Abstract:

Objective: To analyze the influence of air pollutants and meteorological factors on the incidence of pulmonary tuberculosis and the interaction of them in Yulin. Methods: The case data of 11251 patients with newly diagnosed pulmonary tuberculosis in Yulin, Guangxi Zhuang Autonomous Region from January 1, 2017 to December 31, 2021 were collected, and the meteorological data of air pollutants and meteorological factors in Yulin were also collected. Spearman correlation analysis was used to analyze the correlation between air pollutants and meteorological factors and the incidence of pulmonary tuberculosis. Bivariate response surface model and single pollutant-air temperature interaction model were used to analyze the interaction between air pollutants and air temperature on the risk of pulmonary tuberculosis. Results: The incidence of pulmonary tuberculosis in Yulin had obvious seasonal fluctuation from 2017 to 2021, and the peak was concentrated in spring (27.57%, 3102/11251) and summer (27.89%, 3138/11251). The incidence rates of males and farmers were higher (74.70% (8405/11251) and 87.74% (9872/11252), respectively). The daily concentrations (median (quartile)) of PM_2.5, PM₁₀, SO₂, NO₂, CO and O₃ in Yulin from 2017 to 2021 were 27.00 (19.00, 41.00) μg/m³, 44.00 (32.00, 64.00) μg/m³, 13.00 (8.00, 21.00) μg/m³, 15.00 (12.00, 21.00) μg/m³, 0.82 (0.69, 0.99) mg/m³ and 53.00 (39.00, 69.00) μg/m³, respectively. The daily average temperature (median (quartile)) was 24.50 (19.00, 29.00) ℃. The average daily incidence of pulmonary tuberculosis was 6 cases (11251/1825). When high temperature (37.00 ℃) lasted for 0-4 days, the incidence of pulmonary tuberculosis in Yulin increased. Compared with the median of daily temperature (24.50 ℃, RR value was 1.00), the RR value was 1.20 when 37.00 ℃ lasted for 0-4 days. Low temperature (3.00 ℃) lasting for 0-2 days could also increase the incidence of tuberculosis in Yulin. Compared with the median of daily temperature (24.50 ℃, RR value was 1.00), the RR value of was 1.22 when 3.00 ℃ lasted for 0-2 days. At low temperature (3.00 ℃), PM_2.5, PM₁₀, NO₂ and CO had a strong effect on the incidence of pulmonary tuberculosis, while at high temperature (37.00 ℃), PM_2.5, PM₁₀, SO₂, NO₂, CO and O₃ had a weak effect on the incidence of pulmonary tuberculosis. Conclusion: High or low temperature exposure can increase the risk of tuberculosis in Yulin, there is no synergistic effect between meteorological factors and air pollutants on the risk of tuberculosis in Yulin.

Key words: Pulmonary tuberculosis, Air pollutants, Temperature, Risk factors