Outdoor environmental exposome and the burden of tuberculosis: Findings from nearly two million adults in northwestern China

• Published in: Journal of hazardous materials 2023-10, Vol.459, p.132222-132222, Article 132222
• Main Authors: Li, Jia-Xin, Luan, Qiyun, Li, Beibei, Dharmage, Shyamali C., Heinrich, Joachim, Bloom, Michael S., Knibbs, Luke D., Popovic, Igor, Li, Li, Zhong, Xuemei, Xu, Aimin, He, Chuanjiang, Liu, Kang-Kang, Liu, Xiao-Xuan, Chen, Gongbo, Xiang, Mingdeng, Yu, Yunjiang, Guo, Yuming, Dong, Guang-Hui, Zou, Xiaoguang, Yang, Bo-Yi
• Format: Article
• Language: English
• Subjects: Air pollutants; Geography; Meteorology; Outdoor environment; Tuberculosis
• ISSN: 0304-3894; 1873-3336
• DOI: 10.1016/j.jhazmat.2023.132222

We simultaneously assessed the associations for a range of outdoor environmental exposures with prevalent tuberculosis (TB) cases in a population-based health program with 1940,622 participants ≥ 15 years of age. TB status was confirmed through bacteriological and clinical assessment. We measured 14 outdoor environmental exposures at residential addresses. An exposome-wide association study (ExWAS) approach was used to estimate cross-sectional associations between environmental exposures and prevalent TB, an adaptive elastic net model (AENET) was implemented to select important exposure(s), and the Extreme Gradient Boosting algorithm was subsequently applied to assess their relative importance. In ExWAS analysis, 12 exposures were significantly associated with prevalent TB. Eight of the exposures were selected as predictors by the AENET model: particulate matter ≤ 2.5 µm (odds ratio [OR]=1.01, p = 0.3295), nitrogen dioxide (OR=1.09, p