Association Between Ambient Air Pollution and Elevated Risk of Tuberculosis Development
Association Between Ambient Air Pollution and Elevated Risk of Tuberculosis Development
复制标题
DOI：
10.2147/idr.s227823
复制
发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Liao, Chung-Min
中科院分区：
文献类型：
--
作者：
Lin, Yi-Jun;Lin, Hsing-Chieh;Liao, Chung-Min
背景：广泛的证据表明，环境空气污染物与结核病(TB)的发展密切相关。目的：建立台湾不同地区空气污染暴露对结核病发病风险贡献的概率综合人口水平风险评估方法。材料与方法：采用基于贝叶斯的概率风险评估模型，将各种空气污染物暴露浓度以概率方式量化，并与流行病学调查建立的人群暴露-反应模型联系起来。结果：环境空气污染暴露风险增加发生在空气污染水平较高的地区，表明环境空气污染暴露与结核病发病密切相关。一氧化碳(CO)暴露显示出最高的群体归因分数(PAF)，其次是氮氧化物(NOx)和二氧化氮(NO2)暴露。在环境空气污染较高的地区，CO暴露对结核病发病的贡献最有可能(80%的风险概率)为1.6-12.2%(PAF的中位数范围)，而NOx和NO2暴露对TB的发病贡献为1.2-9.8%。结论：我们的研究结果为空气质量差的假设和文献中的观察结果提供了强有力的经验支持，即空气质量差很可能在病因学上与结核病风险有关。因此，CO、NOx和NO2暴露的大幅减少预计将对易感人群和潜伏感染人群的健康有益，从而在减轻结核病负担方面提供补充缓解努力。考虑到人们继续暴露在结核杆菌和环境空气污染物中，我们的方法可以应用于不同的国家/地区，以确定哪些空气污染物导致更高的结核病风险，以便制定潜在的缓解计划。
Background: Broad-scale evidence has shown the significant association between ambient air pollutants and the development of tuberculosis (TB). However, the impact of air quality on the risk of TB in Taiwan is still poorly understood.Objective: To develop a probabilistic integrated population-level risk assessment approach for evaluating the contribution of ambient air pollution exposure to the risk of TB development among different regions of Taiwan.Materials and methods: A Bayesian-based probabilistic risk assessment model was implemented to link exposure concentrations of various air pollutants quantified in a probabilistic manner with the population-based exposure-response models developed by using an epidemiological investigation.Results: The increment of the risk of TB occurred in a region with a higher level of air pollution, indicating a strong relationship between ambient air pollution exposures and TB incidences. Carbon monoxide (CO) exposure showed the highest population attributable fraction (PAF), followed by nitrogen oxides (NOx) and nitrogen dioxide (NO2) exposures. In a region with higher ambient air pollution, it is most likely (80% risk probability) that the contributions of CO exposure to development of TB were 1.6-12.2% (range of median PAFs), whereas NOx and NO2 exposures contributed 1.2-9.8% to developing TB.Conclusion: Our findings provide strong empirical support for the hypothesis and observations from the literature that poor air quality is highly likely to link aetiologically to the risk of TB. Therefore, substantial reductions in CO, NOx, and NO2 exposures are predicted to have health benefits to susceptible and latently infected individuals that provide complementary mitigation efforts in reducing the burden of TB. Considering that people continue to be exposed to both TB bacilli and ambient air pollutants, our approach can be applied for different countries/regions to identify which air pollutants contribute to a higher risk of TB in order to develop potential mitigation programs.