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.
- initial outpatient visits
- air pollution
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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.
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