Abstract
There has been a gap regarding current knowledge of the effect of PM on pulmonary TB, such as the exposure-time-response between them. This study aimed to explore the distributed lag effects of particulate matter (PM) on active pulmonary tuberculosis (TB) and identify the vulnerable groups. A generalized additive mixed model combined with a distributed lag non-linear model was applied to quantify the association between PM and active pulmonary TB with adjustment for potential confounders. Relative risk (RR) and cumulative RR with 95% confidence interval (CI) were calculated to quantify the exposure-time-response. A total of 16,486 cases of active pulmonary TB were notified. Results suggested that a unit 10 µg/m3 increase of daily PM2.5 concentration was positively associated with active pulmonary TB morbidity at 36–115 lag day and RR reached maximum at 66 lag day (1.0076; 95%CI, 1.0031–1.0122), and the cumulative RR was 2.1940 (95%CI, 1.2292–3.9161). For PM10, this association was significantly positive at 73–117 lag day, and RR reached maximum at 100 lag day (1.0036; 95%CI, 1.0003–1.0067), and the cumulative RR was not significant. This study provides evidence that PM significantly associate with active pulmonary TB. Vulnerability to PM2.5 was identified in male, female, 0–18 ages, 19–64 ages, workers, and students. Our findings have significant implications for developing local strategies to prevent and reduce health impact in PM polluted areas.
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Data availability
The data of disease is not publicly available due to the strict requirement of Nation Health Commission of China for the confidentiality of notable infectious disease data. However, the data are available for research upon a necessary request to the correspondence (email: qshi@cqmu.edu.cn). The request should meet the framework of the Chinese data protection legislation and any required permission from the National Health Commission of the People’s Republic of China. The data request must specify the research purpose, specific method, expected results, results sharing plan, and whether it involves ethics and other details. Expect a time frame of at least 8–10 months for data requests to be processed.
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Acknowledgements
We thank the Chinese Center for Disease Control and Prevention, National Meteorological Information Center of China, and the Data Center for the Institute of Geographic Sciences and Natural Resources Research of China for sharing with us the data needed for this study.
Funding
This work was supported by Chongqing Graduate Research Innovation Project (Grant No. CYB22224), project supported by Peking University People’s Hospital Scientific Research Development Funds (Grant No. RDJP2022-63), and Medical and Health Technology Development Plan Project of Shandong Province (Grant No. 20220503137).
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WN conducted the literature review and analyses, drafted the manuscript, and approved the final manuscript as submitted. QS attributed to the conceptualization and critically reviewed the manuscript and approved the final manuscript as submitted.
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Ni, W., Shi, Q. Distributed lag effects and vulnerable groups of PM and active pulmonary TB in Qingdao, China. Int J Biometeorol 68, 179–188 (2024). https://doi.org/10.1007/s00484-023-02581-6
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DOI: https://doi.org/10.1007/s00484-023-02581-6