tetano
Editor, Senior Moderator
Int J Environ Health Res
. 2025 Aug 12:1-16.
doi: 10.1080/09603123.2025.2545998. Online ahead of print. Global association between air pollution and risk of influenza-related outcomes: a systematic review and meta-analysis
Xiaoke Gao[SUP] 1 [/SUP], Sujuan Chen[SUP] 2 [/SUP], Zijie Zhong[SUP] 1 [/SUP], Junjie Li[SUP] 1 [/SUP], Jinjian Chen[SUP] 1 [/SUP], Bixia Li[SUP] 1 [/SUP], Kaili Lin[SUP] 1 [/SUP], Qiuhan Hua[SUP] 1 [/SUP], Rong Zhang[SUP] 3 [/SUP], Di Liu[SUP] 1 [/SUP], Jun Yang[SUP] 1 [/SUP]
Affiliations
Despite extensive research, air pollution-influenza associations remain inconsistent. This evidence synthesis aggregated evidence from 28 studies to quantify air pollution-influenza associations, employing the Office of Health Assessment and Translation (OHAT) and Navigation Guide tools for quality assessment. We derived combined relative risk (RR) per 10 µg/m[SUP]3[/SUP] increase in air pollution, 95% confidence intervals (CIs) and 95% prediction intervals (PIs) to quantify the link. PM[SUB]2.5[/SUB] (RR = 1.037; 95% CI: 1.019-1.055), SO[SUB]2[/SUB] (RR = 1.351; 95% CI: 1.107-1.649) and CO (RR = 1.003, 95% CI: 1.001-1.004) showed significant links to higher influenza risk. PM[SUB]10[/SUB] (RR = 1.064, 95% CI: 0.964-1.174), NO[SUB]2[/SUB] (RR = 1.207, 95% CI: 0.988-1.475), and O[SUB]3[/SUB] (RR = 1.027, 95% CI: 0.962-1.097) demonstrated a nonsignificant tendency to increase influenza risk. Stratified analyses indicated heightened vulnerability to SO[SUB]2[/SUB] in Asian populations relative to Australians, and to PM[SUB]2.5[/SUB] in Europe compared to Asia. Males experienced greater risks for PM[SUB]2.5[/SUB], PM[SUB]10[/SUB], NO[SUB]2[/SUB] and SO[SUB]2[/SUB]. However, these associations were characterized by substantial between-study heterogeneity even after stratification, which was reflected in 95% PI that suggested an inconsistent direction of effect in future studies. Our analysis confirmed air pollutants increase influenza risk, but confounding, exposure variability, and mechanistic pathways warrant further study, particularly in underrepresented regions.
Keywords: Air pollution; heterogeneity; influenza; meta-analysis; systematic review.
. 2025 Aug 12:1-16.
doi: 10.1080/09603123.2025.2545998. Online ahead of print. Global association between air pollution and risk of influenza-related outcomes: a systematic review and meta-analysis
Xiaoke Gao[SUP] 1 [/SUP], Sujuan Chen[SUP] 2 [/SUP], Zijie Zhong[SUP] 1 [/SUP], Junjie Li[SUP] 1 [/SUP], Jinjian Chen[SUP] 1 [/SUP], Bixia Li[SUP] 1 [/SUP], Kaili Lin[SUP] 1 [/SUP], Qiuhan Hua[SUP] 1 [/SUP], Rong Zhang[SUP] 3 [/SUP], Di Liu[SUP] 1 [/SUP], Jun Yang[SUP] 1 [/SUP]
Affiliations
- PMID: 40794757
- DOI: 10.1080/09603123.2025.2545998
Despite extensive research, air pollution-influenza associations remain inconsistent. This evidence synthesis aggregated evidence from 28 studies to quantify air pollution-influenza associations, employing the Office of Health Assessment and Translation (OHAT) and Navigation Guide tools for quality assessment. We derived combined relative risk (RR) per 10 µg/m[SUP]3[/SUP] increase in air pollution, 95% confidence intervals (CIs) and 95% prediction intervals (PIs) to quantify the link. PM[SUB]2.5[/SUB] (RR = 1.037; 95% CI: 1.019-1.055), SO[SUB]2[/SUB] (RR = 1.351; 95% CI: 1.107-1.649) and CO (RR = 1.003, 95% CI: 1.001-1.004) showed significant links to higher influenza risk. PM[SUB]10[/SUB] (RR = 1.064, 95% CI: 0.964-1.174), NO[SUB]2[/SUB] (RR = 1.207, 95% CI: 0.988-1.475), and O[SUB]3[/SUB] (RR = 1.027, 95% CI: 0.962-1.097) demonstrated a nonsignificant tendency to increase influenza risk. Stratified analyses indicated heightened vulnerability to SO[SUB]2[/SUB] in Asian populations relative to Australians, and to PM[SUB]2.5[/SUB] in Europe compared to Asia. Males experienced greater risks for PM[SUB]2.5[/SUB], PM[SUB]10[/SUB], NO[SUB]2[/SUB] and SO[SUB]2[/SUB]. However, these associations were characterized by substantial between-study heterogeneity even after stratification, which was reflected in 95% PI that suggested an inconsistent direction of effect in future studies. Our analysis confirmed air pollutants increase influenza risk, but confounding, exposure variability, and mechanistic pathways warrant further study, particularly in underrepresented regions.
Keywords: Air pollution; heterogeneity; influenza; meta-analysis; systematic review.