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Air Pollution and Pulmonary Tuberculosis: A Nested Case–Control Study among Members of a Northern California Health Plan
- Source :
- Environmental Health Perspectives
- Publication Year :
- 2016
- Publisher :
- Environmental Health Perspectives, 2016.
-
Abstract
- Background: Ecologic analyses, case–case comparisons, and animal experiments suggest positive associations between air pollution and tuberculosis. Objectives: We evaluated this hypothesis in a large sample, which yielded results that are applicable to the general population. Methods: We conducted a case–control study nested within a cohort of Kaiser Permanente of Northern California members. All active pulmonary tuberculosis (TB) cases newly diagnosed between 1996 and 2010 (n = 2,309) were matched to two controls (n = 4,604) by age, sex, and race/ethnicity on the index date corresponding with the case diagnosis date. Average individual-level concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) and 10 μm (PM10) for 2 years before diagnosis/entry into the study were estimated using measurements from the California Air Resources Board monitor closest to the participant’s residence. Results: In single-pollutant adjusted conditional logistic regression models, the pulmonary TB odds ratios (95% confidence intervals) for the highest quintile (vs. lowest) were 1.50 (95% CI: 1.15, 1.95) for CO and 1.42 (95% CI: 1.10, 1.84) for NO2. Corresponding estimates were higher among never [1.68 (95% CI: 1.26, 2.24)] than ever [1.19 (95% CI: 0.74, 1.92)] smokers for CO. In contrast, for NO2, estimates were higher among ever [1.81 (95% CI: 1.13, 2.91)] than never [1.29 (95% CI: 0.97, 1.71)] smokers. O3 was inversely associated for smokers [0.66 (95% CI: 0.43, 1.02)] and never smokers [0.65 (95% CI: 0.52, 0.81)]. No other consistent patterns were observed. Conclusions: In this first, to our knowledge, U.S. nested case–control study on air pollution and pulmonary TB, we observed positive associations with ambient CO and NO2, which require confirmation. Citation: Smith GS, Van Den Eeden SK, Garcia C, Shan J, Baxter R, Herring AH, Richardson DB, Van Rie A, Emch M, Gammon MD. 2016. Air pollution and pulmonary tuberculosis: a nested case-control study among members of a Northern California health plan. Environ Health Perspect 124:761–768; http://dx.doi.org/10.1289/ehp.1408166
- Subjects :
- Adult
Male
Health plan
Tuberculosis
Health, Toxicology and Mutagenesis
Nitrogen Dioxide
Air pollution
010501 environmental sciences
medicine.disease_cause
01 natural sciences
California
03 medical and health sciences
0302 clinical medicine
Air pollutants
Pulmonary tuberculosis
Air Pollution
Environmental health
Statistics
Odds Ratio
Humans
Sulfur Dioxide
Medicine
030212 general & internal medicine
Tuberculosis, Pulmonary
0105 earth and related environmental sciences
Air Pollutants
Carbon Monoxide
Extramural
business.industry
Research
Public Health, Environmental and Occupational Health
Environmental Exposure
Environmental exposure
medicine.disease
3. Good health
13. Climate action
Case-Control Studies
Nested case-control study
Female
Particulate Matter
business
Subjects
Details
- ISSN :
- 15529924 and 00916765
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- Environmental Health Perspectives
- Accession number :
- edsair.doi.dedup.....b5faebb7ab86a1612fbcd4f2255853ee