Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China
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.
KeywordsAir pollution Influenza Influenza-like illness
Bayesian information criterion
Generalized additive regression model
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
The authors declare that they have no competing interest.
- Fairchild GA (1977) Effects of ozone and sulfur dioxide on virus growth in mice. Arch Environ Health 32(1):28–33Google Scholar
- Government of China (2012) Ambient Air Quality Standards (in Chinese). GB 3095–2012. . http://kjs.mep.gov.cn/hjbhbz/bzwb/dqhjbh/dqhjzlbz/201203/W020120410330232398521.pdf. Accessed 29 Feb 2012
- Greenpeace (2014) Bad to worse: ranking 74 Chinese cities by air pollution. http://www.greenpeace.org/eastasia/news/blog/bad-to-worse-ranking-74-chinese-cities-by-air/blog/48181/. Accessed 19 Feb 2014
- Grinsted A, Moore JC, Jevrejeva S (2004) Application of the cross wavelet transform and wavelet coherence to geophysical time series. Nonlinear Process Geophys 11(5/6):561–566Google Scholar
- Hair JF Jr, Anderson RE, Tatham RL, Black WC (1995) Multivariate data analysis, 3rd edn. Macmillan Publishing Company, New YorkGoogle Scholar
- Hajat S, Haines A, Goubet SA, Atkinson RW, Anderson HR (1999) Association of air pollution with daily GP consultations for asthma and other lower respiratory conditions in London. Thorax 54(7):597–605Google Scholar
- Hefei Municipal People's Government The General Situation of Hefei. http://www.hefei.gov.cn/dhmc/csgk/ztgk/201508/t20150827_1152199.html. Accessed 11 Aug 2016
- Host S, Larrieu S, Pascal L, Blanchard M, Declercq C, Fabre P, Jusot JF, Chardon B, Le Tertre A, Wagner V, Prouvost H, Lefranc A (2008) Short-term associations between fine and coarse particles and hospital admissions for cardiorespiratory diseases in six French cities. Occup Environ Med 65(8):544–551. https://doi.org/10.1136/oem.2007.036194 Google Scholar
- Hwang JS, Chan CC (2002) Effects of air pollution on daily clinic visits for lower respiratory tract illness. Am J Epidemiol 155(1):1–10Google Scholar
- Johansson MA, Cummings DA, Glass GE (2009) Multiyear climate variability and dengue--El Niño southern oscillation, weather, and dengue incidence in Puerto Rico, Mexico, and Thailand: a longitudinal data analysis. PLoS Med 6(11):e1000168Google Scholar
- Kulle TJ, Clements ML (1988) Susceptibility to virus infection with exposure to nitrogen dioxide. Res Rep (Health Effects Institute) 15:5–21Google Scholar
- Lowen A, Palese P (2009) Transmission of influenza virus in temperate zones is predominantly by aerosol, in the tropics by contact: a hypothesis. PLoS Curr 1:Rrn1002Google Scholar
- Marquaridt DW (1970) Generalized inverses, ridge regression, biased linear estimation, and nonlinear estimation. Technometrics 12(3):591–612Google Scholar
- National Health and Family Planning Commission of the People’s Republic of China (2010) Infuenza sentinel surveillance protocol. http://www.nhfpc.gov.cn/jkj/s3577/201009/3fa356d0f4834d408fde6c12891a6482.shtml. Accessed 10 Sep 2010
- Ravelli AC, Kreis IA (1991) A time series analysis of sulphur dioxide, temperature, and influenza incidence in 1976-1987. Public Health Rev 19(1–4):93–101Google Scholar
- Riedel F, Kramer M, Scheibenbogen C, Rieger CH (1988) Effects of SO2 exposure on allergic sensitization in the guinea pig. J Allergy Clin Immunol 82(4):527–534Google Scholar
- Ryan LK, Neldon DL, Bishop LR, Gilmour MI, Daniels MJ, Sailstad DM, Selgrade MJ (2000) Exposure to ultraviolet radiation enhances mortality and pathology associated with influenza virus infection in mice. Photochem Photobiol 72(4):497–507Google Scholar
- Straliotto SM, Siqueira MM, Muller RL, Fischer GB, Cunha ML, Nestor SM (2002) Viral etiology of acute respiratory infections among children in Porto Alegre, RS, Brazil. Rev Soc Bras Med Trop 35(4):283–291Google Scholar
- Torrence C, Compo GP (1998) A practical guide to wavelet analysis. Bull Am Meteorol Soc 79(79):61–78Google Scholar
- World Health Organization (2003) Health aspects of air pollution with particulate matter, ozone and nitrogen dioxide: report on a WHO working group, Bonn, Germany 13–15 January 2003Google Scholar
- World Health Organization WHO surveillance case definitions for ILI and SARI. http://www.who.int/influenza/surveillance_monitoring/ili_sari_surveillance_case_definition/en/. Accessed January 2014
- Xing YF, Xu YH, Shi MH, Lian YX (2016) The impact of PM2.5 on the human respiratory system. J Thorac Dis 8(1):E69–E74. https://doi.org/10.3978/j.issn.2072-1439.2016.01.19 Google Scholar