International Journal of Biometeorology

, Volume 63, Issue 1, pp 51–60 | Cite as

Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China

  • Xu-Xiang Liu
  • Yapeng Li
  • Guoyou Qin
  • Yibing Zhu
  • Xiaoru Li
  • Junqing Zhang
  • Kefu Zhao
  • Mingxia Hu
  • Xi-Ling WangEmail author
  • Xueying ZhengEmail author
Original Paper


Accumulating evidence suggests that air pollution is a risk factor for adverse respiratory and cardiovascular health outcomes. However, the different impacts of exposure to air pollutants on influenza virus activity and influenza-like illness (ILI) have not been well documented in epidemiological studies. We examined the association between air pollutants of particular matters < 2.5 μm (PM2.5), particular matters < 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and influenza occurrences in Hefei, China, from December 2013 to December 2015 by generalized Poisson additive regression models. The result suggested that PM2.5 and PM10 had similar effects on clinical ILI and influenza incidence. PM10 was negatively associated with clinical ILI (relative risk (RR) 0.980, 95% confidence interval (CI) 0.974–0.987), while PM2.5 were positively associated with clinical ILI (RR 1.040; 95% CI 1.032–1.049). RRs for the laboratory-confirmed cases of influenza were 0.813 (95% CI, 0.755–0.875) for PM10 and 1.216 (95% CI, 1.134–1.304) for PM2.5. Nevertheless, the impacts of SO2 and NO2 on ILI and influenza were distinct. SO2 had significant influence on laboratory-confirmed influenza and had no significant linear relationship with ILI. NO2 was negatively correlated with influenza but had no obvious effect on clinical ILI cases. The present study contributes novel evidence on understanding of the effects of various air pollutants on influenza activities, and these findings can be useful and important for the development of influenza surveillance and early warning systems.


Air pollution Influenza Influenza-like illness 



Bayesian information criterion


Confidential intervals


Generalized additive regression model


Relative risk


Influenza-like illness


Laboratory-confirmed influenza


Relative humidity


Vapor pressure


Author’s contributions

XW and XZ conceived the idea and designed the study. XxL, GQ, YZ, XrL, JZ, KZ, and MH collected the data. YL, XxL, and XZ performed statistical analyses and interpreted the data. YL, XW, and XZ wrote the manuscript. All authors read and approved the final manuscript.


This work was funded by The National Natural Science Foundation of China (11501124; 81602936).

Compliance with ethical standards

Competing interests

The authors declare that they have no competing interest.

Supplementary material

484_2018_1633_MOESM1_ESM.docx (33 kb)
ESM 1 (DOCX 32 kb)


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Copyright information

© ISB 2018

Authors and Affiliations

  1. 1.Hefei Center for Disease Control and PreventionHefeiChina
  2. 2.Department of Biostatistics, School of Public Health and Key Laboratory of Public Health SafetyFudan UniversityShanghaiChina
  3. 3.Shanghai Key Laboratory of Meteorology and HealthShanghaiChina

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