Long-term exposure to ambient fine particulate matter (PM2.5) and attributable pulmonary tuberculosis notifications in Ningxia Hui Autonomous Region, China: a health impact assessment

被引：1

作者：

Popovic, Igor ^{[1
,2
]}

Magalhaes, Ricardo Soares ^{[2
,3
]}

Yang, Shukun ^{[4
]}

Yang, Yurong ^{[5
]}

Yang, Bo-Yi ^{[6
]}

Dong, Guang-Hui ^{[7
]}

Wei, Xiaolin ^{[8
]}

Van Buskirk, Joseph ^{[9
,10
]}

Fox, Gregory ^{[11
]}

Ge, Erjia ^{[12
]}

Marks, Guy ^{[13
,14
]}

Knibbs, Luke ^{[15
,16
]}

机构：

[1] Univ Queensland, Fac Med, Sch Publ Hlth, Herston, Qld, Australia

[2] Univ Queensland, Sch Vet Sci, UQ Spatial Epidemiol Lab, Gatton, Qld, Australia

[3] Univ Queensland, UQ Childrens Hlth Res Ctr, Childrens Hlth & Environm Program, South Brisbane, Qld, Australia

[4] Ningxia Med Univ, Peoples Hosp Yinchuan 1, Affiliated Hosp 2, Dept Radiol, Yinchuan, Ningsia, Peoples R China

[5] Ningxia Med Univ, Sch Basic Med Sci, Dept Pathogen Biol & Med Immunol, Yinchuan, Ningxia, Peoples R China

[6] Sun Yat Sen Univ, Guangzhou, Peoples R China

[7] Sun Yat Sen Univ, Sch Publ Hlth, Dept Prevent Med, Guangzhou Key Lab Environm Pollut & Hlth Risk Asse, Guangzhou, Guangdong, Peoples R China

[8] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[9] Sydney Local Hlth Dist, Publ Hlth Unit, Camperdown, NSW, Australia

[10] Univ Sydney, Fac Med & Hlth, Sch Publ Hlth, Sydney, NSW, Australia

[11] Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW, Australia

[12] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[13] Univ Sydney, Univ New South Wales, South Western Sydney Clin Sch, Liverpool, NSW, Australia

[14] Woolcock Inst Med Res, Glebe, NSW, Australia

[15] Sydney Local Hlth Dist, Publ Hlth Unit, Publ Hlth Res Analyt & Methods Evidence, Camperdown, NSW, Australia

[16] Univ Sydney, Fac Med & Hlth, Sch Publ Hlth, Sydney, NSW, Australia

来源：

BMJ OPEN | 2024年 / 14卷 / 06期

基金：

美国国家科学基金会;

关键词：

tuberculosis; epidemiology; China; INITIAL OUTPATIENT VISITS; AIR-POLLUTION PREVENTION; CONTROL ACTION PLAN; TIME-SERIES; TRENDS; RISK; ASSOCIATION; MORTALITY; DISEASE;

D O I：

10.1136/bmjopen-2023-082312

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction Long-term exposure to fine particulate matter (<= 2.5 mu m (PM2.5)) has been associated with pulmonary tuberculosis (TB) notifications or incidence in recent publications. Studies quantifying the relative contribution of long-term PM2.5 on TB notifications have not been documented. We sought to perform a health impact assessment to estimate the PM2.5- attributable TB notifications during 2007-2017 in Ningxia Hui Autonomous Region (NHAR), China. Methods PM2.5 attributable TB notifications were estimated at township level (n=358), stratified by age group and summed across NHAR. PM2.5-associated TB-notifications were estimated for total and anthropogenic PM2.5 mass and expressed as population attributable fractions (PAFs). The main analysis used effect and uncertainty estimates from our previous study in NHAR, defining a counterfactual of the lowest annual PM2.5 (30 mu g/m(3)) level, above which we assumed excess TB notifications. Sensitivity analyses included counterfactuals based on the 5th (31 mu g/m(3)) and 25th percentiles (38 mu g/m(3)), and substituting effect estimates from a recent meta-analysis. We estimated the influence of PM2.5 concentrations, population growth and baseline TB-notification rates on PM2.5 attributable TB notifications. Results Over 2007-2017, annual PM2.5 had an estimated average PAF of 31.2% (95% CI 22.4% to 38.7%) of TB notifications while the anthropogenic PAF was 12.2% (95% CI 9.2% to 14.5%). With 31 and 38 mu g/m(3) as counterfactuals, the PAFs were 29.2% (95% CI 20.9% to 36.3%) and 15.4% (95% CI 10.9% to 19.6%), respectively. PAF estimates under other assumptions ranged between 6.5% (95% CI 2.9% to 9.6%) and 13.7% (95% CI 6.2% to 19.9%) for total PM2.5, and 2.6% (95% CI 1.2% to 3.8%) to 5.8% (95% CI 2.7% to 8.2%) for anthropogenic PM2.5. Relative to 2007, overall changes in PM2.5 attributable TB notifications were due to reduced TB-notification rates (-23.8%), followed by decreasing PM2.5 (-6.2%), and population growth (+4.9%). Conclusion We have demonstrated how the potential impact of historical or hypothetical air pollution reduction scenarios on TB notifications can be estimated, using public domain, PM2.5 and population data. The method may be transferrable to other settings where comparable TB-notification data are available.

引用

页数：11

共 59 条

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