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Particulate matter deposition and its impact on tuberculosis severity: A cross-sectional study in Taipei
Firdian Makrufardi1, Hsiao-Chi Chuang2, Chi-Won Suk3
1International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada - Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Abstract:
The objective of this study was to examine the association between the lung lobe-deposited dose of inhaled fine particulate matter (PM2.5) and chest X-ray abnormalities in different lung lobes of pulmonary tuberculosis (TB), multidrug-resistant tuberculosis (MDR-TB), and non-tuberculosis mycobacteria infections (NTM). A cross-sectional study was conducted between 2014 and 2022, comprising 1073 patients who were recruited from chest department clinic in a tertial refer hospital in Taipei City, Taiwan. Ambient 1-, 7-, and 30-day PM2.5 exposure and the deposition of PM2.5 in different lung lobes were estimated in each subject. The β coefficient for PM2.5 and deposited PM2.5 in lungs with the outcome variables (pulmonary TB, MDR-TB, and NTM infection) was derived through regression analysis and adjusted for age, gender, BMI, smoking status, and family income. We observed that a 1 μg/m3 increase in ambient PM2.5 was associated with an increase of MDR-TB infections of 0.004 times (95%CI: 0.001-0.007). A 1 μg/m3 increase in 1-day and 7-day PM2.5 deposition in left upper lobe and left lower lobe was associated with an increase in chest X-ray abnormalities of 9.19 % and 1.18 % (95%CI: 0.87-17.51 and 95%CI: 0.08-2.28), and 4.52 % and 5.20 % (95%CI: 0.66-8.38 and 95%CI: 0.51-9.89) in left lung of TB patients, respectively. A 1 μg/m3 increase in 30-day PM2.5 deposition in alveolar region was associated with an increase in percent abnormality of 2.50 % (95%CI: 0.65-4.35) in left upper lobe and 3.33 % (95%CI: 0.65-6.01) in right middle lobe, while in total lung was 0.63 % (95%CI: 0.01-1.27) in right upper lobe and 0.37 % (95%CI, 0.06-0.81) in right lung of MDR-TB patients. Inhaled PM2.5 deposition in lungs was associated with an exacerbation of the radiographic severity of pulmonary TB, particularly in pulmonary MDR-TB patients in upper and middle lobes. Particulate air pollution may potentially exacerbate the radiographic severity and treatment resistance in individuals with pulmonary TB.
Insights
Fine particulate matter (PM2.5) exposure is linked to increased chest X-ray abnormalities in tuberculosis patients. Air pollution may worsen radiographic severity and treatment resistance, especially in multidrug-resistant tuberculosis (MDR-TB).
Area of Science:
- Environmental Health
- Respiratory Medicine
- Public Health
Background:
- Particulate matter (PM2.5) is a significant air pollutant with known respiratory effects.
- Tuberculosis (TB), including multidrug-resistant TB (MDR-TB), remains a global health challenge.
- The specific impact of PM2.5 deposition on lung abnormalities in TB patients requires further investigation.
Purpose of the Study:
- To investigate the association between lung lobe-deposited dose of inhaled PM2.5 and chest X-ray abnormalities.
- To differentiate these associations across pulmonary tuberculosis (TB), multidrug-resistant tuberculosis (MDR-TB), and non-tuberculosis mycobacteria (NTM) infections.
- To explore the relationship between ambient and deposited PM2.5 and radiographic severity in different lung lobes.
Main Methods:
- A cross-sectional study involving 1073 patients from Taipei City, Taiwan (2014-2022).
- Estimation of ambient and deposited PM2.5 in different lung lobes for each subject.
- Regression analysis adjusted for age, gender, BMI, smoking status, and family income to derive β coefficients.
Main Results:
- A 1 μg/m³ increase in ambient PM2.5 was associated with a 0.004 times increase in MDR-TB infections.
- Increased PM2.5 deposition in specific lung lobes correlated with higher percentages of chest X-ray abnormalities in TB patients.
- PM2.5 deposition in the alveolar region was linked to increased abnormalities in specific lobes of MDR-TB patients.
Conclusions:
- Inhaled PM2.5 deposition is associated with exacerbated radiographic severity of pulmonary TB, particularly in MDR-TB.
- Particulate air pollution may worsen radiographic findings and contribute to treatment resistance in pulmonary TB.
- Findings highlight the potential public health impact of air quality on TB management and outcomes.
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