Liu D, Ma J, Chen J, Yang Z, Hu W, Liu Q, Peng Z,. PM2.5 constituents and risk of influenza-like illness: A nationwide analysis in 289 Chinese cities. J Hazard Mater. 2025 Apr 6;492:138186
Discrepancies in fine particulate matter (PM2.5)-related influenza-like illness (ILI) risk have been widely observed in different studies in China, where the individual effect of PM2.5 constituents might be one of the important reasons. However, the associations between PM2.5 constituents and ILI risk in China have yet to be understood. We collected and aggregated weekly ILI cases in 289 Chinese cities during 2006-2019, and 47.8 million ILI cases were finally included in this study. Quasi-Poisson regression models and a random-effect meta-analysis were applied to estimate the impacts of PM2.5 and its constituents on ILI risk. Stratification analyses were also conducted by region, age group, season, and temperature and humidity quartiles. With per inter-quartile range increase in black carbon, ammonium, sulfate, PM2.5, nitrate and organic matter with a cumulative lag of 0-1 week, the overall ILI incidence would increase by 2.55 % (95 % CI: 1.71, 3.40), 2.32 % (1.33, 3.32), 2.19 % (1.29, 3.10), 2.19 % (1.25, 3.13), 2.15 % (1.08, 3.22) and 2.02 % (1.19, 2.85), respectively. The impacts tended to be much stronger in young- and middle-aged population, in North and East China, in winter, and in colder and drier conditions. PM2.5 and its major constituents all have significantly additive effects on ILI incidence. Specific preventive measures against individual constituent should be implemented for improving public health.
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