Journal article
Traffic-Related Air Pollution and All-Cause Mortality during Tuberculosis Treatment in California
Environmental health perspectives, Vol.125(9), pp.097026-097026
09/29/2017
DOI: 10.1289/EHP1699
PMCID: PMC5915191
PMID: 28963088
Abstract
Ambient air pollution and tuberculosis (TB) have an impact on public health worldwide, yet associations between the two remain uncertain.
We determined the impact of residential traffic on mortality during treatment of active TB.
From 2000-2012, we enrolled 32,875 patients in California with active TB and followed them throughout treatment. We obtained patient data from the California Tuberculosis Registry and calculated traffic volumes and traffic densities in 100- to 400-m radius buffers around residential addresses. We used Cox models to determine mortality hazard ratios, controlling for demographic, socioeconomic, and clinical potential confounders. We categorized traffic exposures as quintiles and determined trends using Wald tests.
Participants contributed 22,576 person-years at risk. There were 2,305 deaths during treatment for a crude mortality rate of 1,021 deaths per 10,000 person-years. Traffic volumes and traffic densities in all buffers around patient residences were associated with increased mortality during TB treatment, although the findings were not statistically significant in all buffers. As the buffer size decreased, fifth-quintile mortality hazards increased, and trends across quintiles of traffic exposure became more statistically significant. Increasing quintiles of nearest-road traffic volumes in the 100-m buffer were associated with 3%, 14%, 19%, and 28% increased risk of death during TB treatment [first quintile, referent; second quintile hazard ratio (HR)=1.03 [95% confidence interval (CI): 0.86, 1.25]; third quintile HR=1.14 (95% CI: 0.95, 1.37); fourth quintile HR=1.19 (95% CI: 0.99, 1.43); fifth quintile HR=1.28 (95% CI: 1.07, 1.53), respectively; p-trend=0.002].
Residential proximity to road traffic volumes and traffic density were associated with increased all-cause mortality in patients undergoing treatment for active tuberculosis even after adjusting for multiple demographic, socioeconomic, and clinical factors, suggesting that TB patients are susceptible to the adverse health effects of traffic-related air pollution. https://doi.org/10.1289/EHP1699.
Details
- Title: Subtitle
- Traffic-Related Air Pollution and All-Cause Mortality during Tuberculosis Treatment in California
- Creators
- Robert J Blount - Division of Pediatric Pulmonology, University of California, San Francisco , San Francisco, California, USALisa Pascopella - Tuberculosis Control Branch, California Department of Public Health , Richmond, California, USADonald G Catanzaro - Department of Biological Sciences, University of Arkansas , Fayetteville, Arkansas, USAPennan M Barry - Tuberculosis Control Branch, California Department of Public Health , Richmond, California, USAPaul B English - Environmental Health Investigations Branch, California Department of Public Health , Richmond, California, USAMark R Segal - Department of Epidemiology and Biostatistics, University of California, San Francisco , San Francisco, California, USAJennifer Flood - Tuberculosis Control Branch, California Department of Public Health , Richmond, California, USADan Meltzer - California Environmental Health Tracking Program , Public Health Institute , Oakland, California, USABrenda Jones - Division of Infectious Diseases, University of Southern California , Los Angeles, California, USAJohn Balmes - Environmental Health Sciences, University of California, Berkeley , Berkeley, California, USAPayam Nahid - Division of Pulmonary and Critical Care Medicine, University of California, San Francisco , San Francisco, California, USA
- Resource Type
- Journal article
- Publication Details
- Environmental health perspectives, Vol.125(9), pp.097026-097026
- DOI
- 10.1289/EHP1699
- PMID
- 28963088
- PMCID
- PMC5915191
- ISSN
- 0091-6765
- eISSN
- 1552-9924
- Grant note
- K23 ES025807 / NIEHS NIH HHS F32 ES022582 / NIEHS NIH HHS R01 AI104589 / NIAID NIH HHS
- Language
- English
- Date published
- 09/29/2017
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Occupational and Environmental Health; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984093336502771
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