Air Pollution and Influenza: A Systematic Review and Meta-Analysis
-
Rui Sun
,
Juan Tao
,
Na Tang
,
Zhijun Chen
,
Xiaowei Guo
,
Lianhong Zou
,
Junhua Zhou
Abstract
Background: Influenza is the first infectious disease that implements global monitoring and is one of the major public health issues in the world. Air pollutants have become an important global public health issue, in recent years, and much epidemiological and clinical evidence has shown that air pollutants are associated with respiratory diseases.
Methods: We comprehensively searched articles published up to 15 November 2022 in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Database of Chinese sci-tech periodicals, and Wanfang Database. The search strategies were based on keyword combinations related to influenza and air pollutants. The air pollutants included particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3). Meta-analysis was performed using the R programming language (R4.2.1).
Results: A total of 2926 records were identified and 1220 duplicates were excluded. Finally, 19 studies were included in the meta-analysis according to inclusion and exclusion criteria. We observed a significant association between partial air pollutants (PM2.5, NO2, PM10 and SO2) and the incidence risk of influenza. The RRs were 1.0221 (95% CI: 1.0093~1.0352), 1.0395 (95% CI: 1.0131~1.0666), 1.007 (95% CI: 1.0009~1.0132), and 1.0352 (95% CI. 1.0076~1.0635), respectively. However, there was no significant relationship between CO and O3 exposure and influenza, and the RRs were 1.2272 (95% CI: 0.9253~1.6275) and 1.0045 (95% CI: 0.9930~1.0160), respectively.
Conclusion: Exposure to PM2.5, NO2, PM10, and SO2 was significantly associated with influenza, which may be risk factors for influenza. The association of CO and O3 with influenza needs further investigation.
1. Zeng YM, Chen AL, Huang BR (2018). Correlation between the incidence of influenza-like cases and PM(2.5) in Dongguan City. Hainan Medical Journal, 29 (12):1654-1656.
2. Liao Q (2019). Short-term effects of air pollutants on influenza-like cases in Yichang City from 2014 to 2017. Master. Huazhong University of Science and Technology.
3. Fan CY (2022). Effects of meteorological factors and air pollutants on the incidence of influenza in Wuwei City. Master. Gansu University of Chinese Medicine.
4. Lindner-Cendrowska K, Bröde P (2021). Impact of biometeorological conditions and air pollution on influenza-like illnesses incidence in Warsaw. Int J Biometeorol, 65 (6):929-944.
5. Seah A, Loo LH, Jamali N, Maiwald M, Aik J (2023). The influence of air quality and meteorological variations on influenza A and B virus infections in a paediatric population in Singapore. Environ Res, 216 (Pt 1):114453.
6. Zhang Y, Wang S, Feng Z, Song Y (2022). Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China. Front Public Health, 10:1071229.
7. Chen Q, Wang YP, Liu D, Zhu WP, Gu HZ, Zhao Q, Hao LP (2021). Time series study on the correlation between atmospheric particulate matter and confirmed influenza cases in Pudong New Area of Shanghai. Journal of Public Health and Preventive Medicine 32 (01):36-39+71.
8. Li X, Xu J, Wang W, et al (2021). Air pollutants and outpatient visits for influenza-like illness in Beijing, China. PeerJ, 9:e11397.
9. Meng Y, Lu Y, Xiang H, Liu S (2021). Short-term effects of ambient air pollution on the incidence of influenza in Wuhan, China: A time-series analysis. Environ Res, 192:110327.
10. Li P, Yu TZ, Ge KF, et al (2021). The influence of air pollutants on the incidence of influenza and its early warning in Jining City from 2014 to 2017. Journal of Jining Medical University, 44 (03):153-157.
11. liao Q, Hu XJ, Xue Q, et al (2018). Short-term effects of air pollutants on influenza-like cases in Yichang City. Journal of Environmental and Occupational Medicine 35 (10):879-884+891.
12. Li Y, Wang XL, Zheng X (2018). Impact of weather factors on influenza hospitalization across different age groups in subtropical Hong Kong. Int J Biometeorol, 62 (9):1615-1624.
13. Tamerius J, Nelson MI, Zhou SZ, Viboud C, Miller MA, Alonso WJ (2011). Global influenza seasonality: reconciling patterns across temperate and tropical regions. Environ Health Perspect, 119 (4):439-45.
