PDF(Pubmed)
Abstract：
UNASSIGNED: The evidence on the association of fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) with pulmonary tuberculosis (PTB) retreatment is limited. There are no data on whether greenness exposure protects air pollution-related PTB retreatment in patients with prior PTB.
UNASSIGNED: In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment.
UNASSIGNED: A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index.
UNASSIGNED: Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 μg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance.
UNASSIGNED: Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment.
UNASSIGNED: In a population-based retrospective study, we aimed to investigate the influence of PM2.5 and residential greenness on the risk of PTB retreatment.
UNASSIGNED: A total of 26,482 patients with incident PTB, registered in a mandatory web-based reporting system between 2012 and 2019 in Zhengzhou, China, were included in the analysis. The exposure to PM2.5 was assessed based on the China High Air Pollutants dataset, and the level of greenness was estimated using the Normalized Difference Vegetation Index (NDVI) values. The associations of PTB retreatment with exposure to PM2.5 and greenness were evaluated, respectively, considering the local socioeconomic level indicated by the nighttime light index.
UNASSIGNED: Among the 26,482 patients (mean age 46.86, SD 19.52 years) with a median follow-up time of 1523 days per patient, 1542 (5.82%) PTB retreatments were observed between 2012 and 2019. Exposure to PM2.5 was observed to be significantly associated with the increased risk of PTB retreatment in fully adjusted models with a hazard ratio of 1.97 (95% CI 1.34-2.83) per 10 μg/m3 increase in PM2.5. Patients living in the regions with relatively high quartiles of NDVI values had a 45% lower risk of PTB retreatment than those living in the regions with the lowest quartile for the 500 m buffers (hazard ratio 0.55, 95% CI 0.40-0.77). Such a protective effect of residential greenness was more pronounced among patients living in lower nighttime light areas. The strength of the association between PM2.5 exposure and the risk of PTB retreatment was attenuated by greenness. No significant association was observed between NDVI and the incidence of drug resistance.
UNASSIGNED: Long-term exposure to PM2.5 might be a risk factor for PTB retreatment, while an increased level of residential greenness was found to be associated with reduced risks of PTB retreatment. Our results suggest strengthening the control of ambient air pollution and improving residential greenness may contribute to the reduction of PTB retreatment.
摘要：
■关于空气动力学直径为2.5μm或更小的细颗粒物（PM2.5）与肺结核（PTB）再治疗相关联的证据有限。没有关于绿色暴露是否可以保护先前PTB患者与空气污染相关的PTB再治疗的数据。
■在一项基于人群的回顾性研究中，我们旨在调查PM2.5和住宅绿色对PTB再治疗风险的影响。
■共有26,482例PTB患者，2012年至2019年在郑州的强制性网络报告系统中注册，中国,包括在分析中。PM2.5的暴露是根据中国高空气污染物数据集进行评估的，并使用归一化植被指数（NDVI）值估算绿色水平。评估了PTB再治疗与PM2.5暴露和绿色的关系，分别,考虑到夜间灯光指数所显示的当地社会经济水平。
■在26,482名患者（平均年龄46.86，SD19.52岁）中，每位患者的中位随访时间为1523天，在2012年至2019年期间观察到1542次（5.82%）PTB再治疗。在完全调整的模型中，发现暴露于PM2.5与PTB再治疗风险增加显着相关，PM2.5每增加10μg/m3，风险比为1.97（95％CI1.34-2.83）。生活在NDVI值四分位数相对较高的地区的患者比生活在500m缓冲液四分位数最低的地区的患者的PTB再治疗风险低45％（风险比0.55，95％CI0.40-0.77）。在居住在夜间光线较低的地区的患者中，住宅绿色的这种保护作用更为明显。绿色减弱了PM2.5暴露与PTB再治疗风险之间的关联强度。在NDVI和耐药发生率之间没有观察到显著关联。
■长期暴露于PM2.5可能是PTB再治疗的危险因素，虽然发现住宅绿色水平的提高与PTB再治疗的风险降低有关。我们的结果表明，加强对环境空气污染的控制和改善住宅绿色可能有助于减少PTB的再处理。
■在一项基于人群的回顾性研究中，我们旨在调查PM2.5和住宅绿色对PTB再治疗风险的影响。
■共有26,482例PTB患者，2012年至2019年在郑州的强制性网络报告系统中注册，中国,包括在分析中。PM2.5的暴露是根据中国高空气污染物数据集进行评估的，并使用归一化植被指数（NDVI）值估算绿色水平。评估了PTB再治疗与PM2.5暴露和绿色的关系，分别,考虑到夜间灯光指数所显示的当地社会经济水平。
■在26,482名患者（平均年龄46.86，SD19.52岁）中，每位患者的中位随访时间为1523天，在2012年至2019年期间观察到1542次（5.82%）PTB再治疗。在完全调整的模型中，发现暴露于PM2.5与PTB再治疗风险增加显着相关，PM2.5每增加10μg/m3，风险比为1.97（95％CI1.34-2.83）。生活在NDVI值四分位数相对较高的地区的患者比生活在500m缓冲液四分位数最低的地区的患者的PTB再治疗风险低45％（风险比0.55，95％CI0.40-0.77）。在居住在夜间光线较低的地区的患者中，住宅绿色的这种保护作用更为明显。绿色减弱了PM2.5暴露与PTB再治疗风险之间的关联强度。在NDVI和耐药发生率之间没有观察到显著关联。
■长期暴露于PM2.5可能是PTB再治疗的危险因素，虽然发现住宅绿色水平的提高与PTB再治疗的风险降低有关。我们的结果表明，加强对环境空气污染的控制和改善住宅绿色可能有助于减少PTB的再处理。
