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Front Epidemiol . A systematic review and meta-analysis on the association between PM2.5 exposure and increased influenza risk

tetano

Editor, Senior Moderator
Front Epidemiol


. 2025 Apr 11:5:1475141.
doi: 10.3389/fepid.2025.1475141. eCollection 2025. A systematic review and meta-analysis on the association between PM[SUB]2.5[/SUB] exposure and increased influenza risk

Ava Orr[SUP] 1 2 [/SUP], Rebekah L Kendall[SUP] 1 [/SUP], Zeina Jaffar[SUP] 1 [/SUP], Jon Graham[SUP] 2 3 [/SUP], Christopher T Migliaccio[SUP] 1 [/SUP], Jonathon Knudson[SUP] 2 [/SUP], Curtis Noonan[SUP] 2 [/SUP], Erin L Landguth[SUP] 2 [/SUP]



Affiliations
Abstract

Introduction: This systematic review and meta-analysis investigate the relationship between PM[SUB]2.5[/SUB] exposure and increased influenza risk (e.g., increased hospital admissions, confirmed influenza cases), synthesizing previous findings related to pollutant effects and exposure durations.
Methods: We searched PubMed, Web of Science, and Scopus for relevant studies up to 1 January 2010, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines for selection and analysis.
Results: Our review included 16 studies and found that a 10 μg/m[SUP]3[/SUP] increase in daily PM[SUB]2.5[/SUB] levels was associated with an increase of 1.5% rise in influenza risk (95% CI: 0.08%, 2.2%), with significant variations across different temperatures and lag times post-exposure. The analysis revealed heightened risks, with the most significant increases observed under extreme temperature conditions. Specifically, colder conditions were associated with a 14.2% increase in risk (RR = 14.2%, 95% CI: 3.5%, 24.9%), while warmer conditions showed the highest increase, with a 29.4% rise in risk (RR = 29.4%, 95% CI: 7.8%, 50.9%). Additionally, adults aged 18-64 were notably affected (RR = 4%, 95% CI: 2.9%, 5.1%).
Discussion: These results highlight PM[SUB]2.5[/SUB]'s potential to impair immune responses, increasing flu susceptibility. Despite clear evidence of PM[SUB]2.5[/SUB]'s impact on flu risk, gaps remain concerning exposure timing and climate effects. Future research should broaden to diverse regions and populations to deepen understanding and inform public health strategies.

Keywords: fine particulate matter; infections; influenza; lag effects; respiratory viral.

 
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