Associations of ambient air pollutants with regional pulmonary tuberculosis incidence in the central Chinese province of Hubei: a Bayesian spatial-temporal analysis

Fuqiang Liu,Hongying Chen,Shaofa Nie,Zhixia Zhang

doi:10.1186/s12940-020-00604-y

Abstract

BackgroundAir pollution and pulmonary tuberculosis (PTB) are still serious worldwide problems, especially in areas of developing countries. Whether there is an association between high ambient air pollutant concentrations and PTB has not been fully explored.MethodsBayesian spatial-temporal models were constructed to analyse the association between ambient air pollutants (particulate matter with aerodynamic diameters of ≤10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2)) and PTB incidence, adjusting for socioeconomic covariates. We collected data on pulmonary TB, ambient air pollution (PM10, SO2 and NO2) concentrations and socioeconomic covariates from 17 prefectures in the central Chinese province of Hubei between Jan 1, 2006, and Dec 31, 2015.ResultsFor every annual 10 μg/m3 increase in SO2, the relative risk (RR) of PTB incidence was 1.046 (95% credible interval [CI], 1.038–1.054) in the study area. Moreover, we found positive associations with each annual 10 μg/m3 increase in ambient air pollutants (PM10, SO2 and NO2) in females but only with SO2 in males. A significant association for each 10 μg/m3 increase in SO2 was observed in all the age groups, with a significant association for PM10 only in children under 14 years of age. A significant response relationship was also observed at a 0–1 month moving average lag for each 10 μg/m3 increase in SO2.ConclusionsHigh ambient air pollution concentrations in areas of developing countries might increase the risk of regional PTB incidence, especially for women and young people. Precautions and protective measures and efforts to reduce ambient air pollutant concentrations should be strengthened in developing countries.

Highlights

Tuberculosis (TB) is likely to have emerged approximately 70,000 years ago, it remains a major health problem worldwide [1, 2]
According to information recently published by the World Health Organization (WHO), the 20 countries with the highest TB burden based on the absolute number of incident cases and 10 countries with the highest TB burden based on the severity of the disease are all developing countries [5]
The risk of pulmonary tuberculosis (PTB) increased with age, with the lowest PTB incidence in children under 14 years old

Summary

Introduction

Tuberculosis (TB) is likely to have emerged approximately 70,000 years ago, it remains a major health problem worldwide [1, 2]. As a developing country with a high TB burden, China is currently facing a serious health problem due to the prevalence of tuberculosis [5, 6]. Since TB can lead to substantial chronic lung disability, the loss of working ability and death among people in the most economically productive age groups [8], high TB incidences in developing countries will further aggravate the disease burden among low-income populations and hinder social and economic development. Air pollution and pulmonary tuberculosis (PTB) are still serious worldwide problems, especially in areas of developing countries. Whether there is an association between high ambient air pollutant concentrations and PTB has not been fully explored

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