tetano
Editor, Senior Moderator
Environ Health Perspect
. 2023 Dec;131(12):127009.
doi: 10.1289/EHP12145. Epub 2023 Dec 11. Associations between Short-Term Exposure to Ambient Air Pollution and Influenza: An Individual-Level Case-Crossover Study in Guangzhou, China
Rong Zhang[SUP] 1 2 [/SUP], Ka Yan Lai[SUP] 1 2 [/SUP], Wenhui Liu[SUP] 3 [/SUP], Yanhui Liu[SUP] 3 [/SUP], Xiaowei Ma[SUP] 3 [/SUP], Chris Webster[SUP] 1 2 [/SUP], Lei Luo[SUP] 3 [/SUP], Chinmoy Sarkar[SUP] 1 2 4 [/SUP]
Affiliations
Background: Influenza imposes a heavy burden on public health. Little is known, however, of the associations between detailed measures of exposure to ambient air pollution and influenza at an individual level.
Objective: We examined individual-level associations between six criteria air pollutants and influenza using case-crossover design.
Methods: In this individual-level time-stratified case-crossover study, we linked influenza cases collected by the Guangzhou Center for Disease Control and Prevention from 1 January 2013 to 31 December 2019 with individual residence-level exposure to particulate matter (PM2.5
and PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3
) and carbon monoxide (CO). The exposures were estimated for the day of onset of influenza symptoms (lag 0), 1-7 d before the onset (lags 1-7), as well as an 8-d moving average (lag07), using a random forest model and linked to study participants' home addresses. Conditional logistic regression was developed to investigate the associations between short-term exposure to air pollution and influenza, adjusting for mean temperature, relative humidity, public holidays, population mobility, and community influenza susceptibility.
Results: N=108,479
eligible cases were identified in our study. Every 10-μg/m3 increase in exposure to PM2.5, PM10, NO2, and CO and every 5-μg/m3 increase in SO2 over 8-d moving average (lag07) was associated with higher risk of influenza with a relative risk (RR) of 1.028 (95% CI: 1.018, 1.038), 1.041 (95% CI: 1.032, 1.049), 1.169 (95% CI: 1.151, 1.188), 1.004 (95% CI: 1.003, 1.006), and 1.134 (95% CI: 1.107, 1.163), respectively. There was a negative association between O3
and influenza with a RR of 0.878 (95% CI: 0.866, 0.890).
Conclusions: Our findings suggest that short-term exposure to air pollution, except for O3
, is associated with greater risk for influenza. Further studies are necessary to decipher underlying mechanisms and design preventive interventions and policies. https://doi.org/10.1289/EHP12145.
. 2023 Dec;131(12):127009.
doi: 10.1289/EHP12145. Epub 2023 Dec 11. Associations between Short-Term Exposure to Ambient Air Pollution and Influenza: An Individual-Level Case-Crossover Study in Guangzhou, China
Rong Zhang[SUP] 1 2 [/SUP], Ka Yan Lai[SUP] 1 2 [/SUP], Wenhui Liu[SUP] 3 [/SUP], Yanhui Liu[SUP] 3 [/SUP], Xiaowei Ma[SUP] 3 [/SUP], Chris Webster[SUP] 1 2 [/SUP], Lei Luo[SUP] 3 [/SUP], Chinmoy Sarkar[SUP] 1 2 4 [/SUP]
Affiliations
- PMID: 38078424
- PMCID: PMC10711742
- DOI: 10.1289/EHP12145
Background: Influenza imposes a heavy burden on public health. Little is known, however, of the associations between detailed measures of exposure to ambient air pollution and influenza at an individual level.
Objective: We examined individual-level associations between six criteria air pollutants and influenza using case-crossover design.
Methods: In this individual-level time-stratified case-crossover study, we linked influenza cases collected by the Guangzhou Center for Disease Control and Prevention from 1 January 2013 to 31 December 2019 with individual residence-level exposure to particulate matter (PM2.5
and PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3
) and carbon monoxide (CO). The exposures were estimated for the day of onset of influenza symptoms (lag 0), 1-7 d before the onset (lags 1-7), as well as an 8-d moving average (lag07), using a random forest model and linked to study participants' home addresses. Conditional logistic regression was developed to investigate the associations between short-term exposure to air pollution and influenza, adjusting for mean temperature, relative humidity, public holidays, population mobility, and community influenza susceptibility.
Results: N=108,479
eligible cases were identified in our study. Every 10-μg/m3 increase in exposure to PM2.5, PM10, NO2, and CO and every 5-μg/m3 increase in SO2 over 8-d moving average (lag07) was associated with higher risk of influenza with a relative risk (RR) of 1.028 (95% CI: 1.018, 1.038), 1.041 (95% CI: 1.032, 1.049), 1.169 (95% CI: 1.151, 1.188), 1.004 (95% CI: 1.003, 1.006), and 1.134 (95% CI: 1.107, 1.163), respectively. There was a negative association between O3
and influenza with a RR of 0.878 (95% CI: 0.866, 0.890).
Conclusions: Our findings suggest that short-term exposure to air pollution, except for O3
, is associated with greater risk for influenza. Further studies are necessary to decipher underlying mechanisms and design preventive interventions and policies. https://doi.org/10.1289/EHP12145.