Outdoor particulate matter and risk of drug resistance for workers and farmers with pulmonary tuberculosis: a population-based time-series study in Suzhou, China.

OBJECTIVES

The detrimental effects of particulate matter (PM) on human health have been widely corroborated. We aimed to examine the association between outdoor PM and the drug resistance risk among workers and farmers with pulmonary tuberculosis (PTB).

DESIGN

We performed a population-based time-series study using routinely collected meteorological and TB surveillance data.

SETTING

We selected Suzhou City, China, as the study area. Data on patients with PTB and meteorological factors were extracted from the National Tuberculosis Online Registration System and the China Meteorological Data Sharing Center.

PARTICIPANTS

This study included 7868 patients with PTB diagnosed from January 2017 to December 2021 in Suzhou.

METHODS

The generalised additive model was used to estimate the effects of outdoor PM on the drug resistance risk of TB among workers and farmers who typically work outdoors. Moreover, subgroup analyses were carried out to evaluate the associations in different populations and seasons.

RESULTS

Although there was no significant association between PM with an aerodynamic diameter≤10 µm (PM10) and drug-resistant risk in the overall analysis, subgroup analysis revealed a significant positive association in the winter season. Similarly, PM with an aerodynamic diameter≤2.5 µm (PM2.5) was significantly associated with drug resistance risk among males with a lag of 0-3 days, people ≤60 years with a lag of 0-7 days and in the winter season with a lag of 0-7 days, 0-15 days, 0-90 days or 0-180 days.

CONCLUSIONS

Outdoor PM10 and PM2.5 were positively related to the drug resistance risk of workers and farmers with PTB. Reducing ambient PM pollution might reduce the burden of TB. Further research is required to verify the association through in vitro experiments and extensive cohort studies.