title: Acute effects of air pollution on influenza-like illness in Nanjing, China: A population-based study.
abstract: Influenza-like illness causes substantial morbidity and mortality. Air pollution has already been linked to many health issues, and increasing evidence in recent years supports an association between air pollution and respiratory infections. It is a pioneer study in China to quantify the effects of air pollution on influenza-like illness. This study used wavelet coherence analysis and generalized additive models to explore the potential association between air pollution (including particulate matter with aerodynamic diameter ≦2.5 μm (PM2.5), particulate matter with aerodynamic diameter ≦10 μm (PM10) and nitrogen dioxide (NO2)) and influenza-like illness (a total of 59860 cases) in Nanjing, China from January 1, 2013 to December 31, 2013. The average concentrations of PM2.5, PM10 and NO2 were 77.37 μg/m(3), 135.20 μg/m(3) and 55.80 μg/m(3). An interquartile range increase in PM2.5 concentration was associated with a 2.99% (95% confidence interval (CI): 1.64%, 4.36%) increase in daily influenza-like cases on the same day, while the corresponding increase in NO2 was associated with a 3.77% (95% CI: 2.01%, 5.56%) increase in daily cases. People aged 0-4 were proved to be significantly susceptible to PM10 and NO2; 5-14 ages were significantly susceptible to PM2.5 and PM10; and 15-24 ages were significantly susceptible to all the analyzed air pollutants. Air pollution effects tended to be null or negative for patients aged over 25, which might be due to the small number of influenza-like cases in this age group. This study can be useful for understanding the adverse health effects of air pollution and the cause of influenza-like illness.
authors.affiliation: State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Huang
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Pollution Control & Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China. Electronic address: hjsjscdc@163.com.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China. Electronic address: tfyjscdc@163.com.
authors.forename: Fenyang
authors.initials: F
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000633:toxicity*; D002648:Child; D002675:Child, Preschool; D002681:China; D002947:Cities; D004781:Environmental Exposure; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology / Q000821:virology; D008875:Middle Aged; D008962:Models, Theoretical; D009585:Nitrogen Dioxide / Q000633:toxicity*; D010316:Particle Size; D052638:Particulate Matter / Q000633:toxicity*; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D009585:Nitrogen Dioxide
keywords: Acute effects; Air pollution; Generalized additive models; Influenza-like illness; Wavelet coherence analysis