Long-term exposure to ambient fine particulate matter (PM 2.5 ) and attributable pulmonary tuberculosis notifications in Ningxia Hui Autonomous Region, China: a health impact assessment.

Autor:	Popovic I; Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia i.popovic@uqconnect.edu.au.; UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia., Soares Magalhaes R; UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.; Children's Health and Environment Program, UQ Children's Health Research Center, The University of Queensland, South Brisbane, Queensland, Australia., Yang S; Department of Radiology, The First People's Hospital in Yinchuan, The Second Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningsia, China., Yang Y; Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan, Ningxia, China., Yang BY; Environmental Epidemiology, Sun Yat-Sen University, Guangzhou, China., Dong GH; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China., Wei X; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada., Van Buskirk J; Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.; School of Public Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia., Fox G; Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia., Ge E; University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada., Marks G; South Western Sydney Clinical School, University of New South Wales, The University of Sydney, Liverpool, New South Wales, Australia.; Woolcock Institute of Medical Research, Glebe, New South Wales, Australia., Knibbs L; Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, New South Wales, Australia.; Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jun 04; Vol. 14 (6), pp. e082312. Date of Electronic Publication: 2024 Jun 04.
DOI:	10.1136/bmjopen-2023-082312
Abstrakt:	Introduction: Long-term exposure to fine particulate matter (≤2.5 µm (PM 2.5 )) has been associated with pulmonary tuberculosis (TB) notifications or incidence in recent publications. Studies quantifying the relative contribution of long-term PM 2.5 on TB notifications have not been documented. We sought to perform a health impact assessment to estimate the PM 2.5 - attributable TB notifications during 2007-2017 in Ningxia Hui Autonomous Region (NHAR), China. Methods: PM 2.5 attributable TB notifications were estimated at township level (n=358), stratified by age group and summed across NHAR. PM 2.5 -associated TB-notifications were estimated for total and anthropogenic PM 2.5 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 PM 2.5 (30 µg/m 3 ) level, above which we assumed excess TB notifications. Sensitivity analyses included counterfactuals based on the 5th (31 µg/m 3 ) and 25th percentiles (38 µg/m 3 ), and substituting effect estimates from a recent meta-analysis. We estimated the influence of PM 2.5 concentrations, population growth and baseline TB-notification rates on PM 2.5 attributable TB notifications. Results: Over 2007-2017, annual PM 2.5 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 µg/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 PM 2.5 , and 2.6% (95% CI 1.2% to 3.8%) to 5.8% (95% CI 2.7% to 8.2%) for anthropogenic PM 2.5 . Relative to 2007, overall changes in PM 2.5 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, PM 2.5 and population data. The method may be transferrable to other settings where comparable TB-notification data are available. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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