The short-term effects of air pollutants on influenza-like illness in Jinan, China.

Background: There is valid evidence that air pollution is associated with respiratory disease. However, few studies have quantified the short-term effects of six air pollutants on influenza-like illness (ILI). This study explores the potential relationship between air pollutants and ILI in Jinan, China.

Methods: Daily data on the concentration of particulate matters < 2.5 μm (PM 2.5), particulate matters < 10 μm (PM10), sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), and ozone (O) and ILI counts from 2016 to 2017 were retrieved. The wavelet coherence analysis and generalized poisson additive regression model were employed to qualify the relationship between air pollutants and ILI risk. The effects of air pollutants on different age groups were investigated.

Results: A total of 81,459 ILI counts were collected, and the average concentrations of PM2.5, PM10, O, CO, SO and NO were 67.8 μg/m, 131.76 μg/ m, 109.85 μg/ m, 1133 μg/ m, 33.06 μg/ m and 44.38 μg/ m, respectively. A 10 μg/ m increase in concentration of PM2.5, PM10, CO at lag0 and SO at lag01, was positively associated with a 1.0137 (95% confidence interval (CI): 1.0083-1.0192), 1.0074 (95% CI: 1.0041-1.0107), 1.0288 (95% CI: 1.0127-1.0451), and 1.0008 (95% CI: 1.0003-1.0012) of the relative risk (RR) of ILI, respectively. While, O3 (lag5) was negatively associated with ILI (RR 0.9863; 95%CI: 0.9787-0.9939), and no significant association was observed with NO, which can increase the incidence of ILI in the two-pollutant model. A short-term delayed impact of PM2.5, PM10, SO2 at lag02 and CO, O3 at lag05 was also observed. People aged 25-59, 5-14 and 0-4 were found to be significantly susceptible to PM2.5, PM10, CO; and all age groups were significantly susceptible to SO; People aged ≥60 year, 5-14 and 0-4 were found to be significantly negative associations with O.

Conclusion: Air pollutants, especially PM2.5, PM10, CO and SO, can increase the risk of ILI in Jinan. The government should create regulatory policies to reduce the level of air pollutants and remind people to practice preventative and control measures to decrease the incidence of ILI on pollution days.