Global association between air pollution and risk of influenza-related outcomes: a systematic review and meta-analysis.

IF 1.9 4区医学 Q3 ENVIRONMENTAL SCIENCES

International Journal of Environmental Health Research Pub Date : 2025-08-12 DOI:10.1080/09603123.2025.2545998

Xiaoke Gao, Sujuan Chen, Zijie Zhong, Junjie Li, Jinjian Chen, Bixia Li, Kaili Lin, Qiuhan Hua, Rong Zhang, Di Liu, Jun Yang

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Abstract

Despite extensive research, air pollution-influenza associations remain inconsistent. This evidence synthesis aggregated evidence from 28 studies to quantify air pollution-influenza associations, employing the Office of Health Assessment and Translation (OHAT) and Navigation Guide tools for quality assessment. We derived combined relative risk (RR) per 10 µg/m³ increase in air pollution, 95% confidence intervals (CIs) and 95% prediction intervals (PIs) to quantify the link. PM_2.5 (RR = 1.037; 95% CI: 1.019-1.055), SO₂ (RR = 1.351; 95% CI: 1.107-1.649) and CO (RR = 1.003, 95% CI: 1.001-1.004) showed significant links to higher influenza risk. PM₁₀ (RR = 1.064, 95% CI: 0.964-1.174), NO₂ (RR = 1.207, 95% CI: 0.988-1.475), and O₃ (RR = 1.027, 95% CI: 0.962-1.097) demonstrated a nonsignificant tendency to increase influenza risk. Stratified analyses indicated heightened vulnerability to SO₂ in Asian populations relative to Australians, and to PM_2.5 in Europe compared to Asia. Males experienced greater risks for PM_2.5, PM₁₀, NO₂ and SO₂. However, these associations were characterized by substantial between-study heterogeneity even after stratification, which was reflected in 95% PI that suggested an inconsistent direction of effect in future studies. Our analysis confirmed air pollutants increase influenza risk, but confounding, exposure variability, and mechanistic pathways warrant further study, particularly in underrepresented regions.

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空气污染与流感相关后果风险之间的全球关联：系统综述和荟萃分析。

尽管进行了广泛的研究，但空气污染与流感之间的关联仍然不一致。这一证据综合利用卫生评估和翻译办公室（OHAT）和导航指南工具进行质量评估，汇总了来自28项研究的证据，以量化空气污染与流感的关联。我们推导出空气污染每增加10µg/m3的综合相对风险（RR）、95%置信区间（ci）和95%预测区间（pi）来量化这种联系。Pm2.5 (rr = 1.037；95% ci: 1.019-1.055), so2 (rr = 1.351；95% CI: 1.107-1.649)和CO （RR = 1.003, 95% CI: 1.001-1.004）与流感风险增加有显著联系。PM10 （RR = 1.064, 95% CI: 0.964-1.174）、NO2 （RR = 1.207, 95% CI: 0.988-1.475）和O3 （RR = 1.027, 95% CI: 0.962-1.097）无显著增加流感风险的趋势。分层分析表明，相对于澳大利亚人，亚洲人口对二氧化硫的脆弱性更高，而与亚洲相比，欧洲人口对PM2.5的脆弱性更高。男性对PM2.5、PM10、NO2和SO2的风险更高。然而，即使在分层之后，这些关联也表现出大量的研究间异质性，95%的PI反映了这一点，这表明未来研究的影响方向不一致。我们的分析证实，空气污染物增加了流感风险，但混杂、暴露变异性和机制途径值得进一步研究，特别是在代表性不足的地区。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Environmental Health Research 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.70

自引率

3.10%

发文量

134

审稿时长

>12 weeks

期刊介绍： International Journal of Environmental Health Research ( IJEHR ) is devoted to the rapid publication of research in environmental health, acting as a link between the diverse research communities and practitioners in environmental health. Published articles encompass original research papers, technical notes and review articles. IJEHR publishes articles on all aspects of the interaction between the environment and human health. This interaction can broadly be divided into three areas: the natural environment and health – health implications and monitoring of air, water and soil pollutants and pollution and health improvements and air, water and soil quality standards; the built environment and health – occupational health and safety, exposure limits, monitoring and control of pollutants in the workplace, and standards of health; and communicable diseases – disease spread, control and prevention, food hygiene and control, and health aspects of rodents and insects. IJEHR is published in association with the International Federation of Environmental Health and includes news from the Federation of international meetings, courses and environmental health issues.