Journal of Preventive Medicine and Public Health

  • 제57권2호
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  • Pages.108-119
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  • 2024
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Alleviation of PM2.5-associated Risk of Daily Influenza Hospitalization by COVID-19 Lockdown Measures: A Time-series Study in Northeastern Thailand

  • Benjawan Roudreo (Industrial Toxicology and Risk Assessment Graduate Program, Department of Environmental Science, Faculty of Science, Chulalongkorn University) ;
  • Sitthichok Puangthongthub (Industrial Toxicology and Risk Assessment Graduate Program, Department of Environmental Science, Faculty of Science, Chulalongkorn University)
  • 투고 : 2023.08.04
  • 심사 : 2023.12.13
  • 발행 : 2024.03.31
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초록

Objectives: Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous. Methods: This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand's Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels. Results: Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 ㎛ or less (PM2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 ㎍/m3 increase in PM2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak. Conclusions: Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.

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과제정보

This research was supported by the Industrial Toxicology and Risk Assessment Graduate Program of Chulalongkorn University, Thailand. The authors would like to acknowledge the Thai Pollution Control Department, the Thai Meteorological Department, and the Information and Communication Technology Center of the Ministry of Public Health for providing the data for this study.

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