大气气态污染物对农村结核分枝杆菌潜伏感染者肺结核发病的影响OA北大核心CSTPCD

Objective:To investigate the influence of primary atmospheric gaseous pollutants on the incidence of active pulmonary tuberculosis among adults in rural areas with latent tuberculosis infection(LTBI).Methods:This study utilized a multicenter,longitudinal cohort of rural residents with LTBI(LATENTTB-NSTM),spanning from 2013 to 2018,comprising 3866 participants who were monitored quarterly over five years to document new cases of active pulmonary tuberculosis.Concentrations of atmospheric gaseous pollutants such as sulfur dioxide(SO2),nitrogen dioxide(NO2),ozone(O3),and carbon monoxide(CO)were precisely matched to the residential locations and periods under review.The association between exposure levels and the emergence of active tuberculosis was analyzed using time-dependent Cox proportional hazards models,stratified by age,sex,educational attainment,family income,and lifestyle factors.Results:Among 3866 individuals diagnosed with latent tuberculosis infection,surveillance identified 58 new cases of active pulmonary tuberculosis.Incremental exposures to SO2 and CO by 10 μg/m3 and 100 μg/m3,respectively,over a six-month period were associated with a respective 81.0％(HR=1.810,95％CI:1.153-2.843)and 19.6％(HR=1.196,95％CI:1.031-1.388)increase in the risk of developing active tuberculosis.Notably,these associations appeared more pronounced among older adults and smokers,though the differences did not reach statistical significance(interaction P-values＞0.05).Conclusion:Exposure to atmospheric gaseous pollutants,particularly SO2 and CO,is associated with a heightened risk of developing active pulmonary tuberculosis among individuals with LTBI in rural settings.The management of air quality,therefore,plays a crucial role in the strategic control of tuberculosis.