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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-Württemberg (Germany)

Rittweger, Jörn and Gilardi, Lorenza and Baltruweit, Maxana and Dally, Simon and Erbertseder, Thilo and Mittag, Uwe and Naeem, Muhammad and Schmid, Matthias and Schmitz, Marie-Therese and Wüst, Sabine and Dech, Stefan and Jordan, Jens and 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-Württemberg (Germany). Environmental Health: A Global Access Science Source, 21, p. 131. Springer Nature. doi: 10.1186/s12940-022-00927-y. ISSN 1476-069X.

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Official URL: https://dx.doi.org/10.1186/s12940-022-00927-y

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-Württemberg, 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 °C to 2.01 °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 μg/m³ to 15.98 μg/m³. 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 URL in elib:https://elib.dlr.de/196468/
Document Type:Article
Title: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-Württemberg (Germany)
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
Rittweger, JörnUNSPECIFIEDhttps://orcid.org/0000-0002-2223-8963UNSPECIFIED
Gilardi, LorenzaUNSPECIFIEDhttps://orcid.org/0000-0003-4472-8530UNSPECIFIED
Baltruweit, MaxanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dally, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Erbertseder, ThiloUNSPECIFIEDhttps://orcid.org/0000-0003-4888-1065UNSPECIFIED
Mittag, UweUNSPECIFIEDhttps://orcid.org/0000-0002-8580-3085UNSPECIFIED
Naeem, MuhammadUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmid, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitz, Marie-ThereseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wüst, SabineUNSPECIFIEDhttps://orcid.org/0000-0002-0359-4946UNSPECIFIED
Dech, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jordan, JensInstitute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germanyhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Antoni, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bittner, MichaelUNSPECIFIEDhttps://orcid.org/0000-0003-4293-930XUNSPECIFIED
Date:16 December 2022
Journal or Publication Title:Environmental Health: A Global Access Science Source
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:21
DOI:10.1186/s12940-022-00927-y
Page Range:p. 131
Publisher:Springer Nature
ISSN:1476-069X
Status:Published
Keywords:Air quality, Epidemiology, Disease burden, Infectious disease
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - Environmental Stressors and Health ME/FE
Location: Köln-Porz , Oberpfaffenhofen
Institutes and Institutions:Institute of Aerospace Medicine > Muscle and Bone Metabolism
German Remote Sensing Data Center > Atmosphere
Deposited By: Gilardi, Lorenza
Deposited On:30 Aug 2023 11:46
Last Modified:11 Sep 2023 10:31

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