DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20194172

Ambient air pollution and the susceptibility to develop pulmonary tuberculosis: a multi country ecological study

Renuka K., Gopalakrishnan S., Umadevi R.

Abstract


Background: Tuberculosis remains a major global health problem with 10.4 million incident cases in 2016. Although Mycobacterium tuberculosis is the causative agent, many environmental factors play a role in disease progression. Several respiratory hazards including smoking and indoor air pollution were suggested to increase the risk of tuberculosis, but only fewer studies has been conducted on the association between ambient air pollution and tuberculosis.

Methods: Data on ambient air quality levels (annual mean concentration of particulate matter 2.5 µg/m3) for the year 2016 was collected from the World Health Organization (WHO) data base for 190 countries which comprises of 6 WHO regions. Similarly data on incidence and mortality rate of tuberculosis for the year 2016 was collected for the above countries from the WHO data base. The data were tabulated and statistical analysis was performed using Pearson’s correlation coefficient model to examine the association of annul mean concentration of particulate matter 2.5 with incidence and mortality rates of tuberculosis.

Results: Incidence and mortality rates of tuberculosis were found to be increasing with increasing levels of air pollution. It was correlated using scatter plot. Pearson’s correlation coefficient for air pollution level and incidence of tuberculosis was 0.331 (95% CI: 0.435-0.883), (p<0.001), and for tuberculosis mortality was 0.39 (95% CI: 0.525-0.906) (p<0.001).

Conclusions: The study suggests there is a significant positive relationship between ambient air pollution level and tuberculosis incidence and mortality rates.


Keywords


Particulate matter 2.5, Air pollutants, Koch’s disease, Tuberculosis

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References


Global tuberculosis report. World Health Organization, 2018. Available at: https://apps.who.int/iris/bitstream/handle/10665/274453/9789241565646-eng.pdf. Accessed on 13 August 2019.

10 things to know about air pollution. Available at: https://www.who.int/air-pollution/news-and-events/ how-air-pollution-is-destroying-our-health/10-things -to-know-about-air-pollution. Accessed on 15 August 2019.

9 out of 10 people worldwide breathe polluted air, but more countries are taking action. Available at: https://www.who.int/news-room/detail/02-05-2018-9-out-of-10-people-worldwide-breathe-polluted-air-but-more-countries-are-taking-action. Accessed on 13 August 2019.

Ambient (outdoor) air quality and health. Available at: https://www.who.int/news-room/fact-sheets/ detail/ambient-(outdoor)-air-quality-and-health. Accessed on 13 August 2019.

Ten threats to global health in 2019. Available at: https://www.who.int/emergencies/ten-threats-to-global-health-in-2019. Accessed on 13 August 2019.

Ambient air pollution: a global assessment of exposure and burden of disease. World Health Organization, 2016. Available at: https://www.who.int/phe/publications/air-pollution-global-assessment/en/. Accessed on 13 August 2019.

Smith G, Schoenbach VJ, Richardson DB, Gammon MD. Particulate air pollution and susceptibility to the development of pulmonary tuberculosis disease in North Carolina: an ecological study. Int J Environ Health Res. 2014 ;24(2):103-12.

Lai TC, Chiang CY, Wu CF, Yang SL, Liu DP, Chan CC, et al. Ambient air pollution and risk of tuberculosis: a cohort study. Occup Environ Med. 2016;73(1):56-61.

A systematic literature review and critical appraisal of epidemiological studies on outdoor air pollution and tuberculosis outcomes. Environ Res. 2019;170:33-45.

Liu Y, Cui L, Hou L, Yu C, Tao N, Liu J, et al. Ambient air pollution exposures and newly diagnosed pulmonary tuberculosis in jinan, china: a time series study. Sci Rep. 2018;8(1):1-11.

Mutalip MHA, Hiong TG, Sarnat SE, Hashim MH, Lodz NA, Pan S, et al. An ambient air pollution and pulmonary tuberculosis in Malaysia. Health. 2018;10(12):1634-49.