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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 2  |  Page : 126-128

Incidence of pulmonary tuberculosis and particulate matter 2.5 pollutant level: The association analysis for 2019 air pollution Crisis, Bangkok Thailand


1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. D. Y. Patil University, Pune, India

Date of Submission31-Jan-2019
Date of Decision27-Mar-2019
Date of Acceptance04-Apr-2019
Date of Web Publication17-Jun-2019

Correspondence Address:
Dr. Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_31_19

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  Abstract 


Background: Pulmonary tuberculosis is an important pulmonary infection that it is common in many developing countries. The poor sanitation is the basic problem relating to the occurrence of the pulmonary tuberculosis. The relationship between air pollutant and incidence of pulmonary tuberculosis becomes the new public health consideration. Here, the author-specific focus is on the effect of particulate matter (PM) 2.5 pollutant on tuberculosis. Methods: The authors hereby assessed the correlation between incidence of pulmonary tuberculosis and PM 2.5 pollutant level regarding 2019 air pollution crisis, Bangkok Thailand. Results: There is no significant relationship between incidence of pulmonary tuberculosis and PM 2.5 pollutant level regarding 2019 air pollution crisis, Bangkok Thailand (P > 0.05). Conclusion: There is a lack of relationship between incidence of pulmonary tuberculosis and PM 2.5 pollutant level.

Keywords: Particulate matter 2.5, pulmonary, tuberculosis


How to cite this article:
Joob B, Wiwanitkit V. Incidence of pulmonary tuberculosis and particulate matter 2.5 pollutant level: The association analysis for 2019 air pollution Crisis, Bangkok Thailand. Biomed Biotechnol Res J 2019;3:126-8

How to cite this URL:
Joob B, Wiwanitkit V. Incidence of pulmonary tuberculosis and particulate matter 2.5 pollutant level: The association analysis for 2019 air pollution Crisis, Bangkok Thailand. Biomed Biotechnol Res J [serial online] 2019 [cited 2019 Sep 23];3:126-8. Available from: http://www.bmbtrj.org/text.asp?2019/3/2/126/260477




  Introduction Top


Pulmonary tuberculosis is an important pulmonary infection that it is common in many developing countries.[1] The poor sanitation is the basic problem relating to the occurrence of the pulmonary tuberculosis. Indeed, the relationship between respiratory disease and quality of air environment is an interesting issue. Bakonyi et al. performed a study in Brazil and found that air pollution could cause adverse effects on children's respiratory health. Bakonyi et al. noted that the problem could still be observed while pollutant levels were lower than the air quality standards.[2] Pollutant effects are more pronounce where there is a poor ventilation system. Even at low levels, air quality can affect respiratory health.[3] Bentayeb et al. found that the effect of pollutant was more serious in the elderly, and there was a trend of increasing problem with age.[3] In 2013, the International Agency for Research on Cancer classified outdoor air pollution as a possible carcinogen to humans.[4] The air pollution becomes an important global public health concern. International standards on air quality are set and implemented as indicators for proper regulations. Nevertheless, the air pollution still exists and still causes the health problem in several areas around the world.[4]

The relationship between air pollutant and incidence of pulmonary tuberculosis becomes a new public health consideration. There are many reports for the positive correlation of several air pollutants and incidence of pulmonary tuberculosis. The mentioned problematic air pollutants include sulfur dioxide, nitric dioxide, ozone, and carbon monoxide.[5],[6],[7] Fernandes et al. studied the relationship between tuberculosis and climatic factors in Brazil and found that there was a relationship between tuberculosis incidence and levels of smoke and particulate matter (PM).[8] Fernandes et al. concluded that surveillance actions for tuberculosis should expand observation time and cover climate indicators and air quality.[8] In another report from China, Sun et al. found that population density and air quality were important determinants for success of tuberculosis control activity.[9] It seems that many reports show the association between environmental air quality and tuberculosis.[2],[5],[6],[7],[8],[9] Nevertheless, there are some reports showing no association. In a report from China, Kan et al. found that there was no statistical relationship between air pollutants due to use of solid fluid and tuberculosis.[10] Slama performed a similar study in France and concluded that there was no sufficient evidence to claim that there was a relationship between tuberculosis and air pollutant from biofuel use.[11] Lin et al. preformed a meta-analysis study and found that there was a weak association between domestic use of solid fuels and tuberculosis.[12] Hence, the study on the association between specific air pollutant and tuberculosis is still required.

