Kumari Nisha, Singh Shashi Bhushan, Kumar Dewesh, Singh Geetu, Yannawar Pravin, Majhee Lakhan, Kumar Anjani, Keshri Nitika, Kumar Sandip, Mahto Sunil Kumar
Department of Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Department of Community Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Lung India. 2025 Jul 1;42(4):359-366. doi: 10.4103/lungindia.lungindia_552_24. Epub 2025 Jun 27.
Tuberculosis (TB) is a major global health challenge, particularly in polluted areas. The relationship between ambient particulate matter and TB risk remains unclear, making this systematic review and meta-analysis (SRMA) vital for assessing this link. This SRMA aimed to estimate the association between exposure to ambient particulate matter (PM10 and PM2.5) and the risk of pulmonary tuberculosis (PTB) infection. A literature search was conducted in PubMed, Web of Science, and Cochrane (English-language studies) on January 29, 2024. The review followed PRISMA Guidelines (2020) for comprehensive literature searches, data extraction, and quality assessment of included studies. A random-effects model was used for meta-analysis to estimate pooled effect sizes and assess heterogeneity. Study quality and publication bias were also evaluated. Of the 507 articles identified, 25 met the inclusion criteria. Long-term PM2.5 exposure was linked to a 26% increase in PTB risk (RR =1.26, 95% CI: 1.07-1.48), while short-term exposure raised the risk by 10% (RR =1.10, 95% CI: 0.98-1.25). Long-term PM10 exposure increased PTB risk by 7% (RR =1.07, 95% CI: 1.02-1.12), with short-term exposure showing a similar increase (RR =1.07, 95% CI: 0.95-1.17). Subgroup analysis revealed PTB risk increased by 15% in males and 29% in females for PM2.5, and by 10% in males and 7% in females for PM10. A 10 µg/m³ increase in Particulate matter is associated with a higher risk of pulmonary tuberculosis, highlighting the need for targeted public health measures to reduce particulate exposure, especially in high-risk urban and industrial areas.
结核病是一项重大的全球卫生挑战,在污染地区尤为如此。环境颗粒物与结核病风险之间的关系仍不明确,因此本系统评价和荟萃分析对于评估这种关联至关重要。本系统评价和荟萃分析旨在估计暴露于环境颗粒物(PM10和PM2.5)与肺结核(PTB)感染风险之间的关联。2024年1月29日,我们在PubMed、科学网和考科蓝(英文研究)数据库中进行了文献检索。本评价遵循PRISMA指南(2020年)进行全面的文献检索、数据提取和纳入研究的质量评估。荟萃分析采用随机效应模型来估计合并效应量并评估异质性。同时还评估了研究质量和发表偏倚。在识别出的507篇文章中,25篇符合纳入标准。长期暴露于PM2.5会使PTB风险增加26%(风险比=1.26,95%置信区间:1.07-1.48),而短期暴露会使风险增加10%(风险比=1.10,95%置信区间:0.98-1.25)。长期暴露于PM10会使PTB风险增加7%(风险比=1.07,95%置信区间:1.02-1.12),短期暴露也有类似程度的增加(风险比=1.07,95%置信区间:0.95-1.17)。亚组分析显示,对于PM2.5,男性的PTB风险增加15%,女性增加29%;对于PM10,男性增加10%,女性增加7%。颗粒物每增加10微克/立方米与患肺结核的风险更高相关,这凸显了采取有针对性的公共卫生措施以减少颗粒物暴露的必要性,尤其是在高风险的城市和工业区。