Epidemiological Correlation of Pulmonary Aspergillus Infections with Ambient Pollutions and Influenza A (H1N1) in
Jien-Wei Liu1,2, Yee-Huang Ku3, Chien-Ming Chao3
1Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
Abstract:
An increase in fungal spores in ambient air is reported during a spike in particulate matter (PM2.5 and PM10) aerosols generated during dust or smog events. However, little is known about the impact of ambient bioaerosols on fungal infections in humans. To identify the correlation between the incidence of pulmonary aspergillosis and PM-associated bioaerosols (PM2.5 and PM10), we retrospectively analyzed data between 2015 and 2018 (first stage) and prospectively analyzed data in 2019 (second stage). Patient data were collected from patients in three medical institutions in Tainan, a city with a population of 1.88 million, located in southern Taiwan. PM data were obtained from the Taiwan Air Quality Monitoring Network. Overall, 544 non-repeated aspergillosis patients (first stage, n = 340; second stage, n = 204) were identified and enrolled for analysis. The trend of aspergillosis significantly increased from 2015 to 2019. Influenza A (H1N1) and ambient PMs (PM2.5 and PM10) levels had significant effects on aspergillosis from 2015 to 2018. However, ambient PMs and influenza A (H1N1) in Tainan were correlated with the occurrence of aspergillosis in 2018 and 2019, respectively. Overall (2015-2019), aspergillosis was significantly correlated with influenza (p = 0.002), influenza A (H1N1) (p < 0.001), and PM2.5 (p = 0.040) in Tainan City. Using a stepwise regression model, influenza A (H1N1) (p < 0.0001) and Tainan PM10 (p = 0.016) could significantly predict the occurrence of aspergillosis in Tainan. PM-related bioaerosols and influenza A (H1N1) contribute to the incidence of pulmonary aspergillosis.
Insights
High levels of particulate matter (PM) and influenza A (H1N1) are linked to increased cases of pulmonary aspergillosis. This study highlights the impact of air quality and viral infections on this fungal disease.
Area of Science:
- Environmental Health
- Mycology
- Infectious Diseases
Background:
- Ambient air pollution, specifically particulate matter (PM2.5 and PM10), is associated with increased fungal spores.
- The impact of these bioaerosols on human fungal infections, particularly pulmonary aspergillosis, remains under-researched.
- Understanding these environmental and infectious links is crucial for public health strategies.
Purpose of the Study:
- To investigate the correlation between pulmonary aspergillosis incidence and PM-associated bioaerosols (PM2.5 and PM10).
- To analyze the influence of influenza A (H1N1) on aspergillosis occurrence.
- To identify key predictors of aspergillosis in Tainan City.
Main Methods:
- Retrospective (2015-2018) and prospective (2019) analysis of 544 aspergillosis patient data from Tainan, Taiwan.
- Correlation analysis with air quality data (PM2.5, PM10) from the Taiwan Air Quality Monitoring Network.
- Stepwise regression modeling to determine significant predictors of aspergillosis.
Main Results:
- A significant increasing trend in aspergillosis cases was observed from 2015 to 2019.
- Both PM2.5 and PM10 levels, along with influenza A (H1N1), showed significant correlations with aspergillosis.
- Influenza A (H1N1) and PM10 were identified as significant predictors of aspergillosis occurrence.
Conclusions:
- PM-associated bioaerosols and influenza A (H1N1) significantly contribute to the incidence of pulmonary aspergillosis.
- Air quality monitoring and influenza surveillance are important for managing aspergillosis risk.
- Findings underscore the interplay between environmental factors, viral infections, and fungal disease.
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