Universität zu Köln

Rittweger, Jorn, Gilardi, Lorenza ORCID: 0000-0003-4472-8530, Baltruweit, Maxana, Dally, Simon, Erbertseder, Thilo ORCID: 0000-0003-4888-1065, Mittag, Uwe, Naeem, Muhammad, Schmid, Matthias, Schmitz, Marie-Therese, Wuest, Sabine, Dech, Stefan, Jordan, Jens, Antoni, Tobias and Bittner, Michael (2022). Temperature and particulate matter as environmental factors associated with seasonality of influenza incidence - an approach using Earth observation-based modeling in a health insurance cohort study from Baden-Wurttemberg (Germany). Environ. Health, 21 (1). LONDON: BMC. ISSN 1476-069X

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Abstract

Background: Influenza seasonality has been frequently studied, but its mechanisms are not clear. Urban in-situ studies have linked influenza to meteorological or pollutant stressors. Few studies have investigated rural and less polluted areas in temperate climate zones. Objectives: We examined influences of medium-term residential exposure to fine particulate matter (PM2.5), NO2, SO2, air temperature and precipitation on influenza incidence. Methods: To obtain complete spatial coverage of Baden-Wurttemberg, we modeled environmental exposure from data of the Copernicus Atmosphere Monitoring Service and of the Copernicus Climate Change Service. We computed spatiotemporal aggregates to reflect quarterly mean values at post-code level. Moreover, we prepared health insurance data to yield influenza incidence between January 2010 and December 2018. We used generalized additive models, with Gaussian Markov random field smoothers for spatial input, whilst using or not using quarter as temporal input. Results: In the 3.85 million cohort, 513,404 influenza cases occurred over the 9-year period, with 53.6% occurring in quarter 1 (January to March), and 10.2%, 9.4% and 26.8% in quarters 2, 3 and 4, respectively. Statistical modeling yielded highly significant effects of air temperature, precipitation, PM2.5 and NO2. Computation of stressor-specific gains revealed up to 3499 infections per 100,000 AOK clients per year that are attributable to lowering ambient mean air temperature from 18.71 & DEG;C to 2.01 & DEG;C. Stressor specific gains were also substantial for fine particulate matter, yielding up to 502 attributable infections per 100,000 clients per year for an increase from 7.49 mu g/m(3) to 15.98 mu g/m(3). Conclusions: Whilst strong statistical association of temperature with other stressors makes it difficult to distinguish between direct and mediated temperature effects, results confirm genuine effects by fine particulate matter on influenza infections for both rural and urban areas in a temperate climate. Future studies should attempt to further establish the mediating mechanisms to inform public health policies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rittweger, Jorn UNSPECIFIED UNSPECIFIED UNSPECIFIED Gilardi, Lorenza UNSPECIFIED orcid.org/0000-0003-4472-8530 UNSPECIFIED Baltruweit, Maxana UNSPECIFIED UNSPECIFIED UNSPECIFIED Dally, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Erbertseder, Thilo UNSPECIFIED orcid.org/0000-0003-4888-1065 UNSPECIFIED Mittag, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Naeem, Muhammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz, Marie-Therese UNSPECIFIED UNSPECIFIED UNSPECIFIED Wuest, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Dech, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Antoni, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Bittner, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-684019
DOI:	10.1186/s12940-022-00927-y
Journal or Publication Title:	Environ. Health
Volume:	21
Number:	1
Date:	2022
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1476-069X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AIR-POLLUTION; TRANSMISSION; ILLNESS; EUROPE Multiple languages Environmental Sciences; Public, Environmental & Occupational Health Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/68401