title: Is short-term exposure to ambient fine particles associated with measles incidence in China? A multi-city study.
abstract: China's rapid economic development has resulted in severe particulate matter (PM) air pollution and the control and prevention of infectious disease is an ongoing priority. This study examined the relationships between short-term exposure to ambient particles with aerodynamic diameter ≤2.5µm (PM2.5) and measles incidence in China.
  
  
  
  Data on daily numbers of new measles cases and concentrations of ambient PM2.5were collected from 21 cities in China during Oct 2013 and Dec 2014. Poisson regression was used to examine city-specific associations of PM2.5and measles, with a constrained distributed lag model, after adjusting for seasonality, day of the week, and weather conditions. Then, the effects at the national scale were pooled with a random-effect meta-analysis.
  
  
  
  A 10µg/m3increase in PM2.5at lag 1day, lag 2day and lag 3day was significantly associated with increased measles incidence [relative risk (RR) and 95% confidence interval (CI) were 1.010 (1.003, 1.018), 1.010 (1.003, 1.016) and 1.006 (1.000, 1.012), respectively]. The cumulative relative risk of measles associated with PM2.5at lag 1-3 days was 1.029 (95% CI: 1.010, 1.048). Stratified analyses by meteorological factors showed that the PM2.5and measles associations were stronger on days with high temperature, low humidity, and high wind speed.
  
  
  
  We provide new evidence that measles incidence is associated with exposure to ambient PM2.5in China. Effective policies to reduce air pollution may also reduce measles incidence.
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Gongbo
authors.initials: G
authors.lastname: Chen
authors.affiliation: Center for Disease Surveillance & Research, Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, China.
authors.forename: Wenyi
authors.initials: W
authors.lastname: Zhang
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia.
authors.forename: Gail
authors.initials: G
authors.lastname: Williams
authors.affiliation: Center for Disease Surveillance & Research, Institute of Disease Control and Prevention, Academy of Military Medical Science, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia.
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Morgan
authors.affiliation: Center for Environmental and Respiratory Health Research, Institute of Health Sciences, University of Oulu, Oulu, Finland.
authors.forename: Jouni J K
authors.initials: JJK
authors.lastname: Jaakkola
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. Electronic address: yuming.guo@monash.edu.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D002681:China / Q000453:epidemiology; D002947:Cities; D004781:Environmental Exposure; D006801:Humans; D015994:Incidence; D008457:Measles / Q000453:epidemiology* / Q000209:etiology; D010316:Particle Size; D052638:Particulate Matter / Q000032:analysis*; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: China; Measles; PM2.5