Short-term effect of ambient air pollutant change on the risk of tuberculosis outpatient visits: a time-series study in Fuyang, China

Abstract There is growing evidence that air pollution plays a role in TB, but few studies have comprehensively included the six common air pollutants. Our objectives were to investigate the association between short-term exposure to six common air pollutants and the risk of tuberculosis outpatient visits in Fuyang, China, during the period 2015-2020. We combined the two models to explore the effects of exposure to six air pollutants on the risk of tuberculosis outpatient visits, including Poisson generalized linear regression model and distributed lag non-linear model (DLNM). We performed stratified analyses for season, gender and age. We used the lag-specific relative risks and cumulative relative risk obtained by increasing pollutant concentration by per 10 units to evaluate the connection between six air pollutants and TB, PM2.5 (RR=1.0018, 95%CI: 1.0004-1.0032, delay of 12 days) and (RR=1.0169,95%CI: 1.0007-1.0333, lag 0-16 days), SO2 were 0.9549 (95%CI: 0.9389-0.9712, lag 0 days) and 0.8212 (95%CI: 0.7351-0.9173, 0-20 days lag). Stratified analyses showed that seasonal differences had a greater impact on TB, and male more likely to develop TB than female, older people more likely to develop TB than younger people. Exposure to O3, CO, PM10, PM2.5, and NO2 increases the risk of TB outpatient visits, except SO2 reduces the risk. Male and elderly people should be protected. We need to pay more attention to the impact of seasonal effects on TB.