Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China

BackgroundInfluenza is a serious public health problem, and its prevalence and spread show significant spatiotemporal characteristics. Previous studies have found that air pollutants are linked to an increased risk of influenza. However, the mechanism of influence and the degree of their association...

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Main Authors: Yu Zhang, Shijun Wang, Zhangxian Feng, Yang Song
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2022.1071229/full
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author Yu Zhang
Shijun Wang
Shijun Wang
Zhangxian Feng
Zhangxian Feng
Yang Song
Yang Song
author_facet Yu Zhang
Shijun Wang
Shijun Wang
Zhangxian Feng
Zhangxian Feng
Yang Song
Yang Song
author_sort Yu Zhang
collection DOAJ
description BackgroundInfluenza is a serious public health problem, and its prevalence and spread show significant spatiotemporal characteristics. Previous studies have found that air pollutants are linked to an increased risk of influenza. However, the mechanism of influence and the degree of their association have not been determined. This study aimed to determine the influence of the air environment on the spatiotemporal distribution of influenza.MethodsThe kernel density estimation and Getis-Ord Gi* statistic were used to analyze the spatial distribution of the influenza incidence and air pollutants in China. A simple analysis of the correlation between influenza and air pollutants was performed using Spearman's correlation coefficients. A linear regression analysis was performed to examine changes in the influenza incidence in response to air pollutants. The sensitivity of the influenza incidence to changes in air pollutants was evaluated by performing a gray correlation analysis. Lastly, the entropy weight method was used to calculate the weight coefficient of each method and thus the comprehensive sensitivity of influenza incidence to six pollution elements.ResultsThe results of the sensitivity analysis using Spearman's correlation coefficients showed the following ranking of the contributions of the air pollutants to the influenza incidence in descending order: SO2 >NO2 >CO> PM2.5 >O3 >PM10. The sensitivity results obtained from the linear regression analysis revealed the following ranking: CO>NO2 >SO2 >O3 >PM2.5 >PM10. Lastly, the sensitivity results obtained from the gray correlation analysis showed the following ranking: NO2 >CO>PM10 >PM2.5 >SO2 >O3. According to the sensitivity score, the study area can be divided into hypersensitive, medium-sensitive, and low-sensitive areas.ConclusionThe influenza incidence showed a strong spatial correlation and associated sensitivity to changes in concentrations of air pollutants. Hypersensitive areas were mainly located in the southeastern part of northeastern China, the coastal areas of the Yellow River Basin, the Beijing-Tianjin-Hebei region and surrounding areas, and the Yangtze River Delta. The influenza incidence was most sensitive to CO, NO2, and SO2, with the occurrence of influenza being most likely in areas with elevated concentrations of these three pollutants. Therefore, the formulation of targeted influenza prevention and control strategies tailored for hypersensitive, medium-sensitive, low-sensitive, and insensitive areas are urgently needed.
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spelling doaj.art-0c122ea219214dc49d5652b0bff59edb2022-12-22T04:16:29ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-12-011010.3389/fpubh.2022.10712291071229Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in ChinaYu Zhang0Shijun Wang1Shijun Wang2Zhangxian Feng3Zhangxian Feng4Yang Song5Yang Song6School of Geographical Sciences, Northeast Normal University, Changchun, ChinaSchool of Geographical Sciences, Northeast Normal University, Changchun, ChinaKey Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, ChinaSchool of Geographical Sciences, Northeast Normal University, Changchun, ChinaKey Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, ChinaSchool of Geographical Sciences, Northeast Normal University, Changchun, ChinaKey Laboratory of Geographical Processes and Ecological Security in Changbai Mountains, Ministry of Education, Changchun, ChinaBackgroundInfluenza is a serious public health problem, and its prevalence and spread show significant spatiotemporal characteristics. Previous studies have found that air pollutants are linked to an increased risk of influenza. However, the mechanism of influence and the degree of their association have not been determined. This study aimed to determine the influence of the air environment on the spatiotemporal distribution of influenza.MethodsThe kernel density estimation and Getis-Ord Gi* statistic were used to analyze the spatial distribution of the influenza incidence and air pollutants in China. A simple analysis of the correlation between influenza and air pollutants was performed using Spearman's correlation coefficients. A linear regression analysis was performed to examine changes in the influenza incidence in response to air pollutants. The sensitivity of the influenza incidence to changes in air pollutants was evaluated by performing a gray correlation analysis. Lastly, the entropy weight method was used to calculate the weight coefficient of each method and thus the comprehensive sensitivity of influenza incidence to six pollution elements.ResultsThe results of the sensitivity analysis using Spearman's correlation coefficients showed the following ranking of the contributions of the air pollutants to the influenza incidence in descending order: SO2 >NO2 >CO> PM2.5 >O3 >PM10. The sensitivity results obtained from the linear regression analysis revealed the following ranking: CO>NO2 >SO2 >O3 >PM2.5 >PM10. Lastly, the sensitivity results obtained from the gray correlation analysis showed the following ranking: NO2 >CO>PM10 >PM2.5 >SO2 >O3. According to the sensitivity score, the study area can be divided into hypersensitive, medium-sensitive, and low-sensitive areas.ConclusionThe influenza incidence showed a strong spatial correlation and associated sensitivity to changes in concentrations of air pollutants. Hypersensitive areas were mainly located in the southeastern part of northeastern China, the coastal areas of the Yellow River Basin, the Beijing-Tianjin-Hebei region and surrounding areas, and the Yangtze River Delta. The influenza incidence was most sensitive to CO, NO2, and SO2, with the occurrence of influenza being most likely in areas with elevated concentrations of these three pollutants. Therefore, the formulation of targeted influenza prevention and control strategies tailored for hypersensitive, medium-sensitive, low-sensitive, and insensitive areas are urgently needed.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1071229/fullinfluenza incidenceair pollutantssensitivitysensitive divisionChina
spellingShingle Yu Zhang
Shijun Wang
Shijun Wang
Zhangxian Feng
Zhangxian Feng
Yang Song
Yang Song
Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
Frontiers in Public Health
influenza incidence
air pollutants
sensitivity
sensitive division
China
title Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
title_full Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
title_fullStr Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
title_full_unstemmed Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
title_short Influenza incidence and air pollution: Findings from a four-year surveillance study of prefecture-level cities in China
title_sort influenza incidence and air pollution findings from a four year surveillance study of prefecture level cities in china
topic influenza incidence
air pollutants
sensitivity
sensitive division
China
url https://www.frontiersin.org/articles/10.3389/fpubh.2022.1071229/full
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