Of several air pollutants, PM is an important air pollutant. There are several studies on the health effect of PM.[13],[14] The very small PMs are of public health concern. PMs are usually inhalable and might cause health effect.[13],[14] It is acceptable that there is a potent role of PM in pathogenesis. The study on the human health impacts due to exposure to inhalable PMs is of primary importance.[13],[14] Regarding PM, there are many reports on the relationship between air PM 10 pollutant and incidence of pulmonary tuberculosis.[5],[6],[7] Regarding PM 2.5 pollution, there are also some few reports. Liu et al. performed a study in China and found that PM 2.5 was associated with increased risk of tuberculosis.[15] A similar study on the effect of PM 2.5 pollution and tuberculosis risk was also reported from India.[16] Nevertheless, in this Indian report, there was no significant relationship between PM 2.5 and tuberculosis.[16] In January 2019, there is an air pollution problem in Bangkok, a tropical country in Indochina. Here, based on the 2019 air pollution crisis in Thailand, the author-specific focus is on the relationship between PM 2.5 pollutant level and incidence of pulmonary tuberculosis.


  Methods Top


The aim of the present study is to assess the relationship between correlation between incidence of pulmonary tuberculosis and PM 2.5 pollutant level regarding 2019 air pollution crisis, Bangkok Thailand. The primary data include official report on ambient air PM 2.5 pollutant level provided by Thai Pollution Control Department and official report on number of newly diagnosed pulmonary tuberculosis provided by Thai Center of Disease Control, Ministry of Public Health. All data are specific data for Bangkok during January 2019. To assess the association between the ambient air PM 2.5 level and number of newly diagnosed case of tuberculosis, a standard correlation analysis is done. This study is based on the public available primary official data and requires no written informed consent or ethical approval.


  Results Top


According to the present study, there is no newly report case of pulmonary tuberculosis. The incidence rate of pulmonary tuberculosis during the study period is equal to 0%. Regarding the ambient air PM 2.5 levels, there was a wide range of PM 2.5 levels. The map representing the ambient air PM 2.5 levels is shown in [Figure 1].
Figure 1: Ambient air particulate matter 2.5 levels in the study setting (a red mark indicates an area with high particulate matter 2.5 level and a green mark indicates an area with acceptable particulate matter 2.5 level)

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According to the correlation analysis, there is no association between ambient air PM 2.5 pollutant and incidence of pulmonary tuberculosis (P > 0.05).


  Discussion Top


PM is an important group of inhalable air pollutants. The specific PM with a diameter smaller than 2.5 μm is called a fine PM. The effect of air pollution on the occurrence of pulmonary tuberculosis is the new interesting issue in clinical pulmonary medicine whereas the old well-known infectious disease such as tuberculosis is still prevalent in several areas around the world, the new coming on environmental pollution-related lung disease occurs. The present report focuses on the situation from Thailand, a tropical country that is well-known for the problem of pulmonary tuberculosis.[17] In fact, as a capital, Bangkok has been known for the high level of PM 2.5 pollutant for a long time.[17] The problem is clearly seen in the area with dense traffic volume.[18] Nevertheless, the big crisis occurs during January 2019.

The present research question is whether there is any relationship between the PM 2.5 pollutant levels and incidence of pulmonary tuberculosis. Of interest, there is no observation on the significant interrelationship. This is discordant with some reports from some Asian countries on the relationship between PM 2.5 and risk of pulmonary tuberculosis.[15],[16],[19] One might consider a possible confounding of background sanitation on the observed association from Asian countries.[15],[16],[17],[18],[19] The lack of association in the present report might be explained by the intense tuberculosis control program by Thai Ministry of Public Health. The finding on null association is concordant with a previous report from India.[16]

On the other hand, if there is a long-term follow-up, there might be an observed association. In a report from Iran, the association between PM 2.5 pollutant and lung disease was observed at 2 weeks of continuous exposure.[20] In fact, a long-term exposure to PM 2.5 and its association with tuberculosis development are also observed in a recent publication by Rajaei et al. from Iran.[21] Rajaei et al. found that there was a high incidence of pulmonary tuberculosis (18–31/100,000) in populations which were exposed to high concentration of PM 2.5.[21] In another report by You et al., the study in the accumulated monthly record data of Hong Kong and Beijing showed that that the outdoor PM 2.5 concentration could be a potential risk factor for the seasonality of tuberculosis.[22] In another long-term cohort study from China, the association between ambient air PM 2.5 pollution and mortality of tuberculosis was also observed.[23]