14. Zhang R, Meng Y, Song H, Niu R, Wang Y, Li Y, Wang S (2021). The modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China. Respir Res, 22 (1):153.
15. Su W, Wu X, Geng X, Zhao X, Liu Q, Liu T (2019). The short-term effects of air pollutants on influenza-like illness in Jinan, China. BMC Public Health, 19 (1):1319.
16. Liu XX, Li Y, Qin G, Zhu Y, et al (2019). Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China. Int J Biometeorol, 63 (1):51-60.
17. Chen G, Zhang W, Li S, et al (2017). The impact of ambient fine particles on influenza transmission and the modification effects of temperature in China: A multi-city study. Environ Int, 98:82-88.
18. Lai HK, Tsang H, Wong CM (2013). Meta-analysis of adverse health effects due to air pollution in Chinese populations. BMC Public Health, 13:360.
19. Yee J, Cho YA, Yoo HJ, Yun H, Gwak HS (2021). Short-term exposure to air pollution and hospital admission for pneumonia: a systematic review and meta-analysis. Environ Health, 20 (1):6.
20. Chen LL, Lei P, Tao Y, et al (2017). Based on statistics: Interpreting fixed effects model and random effects model. Chinese Journal of Evidence-Based Cardiovascular Medicine, 9 (03):261-264.
21. Sterne JA, Sutton AJ, Ioannidis JP, et al (2011). Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ, 343:d4002.
22. Wang SJ, Niao Q, Yi B, et al (2018). Time series study of atmospheric particulate concentration and influenza-like cases in Ningbo City. Chinese Journal of Disease Control and Prevention 22 (05):450-454.
23. Cao MH, Xu YL, Hou S, Zhu M, Ma L (2021). Study on the correlation between atmospheric particulate matter concentration and influenza-like cases. Anhui Journal of Preventive Medicine, 27 (03):179-182+195.
24. Zhang R, Lai KY, Liu W, et al (2022). Community-level ambient fine particulate matter and seasonal influenza among children in Guangzhou, China: A Bayesian spatiotemporal analysis. Sci Total Environ, 826:154135.
25. Toczylowski K, Wietlicka-Piszcz M, Grabowska M, Sulik A (2021). Cumulative Effects of Particulate Matter Pollution and Meteorological Variables on the Risk of Influenza-Like Illness. Viruses, 13 (4):556.
26. Zeng W, Zhao H, Liu R, et al (2020). Association between NO(2) cumulative exposure and influenza prevalence in mountainous regions: A case study from southwest China. Environ Res, 189:109926.
27. Zhao X, Wang SY, Zhng SM, Peng XZ (2020). Correlation between PM2.5 and PM10 short-term exposure and daily outpatient visits in influenza-like cases. Journal of Nanjing Medical University(Natural Sciences), 40 (11):1718-1724.
28. Huang ZF, Liu XJ, Ynag LP, et al (2017). Correlation analysis of atmospheric PM_(2.5) mass concentration and influenza-like cases in Shenzhen. Journal of Environmental and Occupational Medicine, 34 (05):421-425.
29. Feng C, Li J, Sun W, Zhang Y, Wang Q (2016). Impact of ambient fine particulate matter (PM2.5) exposure on the risk of influenza-like-illness: a time-series analysis in Beijing, China. Environ Health, 15:17.
30. Stapleton EM, Manges R, Parker G, et al (2019). Indoor Particulate Matter From Smoker Homes Induces Bacterial Growth, Biofilm Formation, and Impairs Airway Antimicrobial Activity. A Pilot Study. Front Public Health, 7:418.
31. Kulle TJ, Clements ML (1988). Susceptibility to virus infection with exposure to nitrogen dioxide. Res Rep Health Eff Inst, (15):5-21.
32. (1996). Health effects of outdoor air pollution. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Am J Respir Crit Care Med, 153 (1):3-50.
33. Guo Y, Li S, Tian Z, Pan X, Zhang J, Williams G (2013). The burden of air pollution on years of life lost in Beijing, China, 2004-08: retrospective regression analysis of daily deaths. BMJ, 347:f7139.
34. Bennett WD, Zeman KL, Kim C (1996). Variability of fine particle deposition in healthy adults: effect of age and gender. Am J Respir Crit Care Med, 153 (5):1641-7.
