Abstract
To analyze the association of long-term exposure to air pollution and its attributable risks with the number of tuberculosis (TB) cases notified, a quasi-Poisson regression model combined with a distributed lag nonlinear model (DLNM) was constructed using monthly data on air pollution and TB cases notified in Hong Kong from 1999 to 2018. Nonlinear relationships between PM10, PM2.5, and CO and TB cases notified were identified. The concentrations of PM10, PM2.5, and CO corresponding to the minimum numbers of TB cases notified (the minimum TB notification concentrations, MTNCs) were 58.3 μg/m3, 41.7 μg/m3, and 0.1 mg/m3, respectively. Compared with the MTNCs, the overall cumulative numbers of TB cases notified increased by 76.93% (95% CI: 13.08%, 176.83%), 88.81% (95% CI: 26.09%, 182.71%), and 233.43% (95% CI: 13.56%, 879.03%) for the 95th percentiles of PM10 and PM2.5 and for the 97.5th percentiles of CO, respectively. The TB notification rate attributed to concentration ranges above the 97.5th percentile of PM10, PM2.5, and CO was 3.38% (95% empirical confidence intervals [eCI]: 0.93%, 5.61%), 4.73% (95% eCI: 1.87%, 7.15%), and 3.34% (95% eCI: 0.29%, 5.83%), respectively. Long-term exposure to high concentrations of air pollution in Hong Kong may be associated with increases in the number of TB cases notified for this area.
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Acknowledgements
We appreciate the statistical guidance obtained from Professor Songlin Yu, Professor Ping Yin, and Associate Professor Yaohua Tian in the School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
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H. H. and H. R. determined the ideas regarding the association between air pollution and TB notifications; M. X. and P. H. wrote the original draft; M. X. and J. H. conducted the formal analysis; B. L., L. K., H. C., R. C., H. H., and H. R. reviewed and edited the manuscript; M. X. and J. H. developed the model for the association between air pollution and TB notifications; M. X. and J. H. implemented the computer code. All authors read and approved the final manuscript.
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The numbers of TB cases notified in this study were derived from the public database based on the collection and sorting of archived data in previous clinical diagnosis and treatment. The data were at the group level and did not involve individual-level information, which could be exempted from informed consent and ethical review.
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Xu, M., Hu, P., Chen, R. et al. Association of long-term exposure to ambient air pollution with the number of tuberculosis cases notified: a time-series study in Hong Kong. Environ Sci Pollut Res 29, 21621–21633 (2022). https://doi.org/10.1007/s11356-021-17082-5
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DOI: https://doi.org/10.1007/s11356-021-17082-5