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Environment
Original article
Association of air pollution with the risk of initial outpatient visits for tuberculosis in Wuhan, China
  1. Man Xu1,
  2. Jiaqiang Liao1,
  3. Ping Yin2,
  4. Jian Hou3,
  5. Yun Zhou1,
  6. Jiao Huang2,
  7. Bing Liu4,
  8. Ruoling Chen5,
  9. Li Ke4,
  10. Hongying Chen6,
  11. Ping Hu1
  1. 1 Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
  2. 2 Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, Huazhong University of Science and Technology, Wuhan, Hubei, China
  3. 3 Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
  4. 4 Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, Hubei, China
  5. 5 Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
  6. 6 Biological products management office, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China
  1. Correspondence to Mrs Hongying Chen, Biological products management office, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei China; chy0128{at}126.com and Ping Hu, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; pinghu{at}hust.edu.cn

Abstract

Objectives Previous studies suggested the association of air pollution with initial Mycobacterium tuberculosis infection and the disease development. However, few studies have been conducted on air pollution and initial tuberculosis (TB) consults using short-interval data. We investigated the weekly association between air pollution and initial TB outpatient visits.

Methods We used a Poisson regression model combined with a distributed lag non-linear model to conduct a time-series study with weekly air pollution data and TB cases during 2014–2017 in Wuhan, China.

Results A 10 µg/m3 increase in NO2 (nitrogen dioxide) was associated with 11.74% (95% CI: 0.70 to 23.98, lag 0–1 weeks), 21.45% (95% CI: 1.44 to 45.41, lag 0–2 weeks) and 12.8% (95% CI: 0.97 to 26.02, lag 0–1 weeks) increase in initial TB consults among all patients with TB, old patients (≥60 years old) and male ones, respectively. A 10 µg/m3 increase in SO2 (sulfur dioxide) was associated with −22.23% (95% CI: −39.23 to −0.49, lag 0–16 weeks), −28.65% (95% CI: −44.3 to −8.58, lag 0–16 weeks), −23.85 (95% CI: −41.79 to −0.37, lag 0–8 weeks) and −23.82% (95% CI: −41.31 to −1.11, lag 0–16 weeks) increase in initial TB consults among the total, young (aged 15–59 years old), old and male patients, respectively. In old patients, a 0.1 mg/m3 increase in CO (carbon monoxide) and a 10 µg/m3 increase in PM2.5 (particulate matter) were separately associated with 42.32% (95% CI: 1.16 to 100.22, lag 0–16 weeks) and 17.38% (95% CI: 0.28 to 37.38, lag 0–16 weeks) increases in TB consults.

Conclusion Our study first highlighted the importance of weekly association between air pollution and the risk of initial TB consults, which is helpful for the arrangements of TB screening and medical assistance.

  • tuberculosis
  • initial outpatient visits
  • air pollution

https://doi.org/10.1136/oemed-2018-105532

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    Footnotes

    • Contributors MX, JL, HC and PH: study concept and design; HC: data collection and supervision; MX: drafting of the manuscript; MX and JL: analysis and interpretation of data; HC, JH, YZ, BL, LK, RC and PH: involved in the critical revision of the manuscript for important intellectual content; PY, YZ and JH: statistical analysis; RC: polishing the language.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No data are available.

    • Patient consent for publication Not required.