联。
我们使用常规收集的气象和结核病监测数据进行了一项基于人群的时间序列研究。
我们选择中国苏州市作为研究区域。PTB患者数据和气象因素数据分别从全国结核病在线登记系统和中国气象数据共享中心提取。
本研究纳入了2017年1月至2021年12月在苏州诊断的7868例PTB患者。
采用广义相加模型估计室外PM对通常在户外工作的工人和农民结核病耐药风险的影响。此外，还进行了亚组分析，以评估不同人群和季节中的关联。
尽管在总体分析中，空气动力学直径≤10μm的颗粒物（PM₁₀）与耐药风险之间无显著关联，但亚组分析显示在冬季存在显著正相关。同样，空气动力学直径≤2.5μm的颗粒物（PM₂.₅）与男性（滞后0 - 3天）、年龄≤60岁的人群（滞后0 - 7天）以及冬季（滞后0 - 7天、0 - 15天、0 - 90天或0 - 180天）的耐药风险显著相关。
室外PM₁₀和PM₂.₅与PTB患者（工人和农民）的耐药风险呈正相关。减少环境PM污染可能会减轻结核病负担。需要进一步的研究通过体外实验和广泛的队列研究来验证这种关联。
