Temporal Cross-Correlations between Ambient Air Pollutants and Seasonality of Tuberculosis: A Time-Series Analysis

Abstract

The associations between ambient air pollutants and tuberculosis seasonality are unclear. We assessed the temporal cross-correlations between ambient air pollutants and tuberculosis seasonality. Monthly tuberculosis incidence data and ambient air pollutants (PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2)) and air quality index (AQI) from 2013 to 2017 in Shanghai were included. A cross-correlogram and generalized additive model were used. A 4-month delayed effect of PM2.5 (0.55), PM10 (0.52), SO2 (0.47), NO2 (0.40), CO (0.39), and AQI (0.45), and a 6-month delayed effect of O3 (−0.38) on the incidence of tuberculosis were found. The number of tuberculosis cases increased by 8%, 4%, 18%, and 14% for a 10 μg/m3 increment in PM2.5, PM10, SO2, and NO2; 4% for a 10 unit increment in AQI; 8% for a 0.1 mg/m3 increment in CO; and decreased by 4% for a 10 μg/m3 increment in O3. PM2.5 concentrations above 50 μg/m3, 70 μg/m3 for PM10, 16 μg/m3 for SO2, 47 μg/m3 for NO2, 0.85 mg/m3 for CO, and 85 for AQI, and O3 concentrations lower than 95 μg/m3 were positively associated with the incidence of tuberculosis. Ambient air pollutants were correlated with tuberculosis seasonality. However, this sort of study cannot prove causality.

<p>Secular Seasonality and Trend Forecasting of Tuberculosis Incidence Rate in China Using the Advanced Error-Trend-Seasonal Framework</p>

“…While the air pollutant has been a major public health problem in recent years in China, especially in winter per year, the mean concentrations of pollutants are much higher than their standards. 35 Secondly, a previous systematic review and meta-analysis suggested a positive correlation between low serum vitamin D levels and TB. 37 Importantly, several studies have found that the decreased sunshine hours and its potential effect on vitamin D levels in winter appear to be in relation to TB incidence.…”

“…Firstly, growing work has been documenting that ambient air pollutants including PM 2.5 , PM 10 , CO, NO 2 , O 3 , SO 2 and air quality index (AQI) are positively linked with TB seasonality. 35,36 Figure 6 Annual TB incidence projections up to 2035 using the ETS(M,M,M) method based on the entire dataset. As illustrated, albeit the TB incidence continued to display a declined trend at 2.613% per year in China, it showed major challenges ahead to achieve the WHO's milestones and goals.…”

Global and Geographically and Temporally Weighted Regression Models for Modeling PM2.5 in Heilongjiang, China from 2015 to 2018

“…where E(•), Var(•), and Cov(•) denote expectation, variance, and covariance, respectively; "Normal" represents "following a normal distribution". The variance of Y can be estimated by random-effects design matrix Z, and covariance matrices G and R. The estimates of the fixed-effects and random-effects parameters can be expressed by Equations (5) and (6), respectively,…”

“…They may be transported or formed over long distances and have influences on human health, ecosystems, the built environment, and climate in large areas. It has been confirmed by extensive epidemiological studies that air pollution is closely associated with increased risks of mortality or morbidity for cardiovascular and respiratory diseases [2][3][4][5]. It was reported that air pollution ranked the 7 th killer to the global public health and contributed to 3.2 million and 4.2 million premature deaths Worldwide in 2010 and 2016, respectively [6,7].…”

Health Risk and Resilience Assessment with Respect to the Main Air Pollutants in Sichuan

“…Generally, although many studies have investigated the spatial and temporal patterns, chemical composition, potential sources, and effects of meteorological condition based on six criteria air pollutants, these studies have either ignored public health risk assessment [19,20,21,22,23,24,25], or only focused on a specific city or industrial region [3,15,26]. In the face of increasing risks caused by air pollutants, the public health resilience of different groups of people in Sichuan still needs a systematic and comprehensive analysis.…”