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J Hazard Mater . Interactions for exposure to fine particulate matter and multiple time-period cold spells on influenza: A multi-center case-crossov

tetano

Editor, Senior Moderator
J Hazard Mater


. 2025 May 2:494:138470.
doi: 10.1016/j.jhazmat.2025.138470. Online ahead of print. Interactions for exposure to fine particulate matter and multiple time-period cold spells on influenza: A multi-center case-crossover study

Shouxin Peng[SUP] 1 [/SUP], Bin Fang[SUP] 2 [/SUP], Siyu Gan[SUP] 1 [/SUP], Yuxuan Tan[SUP] 1 [/SUP], Wei Liang[SUP] 3 [/SUP], Zhaoyuan Li[SUP] 4 [/SUP], Xinlan Chen[SUP] 1 [/SUP], Jiahui Tong[SUP] 1 [/SUP], Zhongyang Chen[SUP] 1 [/SUP], Bingbing Chen[SUP] 1 [/SUP], Feifei Liu[SUP] 5 [/SUP], Hao Xiang[SUP] 6 [/SUP]



Affiliations
Abstract

With the increasing twin threats of climate change and air pollution, cumulating evidence has revealed that environmental exposure might promote influenza epidemic. However, it remains unclear whether the combination of air pollution and cold spells (CS) synergistically trigger influenza. Through a case-crossover study, we included 13,972 laboratory-diagnosed influenza patients in Hubei province, China, during 2011-2018. We then constructed the conditional logistic regression model to assess the adverse impact of overall-, daytime-, and nighttime-CS exposure, as well as PM[SUB]2.5[/SUB] pollution, on influenza, and further calculated their additive-scale interactions. Our results indicated that both PM[SUB]2.5[/SUB] and CS were associated with influenza. For an interquartile range increment of PM[SUB]2.5[/SUB] was associated with 8 % [odds ratio = 1.08, 95 % confidence interval (CI): 1.04-1.12] increased risk of influenza. The estimated risks of overall-, daytime-, and nighttime-CS exposure on influenza were 1.18 (95 %CI: 1.12-1.23), 1.16 (95 %CI: 1.08-1.25), and 1.28 (95 %CI: 1.19-1.38), respectively. Calculated population attributable fractions were ranged from 1.13 % to 4.42 %. Significant synergetic effects on influenza were observed for co-exposure to PM[SUB]2.5[/SUB], CS, indicated by relative excess risk due to interaction of 0.23 (overall-CS) and 0.26 (nighttime-CS). Exposure to both PM[SUB]2.5[/SUB] and CS, especially nighttime-CS, were associated with influenza, and PM[SUB]2.5[/SUB] and CS could interact synergistically trigger influenza epidemic.

Keywords: Cold spell; Fine particulate matter; Influenza; Interaction effect; Population attributable fraction.

 
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