35. Caini S, Spreeuwenberg P, Donker G, Korevaar J, Paget J (2018). Climatic factors and long-term trends of influenza-like illness rates in The Netherlands, 1970-2016. Environ Res, 167:307-313.
36. Shaw Stewart PD (2016). Seasonality and selective trends in viral acute respiratory tract infections. Med Hypotheses, 86:104-19.
37. Ravindra K, Rattan P, Mor S, Aggarwal AN (2019). Generalized additive models: Building evidence of air pollution, climate change and human health. Environ Int, 132:104987.
38. Gasparrini A, Armstrong B, Kenward MG (2010). Distributed lag non-linear models. Stat Med, 29 (21):2224-34.
2. Liao Q (2019). Short-term effects of air pollutants on influenza-like cases in Yichang City from 2014 to 2017. Master. Huazhong University of Science and Technology.
3. Fan CY (2022). Effects of meteorological factors and air pollutants on the incidence of influenza in Wuwei City. Master. Gansu University of Chinese Medicine.
4. Lindner-Cendrowska K, Bröde P (2021). Impact of biometeorological conditions and air pollution on influenza-like illnesses incidence in Warsaw. Int J Biometeorol, 65 (6):929-944.
5. Seah A, Loo LH, Jamali N, Maiwald M, Aik J (2023). The influence of air quality and meteorological variations on influenza A and B virus infections in a paediatric population in Singapore. Environ Res, 216 (Pt 1):114453.
6. Zhang Y, Wang S, Feng Z, Song Y (2022). Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China. Front Public Health, 10:1071229.
7. Chen Q, Wang YP, Liu D, Zhu WP, Gu HZ, Zhao Q, Hao LP (2021). Time series study on the correlation between atmospheric particulate matter and confirmed influenza cases in Pudong New Area of Shanghai. Journal of Public Health and Preventive Medicine 32 (01):36-39+71.
8. Li X, Xu J, Wang W, et al (2021). Air pollutants and outpatient visits for influenza-like illness in Beijing, China. PeerJ, 9:e11397.
9. Meng Y, Lu Y, Xiang H, Liu S (2021). Short-term effects of ambient air pollution on the incidence of influenza in Wuhan, China: A time-series analysis. Environ Res, 192:110327.
10. Li P, Yu TZ, Ge KF, et al (2021). The influence of air pollutants on the incidence of influenza and its early warning in Jining City from 2014 to 2017. Journal of Jining Medical University, 44 (03):153-157.
11. liao Q, Hu XJ, Xue Q, et al (2018). Short-term effects of air pollutants on influenza-like cases in Yichang City. Journal of Environmental and Occupational Medicine 35 (10):879-884+891.
12. Li Y, Wang XL, Zheng X (2018). Impact of weather factors on influenza hospitalization across different age groups in subtropical Hong Kong. Int J Biometeorol, 62 (9):1615-1624.
13. Tamerius J, Nelson MI, Zhou SZ, Viboud C, Miller MA, Alonso WJ (2011). Global influenza seasonality: reconciling patterns across temperate and tropical regions. Environ Health Perspect, 119 (4):439-45.
14. Zhang R, Meng Y, Song H, Niu R, Wang Y, Li Y, Wang S (2021). The modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China. Respir Res, 22 (1):153.
15. Su W, Wu X, Geng X, Zhao X, Liu Q, Liu T (2019). The short-term effects of air pollutants on influenza-like illness in Jinan, China. BMC Public Health, 19 (1):1319.
16. Liu XX, Li Y, Qin G, Zhu Y, et al (2019). Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China. Int J Biometeorol, 63 (1):51-60.
17. Chen G, Zhang W, Li S, et al (2017). The impact of ambient fine particles on influenza transmission and the modification effects of temperature in China: A multi-city study. Environ Int, 98:82-88.
18. Lai HK, Tsang H, Wong CM (2013). Meta-analysis of adverse health effects due to air pollution in Chinese populations. BMC Public Health, 13:360.
19. Yee J, Cho YA, Yoo HJ, Yun H, Gwak HS (2021). Short-term exposure to air pollution and hospital admission for pneumonia: a systematic review and meta-analysis. Environ Health, 20 (1):6.
