Association between ambient NO2 exposure and active tuberculosis risk in Nanjing:a time-series study
Objective To know the association of ambient NO2 with the risk of active tuberculosis in Nanjing.Methods We collected fine particles(PM2.3),crude particles(PM10),nitrogen dioxide(NO2),sulfur dioxide(SO2),ozone(O3),carbon monoxide(CO),meteorological factors(including temperature and relative humidity)and active TB case reports from the TB surveillance system.Time-series analysis was used to assess the effect of ambient NO2 on the weekly occurrence of active TB,and the effects of different age(under 65,over 65)and gender(male,female)on the risk of active TB were investigated by stratified analysis.Results In single-pollutant model,a 10 μg/m3 increase in NO2 was associated with a maximum cumulative lag effect of 12.57％(95％CI:4.72％-21.01％,lag0-3 weeks)increase in active TB,after stratification,the risk of active tuberculosis increased by 18.53％(95％CI:8.27％-29.77％)and 10.49％(95％CI:2.37％-19.25％)in the elderly and young group respectively,and the risk of active tuberculosis increased by 12.94％(95％CI:4.78％-21.74％)and 11.80％(95％CI:2.07％-22.44％)in the male and female group respectively,thus,elderly people and male were more susceptible to NO2 exposure.In multi-pollutant model,when PM2.5,PM10,SO2,O3,and CO were included separately,each 10 μg/m3 increase in NO2 was associated with 16.84％(95％CI:7.92％-26.50％),17.74％(95％CI:8.33％-27.96％),17.07％(95％CI:8.09％-26.80％),17.07％(95％CI:8.09％-26.80％),and 12.09％(95％CI:4.25％-20.51％)and 14.25％(95％CI:5.60％-23.62％),and the effect was increased in the multi-pollutant model compared to the single-pollutant model except for O3(P＜0.01).Conclusion This study suggests that exposure to NO2 is associated with the incidence of active TB,and may have a greater impact on the elders and males.
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