Ambient air pollution contributed to pulmonary tuberculosis in China

Area of Science:

• Environmental epidemiology
• Public health
• Respiratory medicine

Background:

• Published studies on outdoor air pollution and tuberculosis risk have yielded inconsistent results.
• Discrepancies may stem from limited geographic scope, varied exposure durations, and diverse statistical methods in prior research.

Purpose of the Study:

• To comprehensively investigate the association between ambient air pollutants and tuberculosis risk.
• To address limitations of previous studies by employing a multi-province, multi-city time-series design.

Main Methods:

• A time-series study was conducted across 67 districts/counties in China from 2014 to 2019.
• Data on newly diagnosed pulmonary tuberculosis (PTB) cases, air pollutant concentrations (SO2, NO2, PM10, PM2.5, CO), and meteorological factors were collected.
• A generalized additive model was used to assess the relationship between air pollutants and PTB risk.

Main Results:

• A total of 172,160 new PTB cases were reported during the study period.
• Increases in SO2, NO2, PM10, PM2.5, and CO were associated with elevated PTB risk, with specific percentage increases and lag times reported for each pollutant.
• For instance, a 10-μg/m³ increase in SO2 was linked to a 1.97% rise in PTB risk (lag 0 week).

Conclusions:

• Ambient air pollutants show a positive correlation with tuberculosis risk.
• Findings suggest that reducing outdoor air pollutant concentrations could be a strategy to mitigate the burden of tuberculosis, particularly in regions with high prevalence of both air pollution and TB.