20. Chen LL, Lei P, Tao Y, et al (2017). Based on statistics: Interpreting fixed effects model and random effects model. Chinese Journal of Evidence-Based Cardiovascular Medicine, 9 (03):261-264.
21. Sterne JA, Sutton AJ, Ioannidis JP, et al (2011). Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ, 343:d4002.
22. Wang SJ, Niao Q, Yi B, et al (2018). Time series study of atmospheric particulate concentration and influenza-like cases in Ningbo City. Chinese Journal of Disease Control and Prevention 22 (05):450-454.
23. Cao MH, Xu YL, Hou S, Zhu M, Ma L (2021). Study on the correlation between atmospheric particulate matter concentration and influenza-like cases. Anhui Journal of Preventive Medicine, 27 (03):179-182+195.
24. Zhang R, Lai KY, Liu W, et al (2022). Community-level ambient fine particulate matter and seasonal influenza among children in Guangzhou, China: A Bayesian spatiotemporal analysis. Sci Total Environ, 826:154135.
25. Toczylowski K, Wietlicka-Piszcz M, Grabowska M, Sulik A (2021). Cumulative Effects of Particulate Matter Pollution and Meteorological Variables on the Risk of Influenza-Like Illness. Viruses, 13 (4):556.
26. Zeng W, Zhao H, Liu R, et al (2020). Association between NO(2) cumulative exposure and influenza prevalence in mountainous regions: A case study from southwest China. Environ Res, 189:109926.
27. Zhao X, Wang SY, Zhng SM, Peng XZ (2020). Correlation between PM2.5 and PM10 short-term exposure and daily outpatient visits in influenza-like cases. Journal of Nanjing Medical University(Natural Sciences), 40 (11):1718-1724.
28. Huang ZF, Liu XJ, Ynag LP, et al (2017). Correlation analysis of atmospheric PM_(2.5) mass concentration and influenza-like cases in Shenzhen. Journal of Environmental and Occupational Medicine, 34 (05):421-425.
29. Feng C, Li J, Sun W, Zhang Y, Wang Q (2016). Impact of ambient fine particulate matter (PM2.5) exposure on the risk of influenza-like-illness: a time-series analysis in Beijing, China. Environ Health, 15:17.
30. Stapleton EM, Manges R, Parker G, et al (2019). Indoor Particulate Matter From Smoker Homes Induces Bacterial Growth, Biofilm Formation, and Impairs Airway Antimicrobial Activity. A Pilot Study. Front Public Health, 7:418.
31. Kulle TJ, Clements ML (1988). Susceptibility to virus infection with exposure to nitrogen dioxide. Res Rep Health Eff Inst, (15):5-21.
32. (1996). Health effects of outdoor air pollution. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Am J Respir Crit Care Med, 153 (1):3-50.
33. Guo Y, Li S, Tian Z, Pan X, Zhang J, Williams G (2013). The burden of air pollution on years of life lost in Beijing, China, 2004-08: retrospective regression analysis of daily deaths. BMJ, 347:f7139.
34. Bennett WD, Zeman KL, Kim C (1996). Variability of fine particle deposition in healthy adults: effect of age and gender. Am J Respir Crit Care Med, 153 (5):1641-7.
35. Caini S, Spreeuwenberg P, Donker G, Korevaar J, Paget J (2018). Climatic factors and long-term trends of influenza-like illness rates in The Netherlands, 1970-2016. Environ Res, 167:307-313.
36. Shaw Stewart PD (2016). Seasonality and selective trends in viral acute respiratory tract infections. Med Hypotheses, 86:104-19.
37. Ravindra K, Rattan P, Mor S, Aggarwal AN (2019). Generalized additive models: Building evidence of air pollution, climate change and human health. Environ Int, 132:104987.
38. Gasparrini A, Armstrong B, Kenward MG (2010). Distributed lag non-linear models. Stat Med, 29 (21):2224-34.
| Files | ||
| Issue | Vol 53 No 1 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i1.14678 | |
| Keywords | ||
| Influenza-like illness Air pollutants Meta-analysis | ||
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How to Cite
1.
Sun R, Tao J, Tang N, Chen Z, Guo X, Zou L, Zhou J. Air Pollution and Influenza: A Systematic Review and Meta-Analysis. Iran J Public Health. 2023;53(1):1-11.
