Affiliation:
1. School of Population Medicine and Public Health Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
2. National Center for Respiratory Medicine National Clinical Research Center for Respiratory Diseases, China‐Japan Friendship Hospital Beijing China
3. Institute of Respiratory Medicine Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
4. Department of Clinical Research and Data management Center of Respiratory Medicine, China‐Japan Friendship Hospital Beijing China
5. School of Life Course and Population Sciences King's College London London UK
Abstract
AbstractBackgroundThe impact of exposure to ambient pollutants on influenza transmissibility is poorly understood. We aim to examine the associations of six ambient pollutants with influenza transmissibility in China and assess the effect of the depletion of susceptibles.MethodsProvincial‐level surveillance data on weekly influenza‐like illness (ILI) incidence and viral activity were utilized to estimate the instantaneous reproduction number (Rt) using spline functions. Log‐linear regression and the distributed lag non‐linear model (DLNM) were employed to investigate the effects of ambient pollutants—ozone (O3), particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO)—on influenza transmissibility across 30 Chinese provinces from 2014 to 2019. Additionally, the potential effects of the depletion of susceptibles and regional characteristics were explored.ResultsThere is a significantly positive correlation between influenza transmissibility and five distinct ambient pollutants: PM2.5, PM10, SO2, CO, and NO2. On average, these ambient pollutants explained percentages of the variance in Rt: 0.8%, 0.8%, 1.9%, 1.3%, and 1.4%, respectively. Conversely, O3 was found to be negatively associated with Rt, explaining 1.5% of the variance in Rt. When controlling for the effect of susceptibles depletion, the effects of all pollutants were more pronounced. The effects of PM2.5, PM10, CO, and SO2 were higher in the eastern and southern regions.ConclusionsMost ambient pollutants may potentially contribute to the facilitation of human‐to‐human influenza virus transmission in China. This observed association was maintained even after adjusting for variation in the susceptible population.
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health,Pulmonary and Respiratory Medicine,Epidemiology