Influence Of Meteorological Factors,Air Quality Factors And Their Interaction On The Risk Of Pulmonary Tuberculosis In Urumqi

Objective:According to the results of epidemiological investigation,the epidemiological characteristics of tuberculosis in Urumqi were clarified,and the influence of environmental factors exposure on the risk of tuberculosis was analyzed from the perspective of meteorological factors,air quality factors and their interaction,so as to provide reasonable suggestions for tuberculosis prevention and control.Methods:The data of tuberculosis incidence in Urumqi from 2014 to 2019 were collected,and the characteristics of tuberculosis prevalence were analyzed by descriptive statistical analysis method.Meteorological factors and air quality factors were collected from China National Meteorological Information Center and China National Environmental Monitoring Center.Spearman correlation coefficient was used to explore the correlation between air quality factors and meteorological factors.Based on the generalized additivity model,the influence of meteorological factors,air quality factors and their interaction on the risk of pulmonary tuberculosis in Urumqi city was discussed.At the same time,the subgroup analysis was used to find the vulnerable groups,and the sensitivity analysis was carried out by changing the degree of freedom of long-term trend to evaluate the stability of the model results.Results:1.A total of 14,402 cases of tuberculosis were reported in Urumqi from 2014 to 2019,among which the number of male cases was higher than female cases in all age groups;The highest number of cases occurred in people aged 20-29;In addition,the incidence of tuberculosis had obvious seasonal and cyclical characteristics,with a high incidence of tuberculosis from March to May.2.Among all meteorological factors and air quality factors,except the relative humidity and diurnal temperature difference,the other factors showed periodic changes.O₃,average temperature and average wind speed presented an inverted"U"shape distribution,while average air pressure and other pollutants presented a"U"shape distribution.3.The influence of meteorological factors on tuberculosis in Urumqi presented nonlinear and hysteretic characteristics.The average weekly temperature,relative humidity,wind speed,air pressure and diurnal temperature difference reached the optimal lag order at lag01,lag05,lag02,lag010 and lag07respectively,and the exposure response curve generally presented an inverted"U"shaped distribution.The corresponding thresholds were-5.411°C,52.118%,3.513m/s,1021.625hpa,and 8.161°C,respectively.There was no statistical difference in the influence of meteorological factors on pulmonary tuberculosis in different gender and age groups,but the RR values of male population and elderly population were larger.By changing the degree of freedom of long-term trend（df=5,7）,the results did not change significantly,and the prediction performance of the model was stable.4.The effect of air quality factors on pulmonary tuberculosis in Urumqi was linear and lag.Except for O₃,the other air quality factors were positively correlated with pulmonary tuberculosis,and all reached the maximum at the cumulative lag of 12 weeks.The values of PM_2.5,PM₁₀,SO₂,NO₂and CO were 0.931（0.255,1.612）,1.028（0.301,1.760）,5.061（0.387,9.952）,2.830（0.512,5.200）and 5.789（1.508,10.251）,respectively.Except O₃,the other air quality factors were statistically significant in the female population,but not in the male population.Sensitivity analysis suggested that the results were stable.5.There was an interaction between meteorological factors and air quality factors on pulmonary tuberculosis.Stratified analysis showed that the five air quality factors（except O₃）under the environment of high temperature,high relative humidity,high wind speed,low pressure and large diurnal temperature difference were higher than those under the environment of low temperature,low relative humidity,low wind speed,high pressure and low diurnal temperature difference.The 3D diagram of interaction drawn by response plane method suggested that the risk of pulmonary tuberculosis was higher when the conditions were in high temperature-high air quality factor concentration,high relative humidity-high air quality factor concentration,high wind speed-high air quality factor concentration,low pressure-high air quality factor concentration,and high DTR-high air quality factor concentration.Conclusion:March-May is the high incidence month of pulmonary tuberculosis in Urumqi city every year,and the incidence is higher in the male population and 20-29 years old;meteorological factors and air quality factors have a certain influence on pulmonary tuberculosis,and there is an interaction effect.In future prevention and control,we should strengthen the prevention and control of high-incidence months and good-incidence population and refer to the influence of meteorological factors and air quality factors on tuberculosis in order to achieve the effect of controlling tuberculosis outbreaks.