Environmental science and pollution research international
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Environ Sci Pollut Res Int · Jun 2021
Effect of ambient air pollution on tuberculosis risks and mortality in Shandong, China: a multi-city modeling study of the short- and long-term effects of pollutants.
Few studies conducted in China have assessed the effects of ambient air pollution exposure on tuberculosis (TB) risk and mortality, especially with a multicity setting. We evaluated the effect of short- and long-term ambient sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and particulate matter≤2.5 μm in aerodynamic diameter (PM2.5) exposures on development and mortality of active TB in 7 Chinese cities in Shandong province from January 1, 2013, to December 31, 2017. We estimated the pollution-associated risk to new infection TB, recurrent TB, and mortality in relation to 1-μg/m3 increases in air pollutants using the penalized multivariate Poisson regression models. ⋯ We estimated an increase of 1.33% (95% CI 1.29%, 1.37%) and 3.04% (95% CI 2.98%, 3.11%) in new infection TB count for each 1-μg/m3 increase of SO2 at lag 0-180 days and PM2.5 at lag 0-365 days, respectively. This epidemiologic study in China shows that air pollution exposure is associated with increased risk of active TB development and mortality. The control of ambient air pollution may benefit the control and decrease the mortality of TB disease.