Associations of exposures to air pollution and greenness with mortality in a newly treated tuberculosis cohort

Abstract

Some previous studies had linked air pollutants and greenness to the risk of death from tuberculosis (TB). Only a few studies had examined the effect of particulate matter (PM 2.5 ) on the mortality of TB, and few studies had assessed the impact and interaction of multiple air pollutants and greenness on the mortality of newly treated TB patients. The study included 29,519 newly treated TB patients from three cities in Anhui province. We collected meteorological data and five pollutants data from The National Meteorological Science Center and air quality monitoring stations. Greenness data were generated by remote sensing inversion of medium-resolution satellite images. We geocoded each patient based on the residential address to calculate the average exposure to air pollutants and the average greenness exposure for each patient during treatment. The Cox proportional risk regression model was used to evaluate the effects of air pollutants and greenness on mortality in newly treated tuberculosis patients. Our results found that the higher the concentration of air pollutants in the living environment of newly treated TB patients, the greater the risk of death: HR 1.135 (95% CI: 1.123–1.147) and HR 1.333 (95% CI: 1.296–1.370) per 10 μg/m 3 of PM 2.5 and SO 2 , respectively. Greenness reduced the mortality among newly treated TB patients: HR for NDVI exposure 0.936 (95% CI: 0.925–0.947), HR for NDVI_250m exposure 0.927 (95% CI: 0.916–0.938), and HR for NDVI_500m exposure 0.919 (95% CI: 0.908–0.931). Stratifying the cohort by median greenness exposure, HRs for air pollutants were lower in the high greenness exposure group. Mortality in newly treated TB patients is influenced by air pollutants and greenness. Higher green exposure can mitigate the effects of air pollution. Improving air quality may help reduce mortality among newly treated TB patients. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-022-24433-3.

Greenness and Hospitalization for Cardiorespiratory Diseases in Brazil

“… 26 Other respiratory conditions such as pneumonia and tuberculosis present more intricate origins, encompassing infectious agents, host factors, and environmental elements. 27 In addition, sociodemographic factors such as income and education level can influence the association between greenness and health outcomes. 28 For example, individuals with lower SES may be more likely to live in areas with higher levels of environmental hazards, which could mask the benefits of greenness.…”

The climate crisis and healthcare: What do infection prevention and stewardship professionals need to know?

“…Exposure to air pollution poses a well-documented increased risk for the development of tuberculosis in endemic regions. 26 Increased mortality in newly treated TB patients has also been linked to breathing higher concentrations of air pollution components (particulate matter, in small PM 2.5 and large PM 10 sizes, and noxious gases NO 2 , SO 2 , and O 3 ) in a recent Chinese study. 27 Wildfires represent a significant cause of exposure to ambient air pollution in the United States and are increasingly frequent due to climate change.…”