Indeed, long-term exposure to PM 2.5 is mentioned for the possible association with increased risk of pulmonary tuberculosis; it is also reported from developed Western country as well.[24]

Considering the pathomechanism that long-term exposure to PM 2.5 might contribute to tuberculosis risk, You et al. proposed that PM 2.5 could cause impairment of immunity system, and the immune defect could further promote the tuberculosis infection.[22] Rivas-Santiago et al. mentioned that exposure to PM 2.5 could result in the induction of senescence and downregulation of human β-defensin (HBD)-2 and HBD-3 expression in respiratory epithelial cells. This pathological process can lead to increased susceptibility to Mycobacterium tuberculosis growth.[25] In addition to the relationship between exposure to PM 2.5 and tuberculosis risk, Yao et al. also recently reported on the association between exposure to PM 2.5 and risk of multidrug-resistant tuberculosis.[6] It might confirm that if there is a long-term exposure to PM 2.5, there might be the increased risk for tuberculosis and tuberculosis-related mortality.[26] The possible immunopathological effect of PM 2.5 on tuberculosis is an interesting issue for further researching.


  Conclusion Top


Based on the situation of 2019 Bangkok air pollution crisis, there is a lack of relationship between incidence of pulmonary tuberculosis and PM 2.5 pollutant levels.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Bakonyi SM, Danni-Oliveira IM, Martins LC, Braga AL. Air pollution and respiratory diseases among children in the city of Curitiba, Brazil. Rev Saude Publica 2004;38:695-700.  Back to cited text no. 2
    
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Liu Y, Cui L, Hou L, Yu C, Tao N, Liu J, et al. Ambient air pollution exposures and newly diagnosed pulmonary tuberculosis in Jinan, China: A time series study. Sci Rep 2018;8:17411.  Back to cited text no. 15
    
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Elf JL, Kinikar A, Khadse S, Mave V, Suryavanshi N, Gupte N, et al. The association of household fine particulate matter and kerosene with tuberculosis in women and children in Pune, India. Occup Environ Med 2019;76:40-7.  Back to cited text no. 16
    
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Sahanavin N, Tantrakarnapa K, Prueksasit T. Ambient PM10 and PM2-5 concentrations at different high traffic-related street configurations in Bangkok, Thailand. Southeast Asian J Trop Med Public Health 2016;47:528-35.  Back to cited text no. 18
    
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Lai TC, Chiang CY, Wu CF, Yang SL, Liu DP, Chan CC, et al. Ambient air pollution and risk of tuberculosis: A cohort study. Occup Environ Med 2016;73:56-61.  Back to cited text no. 19
    
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Zieliński M, Gąsior M, Jastrzębski D, Desperak A, Ziora D. Influence of particulate matter air pollution on exacerbation of chronic obstructive pulmonary disease depending on aerodynamic diameter and the time of exposure in the selected population with coexistent cardiovascular diseases. Adv Respir Med 2018;86:227-33.  Back to cited text no. 20
    
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  [Full text]  
22.
You S, Tong YW, Neoh KG, Dai Y, Wang CH. On the association between outdoor PM2.5 concentration and the seasonality of tuberculosis for Beijing and Hong Kong. Environ Pollut 2016;218:1170-9.  Back to cited text no. 22
    
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Peng Z, Liu C, Xu B, Kan H, Wang W. Long-term exposure to ambient air pollution and mortality in a Chinese tuberculosis cohort. Sci Total Environ 2017;580:1483-8.  Back to cited text no. 23
    
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Smith GS, Schoenbach VJ, Richardson DB, Gammon MD. Particulate air pollution and susceptibility to the development of pulmonary tuberculosis disease in North Carolina: An ecological study. Int J Environ Health Res 2014;24:103-12.  Back to cited text no. 24
    
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Rivas-Santiago CE, Sarkar S, Cantarella P4th, Osornio-Vargas Á, Quintana-Belmares R, Meng Q, et al. Air pollution particulate matter alters antimycobacterial respiratory epithelium innate immunity. Infect Immun 2015;83:2507-17.  Back to cited text no. 25
    
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