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ORIGINAL RESEARCH article

Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1454809
This article is part of the Research Topic Air Pollution Levels, Health Effects and Interventions View all 3 articles

Short-term effects of air pollution on the infectious disease spectrum in Shanghai, China: a time-series analysis from 2013 to 2019

Provisionally accepted
Yihan Lin Yihan Lin Hao Meng Hao Meng Yong He Yong He Wenzhuo Liang Wenzhuo Liang Yiran Niu Yiran Niu Zhenliang Liu Zhenliang Liu Ziying Wang Ziying Wang Yangyang Tian Yangyang Tian Shiyang Chang Shiyang Chang *
  • Hebei Medical University, Shijiazhuang, Hebei Province, China

The final, formatted version of the article will be published soon.

    Background: Epidemiological evidence on the effects of air pollution on infectious diseases remained inconsistent, highlighting the need for further research and analysis. We aimed to investigate the relationship between fine particulate matter (PM2.5) and ozone (O3) exposure and the risk of national notifiable infectious diseases in Shanghai, a mega city in China.We fitted a double-pollutant model for each air pollutant, utilizing time-series analysis to separately apply single and distributed lag models (DLMs) to assess the exposure-lag-response relationship for 43 national notifiable infectious diseases (NNIDs) from 2013 to 2019. The model was adjusted for seasonality, long-term trends, mean temperature, relative humidity, and other air pollutants. Analysis was further conducted for seven NNIDs categories (vaccine preventable, bacterial, gastrointestinal and enterovirus, sexually transmitted and bloodborne, vectorborne, zoonotic, and quarantinable diseases) as well as for specific diseases.The study included 661,267 NNID cases and found that PM2.5 and O3 exposures were associated with increased NNID risks, although not within the same categories. A 10 µg/m 3 increase in O3 was associated with a higher risk of total NNIDs (relative risk [RR] at lag 1 month:1.29, 95% confidence interval [CI]: 1.02-1.65), vaccine-preventable diseases (RR at lag 1 month:1.75, 95% CI: 1.02-3.01), and sexually transmitted and bloodborne diseases (RR at lag 2 month:1.12, 95% CI: 1.00-1.26). However, the association with PM2.5 remained inconclusive.These findings suggest a potential link between ambient air pollution exposure and the risk of infectious diseases, highlighting the urgent need for a complete picture of the relationship between air pollution and notifiable infectious diseases, as well as a comprehensive evaluation of the relevant disparities among the disease spectrum.

    Keywords: infectious diseases, Air Pollution, Fine Particulate Matter, Ozone, Time-series study, Distributed lag model

    Received: 25 Jun 2024; Accepted: 14 Jan 2025.

    Copyright: © 2025 Lin, Meng, He, Liang, Niu, Liu, Wang, Tian and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shiyang Chang, Hebei Medical University, Shijiazhuang, 050017, Hebei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.