Effects of air pollutants on occurrences of influenza-like illness and laboratory-confirmed influenza in Hefei, China.

Accumulating evidence suggests that air pollution is a risk factor for adverse respiratory and cardiovascular health outcomes. However, the different impacts of exposure to air pollutants on influenza virus activity and influenza-like illness (ILI) have not been well documented in epidemiological studies. We examined the association between air pollutants of particular matters < 2.5 μm (PM), particular matters < 10 μm (PM), nitrogen dioxide (NO), sulfur dioxide (SO), and influenza occurrences in Hefei, China, from December 2013 to December 2015 by generalized Poisson additive regression models. The result suggested that PM and PM had similar effects on clinical ILI and influenza incidence. PM was negatively associated with clinical ILI (relative risk (RR) 0.980, 95% confidence interval (CI) 0.974-0.987), while PM were positively associated with clinical ILI (RR 1.040; 95% CI 1.032-1.049). RRs for the laboratory-confirmed cases of influenza were 0.813 (95% CI, 0.755-0.875) for PM and 1.216 (95% CI, 1.134-1.304) for PM. Nevertheless, the impacts of SO and NO on ILI and influenza were distinct. SO had significant influence on laboratory-confirmed influenza and had no significant linear relationship with ILI. NO was negatively correlated with influenza but had no obvious effect on clinical ILI cases. The present study contributes novel evidence on understanding of the effects of various air pollutants on influenza activities, and these findings can be useful and important for the development of influenza surveillance and early warning systems.